1 Breastfeeding Briefs N ° 54 , March 2013 Pacifiers and breastfeeding

Castilho SD, Rocha MA. Pacifier habit: history and multidisciplinary view. J Pediatr (Rio J) 2009;85:480-9 [Article in English, Portuguese] The objectives of this study were to review the history of pacifiers using a multidisciplinary literature review, searching for pros and cons of pacifier use, with the purpose of providing health professionals with arguments for parents requesting guidance. History and art books, as well as non-medical literature and museums were used for the historical survey. Multidisciplinary data were collected from MEDLINE, LILACS, SciELO, and The Cochrane Library. Studies published in the last 5 years, with an abstract in Portuguese, English and Spanish, were assessed for inclusion if the keyword “pacifiers” was present. Based on the studies collected, the authors stated that there is evidence that pacifier precursors have been used since neolithic times to calm children. Small balls made of fabric containing food are portrayed in paintings. Other balls made of non-perishable material have persisted over time. Pacifiers have been used to stimulate sucking or to coordinate the sucking reflex in order to assist early breastfeeding initiation in newborns. Some authors suggest that pacifiers reduce the incidence of Sudden Infant Death Syndrome (SIDS), but this is controversial. Others suggest that pacifiers prevent the establishment of breastfeeding and lead to weaning. Their use may cause suffocation, poisoning, or allergies and increases the risk of caries, infections, and parasitic intestinal diseases. Harmful effects are related to the frequency, duration, and intensity of the habit. The authors recommend that pacifier use be discontinued by the age of 3 or 4 years in order not to affect the child’s speech and dentition development. They conclude that there are more harmful effects than benefits in using pacifiers and that health professionals should inform parents of the pros and cons so as to be able to make an informed decision regarding their use. Jaafar SH, Jahanfar S, Angolkar M, Ho JJ. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev 2012 Jul 11;(7):CD007202 Update of Cochrane Database Syst Rev. 2011;(3):CD007202. The World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants as pacifier use is believed to lead to less frequent episodes of breastfeeding and, consequently, may reduce breastmilk production and shorten breastfeeding duration. However, the association between pacifier use and breastfeeding remains unclear. This systematic review aimed to assess the effect of unrestricted versus restricted pacifier use on the duration of breastfeeding, other breastfeeding outcomes and infant health amongst healthy, full-term newborns whose mothers had initiated breastfeeding and