By Ready. Set. Grow!
This article originally appeared in First 5 LA’s newsletter, the Monday Morning Report.
Like most decisions new parents make, whether to give an infant a pacifier is one that is surrounded by conflicting research and lots of opinions. Sucking is a soothing reflex in babies and its use is correlated with a reduction in sudden infant death (SIDS). But pacifier use raises concerns about adequate nutrition, as well as speech and oral development.
In breastfeeding babies, there are fears that pacifiers cause nipple confusion, making it difficult for a baby to learn the distinct sucking and latching needed for breastfeeding, as well as those that newborns not fed from the breast on demand will hinder milk supply. To that end, the American Academy of Pediatrics recommends waiting a month to introduce a pacifier to a breastfeeding baby and Baby-Friendly Hospitals must not give pacifiers to babies born there. The goal is to breastfeed exclusively for six months so that babies receive all the beneficial nutrients and immune system strengthening they can. Baby-Friendly Hospitals are those that have guidelines and resources to support and encourage new mothers in breastfeeding their babies.
But recent research out of the Oregon Health & Science University Doernbecher Children’s Hospital found that babies not given pacifiers in the hospital were less likely to be exclusively breastfed and more likely to receive formula. In data presented on April 30 at the Pediatric Academic Societies’ annual meeting in Boston, the researchers cautioned that more research supporting the withholding of pacifiers in Baby-Friendly Hospitals is needed.
The researchers analyzed data related to the feedings of 2,249 infants admitted to the OHSU Mother-Baby Unit from June 2010 to August 2011. Pacifiers were still being distributed in the Unit from July 2010 to November 2010. Of the infants admitted to the Unit during that time, 79 percent were exclusively breastfed. After the no-pacifier policy was in place beginning in January 2011, the rate decreased to 68 percent.
In addition, there was about a 10 percent increase in babies who received supplemental formula after the no-pacifier policy.
“We view this as an interesting observation, but we do not claim a cause and effect relationship,” said Laura Kair one of the researchers and a resident in pediatrics at OHSU Doernbecher Children’s Hospital. “Our goal in publicizing this data is to stimulate dialogue and scientific inquiry into the relationship between pacifiers and breastfeeding. Our overall goal is to increase breastfeeding rates, even in Oregon which already boasts the highest rate in the nation.”
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Genevieve Colvin
May 14th, 2012
It’s important to keep in mind that this research has NOT been peer- reviewed and was conducted at a hospital that already had extraordinarily high exclusive breastfeeding rates.
This hospital elected to try just 1 step of the 10 steps to successful breastfeeding. It seemed like the low hanging fruit.
What the data shows is that one step is not enough. Not that pacifiers are helpful to exclusive breastfeeding rates.
In fact, if you take away the one comfort measure that nurses can offer (pacifiers,) without teaching nurses (Baby-Friendly steps, 2 and 3) on how to help mothers to initiate breastfeeding and calm a baby, then you will see an increase in formula supplementation, when both mothers and nurses feel helpless. Without a clear infant feeding policy (Step 1) you will see an increase in formula supplementation.
Current research from California shows that when at least 7 steps are implemented, then all women, regardless of socio-economic status or race, breastfeed at similar rates. That is one reason why Kaiser National has elected to take all of their hospitals Baby-Friendly.
It’s why the Baby-Friendly Health Iniaitive is so critical to the families in the County of Los Angeles. We need a level playing field here, where over a third of California babies are born.
And, of course, that is why having First 5LA support the Baby-Friendly Health Initiative is so critical!
It’s only 10 steps, but each of them matter!