To paci or not to paci — that is the dilemma many new parents face. On the one hand, pacifiers are so ubiquitous you probably received one of those Wubbanub stuffed animal pacifiers as a baby shower gift, even if you never asked for one. But as with every decision, there is strong debate on both sides. You probably have friends who never gave their kids a pacifier and when it comes to breastfeeding, the stakes change. A breastfed baby may not accept any kind of artificial nipple, and breastfeeding moms wonder: does using a pacifier decrease your milk supply? Experts agree that you should wait until breastfeeding is well-established before introducing a pacifier.
Pediatrician Rachel Lowdenback of Paducah, Kentucky, says that a strong breastfeeding relationship is the most important thing to establish before you offer your baby a pacifier. Most breastfeeding babies will be ready around 1 month of age, but Lowdenback tells Romper that the risk of introducing a pacifier too soon is that your baby will prefer the artificial nipple to your breast, thereby disrupting your milk supply. According to The Womanly Art of Breastfeeding, "In the early weeks, especially, if a baby wants to suck, he wants to eat, pure and simple... it [a pacifier] can reduce intake at a time when a baby is meant to grow quickly." But as long as you wait until your supply is consistent and established, using a pacifier should not decrease your milk supply.
Of course, some breastfed babies will not accept a pacifier regardless of timing. Lowdenback explains that your baby may try to use you and your breast as a pacifier. There's nothing inherently wrong with this, but if you feel frustrated or burned out, Lowdenback recommends trying some behavioral changes to get your child to stop using nursing as a pacifier. For example, most kids like to have a "lovey" such as a piece of a blanket to hold onto. Ideally, you would transfer their comfort source from breastfeeding to something they can hold, giving them the ability to soothe themselves.
Once you start the paci habit, when should it stop? Lowdenback recommends pacifier weaning at about 1 year of age. However, she notes that some children may want to keep their beloved binkies for a little longer than that. The one-year-mark can also be a time of teething. So Lowdenback says it's all right to wait until all of your child's teeth have come in, whether that's at 1 year or older, before you take the pacifier away.
As for the characteristics that separate "good" pacifiers from ones that can cause harm to a child's teeth or palate, Lowdenback, who is a contributing advisory member to the pacifier manufacturer Smilo, recommends looking for "a very good orthodontic paci" that is "soft and pliable," and "designed to help kids as their palate expands." You should adhere to a pacifier's recommended age and keep up with appropriate sizes as your child grows.
Sometimes you may experience milk supply issues that have nothing to do with whether or not your baby uses a pacifier. Lowdenback says, "it's hard to know why we don't have enough milk." In her own practice, that question comes up a lot, and she recommends working with a lactation consultant (LC) to understand and resolve supply problems.
An LC can do pre- and post-feeding weight checks to determine how much milk your baby is taking in. And although babies always get more than a breast pump can, it may be helpful to try pumping with a double electric to get a close estimate of how much milk your breasts can express in one feeding. "Power pumping," which consists of pumping throughout the day after each nursing session, can also help stimulate your milk production by increasing demand. If supply problems persist and your baby seems to still be hungry or uncomfortable after breastfeeding, talk to your doctor about possible medicines or homeopathic remedies you can take to boost your milk production.
Finally, I asked Lowdenback what she would say to paci detractors who may try to shame parents for giving their children pacifiers. She said the American Academy of Pediatrics has found that pacifier use can actually decrease the risk of SIDs. So while the decision to paci or not to paci is a personal choice, if you do want to use this soothing tool, rest assured that there is a way to do so without harming your milk supply or your child.
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