Restricting pacifier use in breast-fed newborns resulted in breastfeeding decline

BOSTON — Limiting the use of pacifiers in newborn nurseries resulted in a significant decrease in breast-feeding, according to a study presented here during the 2012 Pediatric Academic Societies Annual Meeting in Boston.

In their study, Laura Kair, MD, a resident in pediatrics, and Carrie Phillipi, MD, PhD, medical director, Mother Baby Unit at Doernbecher Children’s Hospital of Oregon Health & Science University (OHSU), sought to determine whether eliminating routine pacifier distribution would increase the rate of exclusive breast-feeding.

In December 2010, the hospital adopted a plan that restricted hospital staff from routinely giving pacifiers to breast-fed newborns. The staff was required to enter a code and a patient’s name to access the pacifiers and also provide a reason for using the pacifier.

Kair and Phillipi analyzed feeding data on 2,249 infants born between June 2010 and August 2011. On average, 79% of infants were exclusively breast-fed from July 2010 to November 2010, when pacifiers were routinely distributed.

This proportion decreased significantly to 68% from January to August 2011 (P<.001). A corresponding increase from 18% to 28% was observed in the number of breast-fed infants receiving supplemental formula feeds in the same time period (P<.001). During the study year, the percentage of exclusively formula-fed infants increased slightly from 1.8% to 3.4% (P=.03).

In addition, the proportion of breast-fed infants receiving supplemental formula increased from 18% before the policy was changed to 28% afterward. The percentage of infants fed only formula remained statistically unchanged during the study period.

“There is a great deal of energy nationally as well as internationally in support of increasing the number of Baby-Friendly Hospitals,” Kair said in a press release. “Taken together, the 10 steps improve exclusive breast-feeding rates in the hospital. However, the effect of pacifier use on initiation and duration of exclusive breast-feeding has not been well-established in the medical literature.”

Kair said the goal with publicizing this data is to encourage conversation and scientific inquiry regarding sufficient evidence to support the universal recommendation of not offering pacifiers to breast-feeding infants in the first few days to weeks of life.

To encourage exclusive breast-feeding, WHO and UNICEF recommend that hospitals caring for newborns follow “Ten Steps to Successful Breastfeeding.” One of the steps states that artificial teats or pacifiers should not be provided to breast-feeding babies. Medical centers that follow the 10 steps can be recognized as Baby-Friendly Hospitals, according to the press release.

For more information:

Kair L. #3310.4. Presented at: the 2012 PAS Annual Meeting; April 29-May 1, 2012; Boston.