The impact of pacifier use on breastfeeding: A prospective cohort study

Objectives: To determine the predictors of pacifier use during the first ye ar of life and to assess the influence of pacifier use on the duration of b reastfeeding. Methodology: A prospective cohort study was conducted. Three hundred and fi fty mother-infant pairs were followed to 1 year of age to determine the imp act of the use of a pacifier on the duration of breastfeeding. Results: A cohort of 441 mothers were enrolled and 79% participated. Ninety four per cent were followed up to 1 year. Daily pacifier use was associate d with early cessation of breastfeeding (risk ratio (RR) 1.71; 95% confiden ce interval (95%CI) 1.29, 2.28) and a reduced duration of full breastfeedin g (adjusted (adj.) RR 1.35; 95%CI 1.05, 1.74). Finger sucking was not assoc iated with a reduced duration of breastfeeding (RR 1.05; 95%CI 0.81, 1.37). Pacifier use less than daily was not associated with a change in duration of breastfeeding (RR 1.02; 95%CI 0.75, 1.39). Most mothers commenced the us e of a pacifier within the first month. Multiple logistic regression analys is found that the use of a pacifier was associated with male gender (adj. R R 1.97; 95%CI 1.23, 3.13), maternal smoking in pregnancy (adj. RR 2.23; 95% CI 1.01, 4.95), and low maternal confidence with breastfeeding (adj. RR 2.7 0; 95%CI 1.48, 4.93). Conclusions: Daily pacifier use is associated with a reduced duration of br eastfeeding. Less frequent pacifier use does not reduce the duration of bre astfeeding.