Pacifiers are everywhere, and mom’s breasts are nowhere to be seen.  In a culture where most moms bottle feed, it is no wonder why we see pacifier use in almost every household throughout the toddler years.  When most babies would still be breastfed if allowed to nurse as long as they desired, a toddler drinking from a bottle would have the same sucking desires as their breastfed peers.  The issue, however, lies in the detrimental impact on breastfeeding and of course on oral and facial development. 

Learning your baby’s cues is an ever changing task.  Our babies communicate with us in a variety of ways, much like we have multiple ways of communicating our thoughts and desires.  We may walk to the kitchen for a drink.  We may ask a loved one to get us a glass of water.  We may point to a cup.  And we may even use different words during our requests.  Our ability to communicate is vast and this isn’t any different just because of age.  In the newborn days, a baby almost always wants to nurse and will root almost every instant that they’re not put to the breast while they’re awake.  Even when they’re hot, gassy, or need a diaper change –they are almost always comforted by simply being put to the breast often and unlimited.  This ensures the meconium and bilirubin is passed, their digestive system is coated with colostrum, and mom’s milk supply is established.  When many babies have a difficult time latching, this helps them to get milk even when their latch isn’t perfect.  A baby that is put to the breast without limits can have a poor latch and still thrive (although mom’s nipples may become damaged if latch isn’t adjusted). 

Their cues may not always be the same, and change as they learn to communicate to an adult’s perspective more efficiently.  They will start smacking their lips, making noises, and sucking on anything that nears their mouth.  When mom doesn’t respond, they start making whining noises, and eventually cry – and many babies skip the whimpers and go straight to screaming.  When mom responds to specific cues repeatedly, they learn that they get a response from certain cues and will continue that cue more.  If crying is what gets responded to, they will cry more – and when early cues of lip smacking…etc. get responded to, they will likely cry less.  This is the beginning of good communication.  They often learn that any cue they make elicits some type of response from mom, and as they grow and develop, their need for the breast for total comfort starts to fade, and they begin to want interaction, holding, and general play along with comfort and nourishment nursing.

What seems to cause some confusion is a baby’s love of sucking causing parents to believe that is the only way they can be comforted.  Some babies will nurse until they’re full, and then get frustrated when they want to comfort nurse and they’re still getting milk, and this is when many parents start introducing a pacifier.  In those early days, moms fill up with a lot of milk, and babies are learning to latch – a forceful letdown and a large milk supply may make breastfeeding difficult for some babies.  But as the milk supply establishes, it often levels off to a manageable amount, and baby’s stomach grows meaning a baby who may not have been happy comfort nursing, will love to do so at a later time.

Additionally, we need to understand that artificial nipples almost always cause some type of issue with breastfeeding, particularly if artificial nipple use is prolonged and not used on a limited basis.  Before breastfeeding is well established, artificial nipples use can cause a lot of difficulties learning to latch and establishing milk supply.  It also causes nipple discomfort for mom because the baby (even when they seem to do OK between artificial nipple and mom’s breast) often has a slight change in nursing that causes a difference in the sensation for mom (and is a contributor to mom ending the breastfeeding relationship early).   Therefore, it is best not to introduce artificial nipples until breastfeeding, and supply, has been well established – somewhere around 6 weeks or more postpartum and then only use it on a limited basis when other means of comforting aren’t working.  This need is likely not to happen very often in most babies who have unlimited access to the breast and are parented with an attachment-style approach.  However, no matter when you begin using a pacifier, do so on a limited basis and only after other methods of comfort have been tried, especially as baby gets older.  Remember, babies are often comforted by nursing even when they need a diaper change, they’re hot, their scared, their bellies hurt, their sick…etc – and trying other methods than nursing can be a great way of determining what they need.  When an artificial nipple is used, especially in the early weeks, it can be difficult to determine if you’re replacing a feeding – because 8-12 feedings per day is a minimum.  If your baby doesn’t have a good latch, they may not be getting an efficient amount of milk, and breastfeeding and health could be damaged.

If your baby has taken a full feeding, you know their latch is well, and they are having difficulty comfort nursing, there are many other things you can try to keep your baby happy before using a pacifier.  Even if a pacifier has been something you’ve used before, it doesn’t mean it is something that needs to continue for months or years.  With my daughter, I initially didn’t want to use a pacifier, and then introduced one at about 2-3 weeks postpartum on a limited basis, and then stopped altogether at 6 weeks when I discovered new ways of comforting her.  With my son, we haven’t used pacifiers at all.  I believe not having a pacifier in the house is less of a temptation – similar to why us lactivists recommend refusing or donating formula samples from providers and hospitals.

Your baby wants to be close to you at all times.  In western cultures, many moms nurse the baby, and then put the baby down (if they’re even nursing at all) and babies really don’t get much skin contact and mommy time.  Sometimes, especially in an older baby, they will suck on their hands (because they now have the control to get them to their mouths) even when they’re not hungry.  In many instances, I would say this is a hunger cue, but for a baby that has just taken a full feeding and seems to be spitting up quite a bit or has a history of comfort nursing to the point of spitting up what seems to be all of their stomach contents and you know it isn’t vomiting) then this act of sucking can be a good indicator that they simply want comforted or interacted with in a different way.  They may simply feel like they want held and talked to, or even taken to a quiet space and rocked.  Often, your baby wants that rhythmic motion and sound they had when they were in the womb, while being close to your heart.

• Holding your baby while singing nursery rhymes can be very comforting.  Humming or even just mimicking the sounds of a heartbeat can be very soothing (especially if you’re not to keen on your singing skills).
• Rocking your baby, or walking while bouncing is quite soothing and mimics the womb quite well.  Most parents can find walking and holding a baby quite tiring, however.
• A birth ball is a great item to have on hand to soothe baby, and even get them to fall asleep.  Just hold he baby and gently bounce.  There were many times where I bounced my daughter to sleep – and sometimes it took 30 minutes or more, and taking turns with my husband and my mom when we got tired.  Sometimes nursing, then bouncing, then nursing, then bouncing… and sometimes even nursing while bouncing.
• Babywearing is an excellent way of allowing baby that comfort while giving you some hands free moments, and not causing tired arms and a sore back.  There were countless days where my daughter wouldn’t fall asleep at all unless she was in the wrap, being walked, as I gently kind o hopped up and down, while also patting her back and butt.  My son loves this as well, and it makes falling asleep while shopping or talking with friends quite easy.  Nursing while babywearing is also a great way of comforting.   
• A swing or a bouncy chair can give you a break from holding your baby in any way while still avoiding a pacifier.  Sometimes a white noise machine or any type of noise or background rhythm can be soothing along with other comfort techniques.

Many times it is a combination of rhythms that soothes them and trying 3-4 different things can be beneficial before choosing a pacifier.  Just remember that pacifiers can be beneficial for some instances, and I am by no means saying they should not exist.  But just try a few things before choosing them as a first option, especially when your baby (and milk supply) is new to breastfeeding, and as your baby gets older and is interacting more.  It is easy to get into a habit and then forget about trying something you tried previously that didn’t work.

What is your favorite way to soothe your baby?