Sucking is a basic instinct that babies are born with. Babies suck for both food and comfort. Breastmilk also provides protection against disease so nature has made sure that babies love to be at the breast. They are comforted by the warmth, smell, delicious milk and reassuring sound of your heartbeat.
Breastfeeding offers a lot of security too, whether your baby is feeling lonely, frightened, sad, cross, or ill at ease with a new situation.
In the early days, it’s easy to feel overwhelmed by your baby’s need to nurse. But meeting his needs makes him feel safe and ensures you have plenty of milk. As he grows, your baby’s nursing pattern will change and life with your new baby should settle down.
Whenever a substitute for sucking at the breast is used there is a risk of affecting the breastfeeding relationship, especially for a baby who has not yet mastered nursing at the breast.
Dummy use may reduce your milk production and result in poor weight gain. In the early weeks it’s really important to nurse often and ensure all sucking is at the breast to establish and maintain good milk production.
Using a dummy can make it harder for your baby to breastfeed comfortably and effectively (1). The shape and firmer feel of a dummy differs from your pliable breast. Some babies may prefer the stronger sucking trigger of a dummy, leading to ‘confusion’ about how to nurse at the softer breast. The result may be sore nipples for you and not enough milk for your baby. He may become frustrated and start to fuss, cry or refuse to breastfeed altogether.
Regular dummy use is associated with premature weaning (1,2). A dummy is often assumed to be an essential parenting tool. A baby is comforted by sucking, so what could be more convenient than a small portable device to pop in his mouth? But will offering a dummy cause problems with breastfeeding or can you combine the two?
Babies like to suck for pure pleasure even when milk flow slows. You have only to look at your older baby to see this—he frequently looks up into your eyes then breaks off sucking to give you a great big smile. You in turn smile and talk to your baby. These are the first steps in your baby’s development of language and relationships.
It’s important to remember that a dummy is a substitute for the breast—an object to silence, or pacify a baby’s crying until the real thing is available. For this reason it doesn’t really make sense for people to suggest a baby is using his mother as a ‘human dummy’ when he wants to nurse for comfort.
There may be occasions when it’s convenient to use a dummy—to calm your baby briefly when you can’t nurse him immediately, for example if you’re driving. Sometimes a baby with colic will find it soothing to suck on a dummy between feeds.
If you decide to give your baby a dummy, it’s better to wait until breastfeeding is well-established and he is gaining weight well. You will also need to follow manufacturer’s guidelines on cleaning and replacement.
In some hospitals premature babies may be given a dummy during tube feeding to stimulate their sucking reflex, help digestion and help them associate the action of sucking with receiving food. It’s best if this is just a temporary substitute and efforts are made to establish breastfeeding as soon as possible.
Your baby has an increased risk of ear infections if he regularly has a dummy (3). Thrush can be a problem too, as it thrives on moist surfaces at room temperature.
Breastfeeding provides exercise for optimum development of a baby’s mouth, tongue and jaws and many orthodontists say they see fewer dental problems in breastfed babies. Regular dummy use can affect the growth of teeth and the shape of babies’ mouths, increasing the risk of sleep apnoea* and the need for braces later on (4,5). It can also increase the levels of decay-causing bacteria in babies’ mouths (4).
You can be at risk of engorgement and mastitis when you introduce a dummy—a particular problem if you have an oversupply of milk. Your periods and fertility may also return earlier as your hormone levels are affected when your baby nurses less.
Many babies have no interest in using a dummy. You are the best pacifier in the world from your baby’s point of view. And what could be more natural than to bring peace to your baby with the warmth of your presence through breastfeeding, rather than with a plastic device.
- Stop using the dummy so that your baby can concentrate on learning to feed well at the breast.
- Offer a breastfeed while he is still calm and pay extra attention to how he is positioned and attached at the breast.
- Encourage your baby to breastfeed at least 8–12 times in 24 hours, offering both sides and allowing him to nurse for comfort.
- To encourage his interest in breastfeeding hand express so milk is flowing before offering the breast.
- Ask your LLL Leader about the technique of breast compression which has been found to encourage babies to continue breastfeeding actively for longer.
- Spend extra time cuddling, carrying and holding your baby, including skin-to-skin contact to help him relax and encourage his interest in breastfeeding.
Regardless of whether it affects breastfeeding, you and your baby can become over-attached to a dummy. It is easy to find yourself using it more and more and your toddler’s language and social development may be delayed. It is recommended that parents stop using a dummy once a baby is 6 months old.
You may need to wean yourself from the convenience of popping in the dummy when your baby fusses and give extra attention, cuddling or nursing instead.
To reduce or cut out dummy use, try:
- Offering to nurse instead.
- Restricting your baby’s dummy use to certain times such as only in the car.
- Carrying him, taking him for a walk in the buggy, giving him a bath, playing games, singing or sharing other interesting activities.
If your baby has become accustomed to falling asleep with a dummy, the simplest option is to breastfeed him instead. From 6 months:
- Try gently removing the dummy once he is asleep or very sleepy so that he gradually learns to fall asleep without it.
- Keep trying as new sleep associations take a while to establish. You could introduce other sleep cues such as wrapping in a blanket, rubbing his back, rocking and/or a key word, for example ‘shh’.
Extra time focussing on your baby’s needs whilst working to reduce dummy use will help the change go more smoothly. If you have any questions or need support as you wean your baby from using a dummy you can contact an LLL Leader by calling our Helpline. You can find your local group here.
Some research has shown that using a dummy to settle a baby to sleep can reduce the risk of sudden infant death syndrome (SIDS) (6,7). The cause and effect is unknown, and may be related to other protective factors. It is possible that a baby falling asleep with a dummy mimics babies falling asleep at the breast (8,9) Babies generally keep a dummy in the mouth for less than 15 minutes at sleep times (10)—similar to the time it takes a baby to breastfeed to sleep.
Current recommendations for dummy use at sleep times (6,11) are that a dummy should:
- Not be used to replace breastfeeding.
- Not be replaced after a baby falls asleep.
- Not be given to a baby who doesn’t want it.
It would seem from these recommendations, that a baby who breastfeeds to sleep is unlikely to want or need a dummy.
*Sleep apnoea: irregular breathing during sleep.
The Womanly Art of Breastfeeding, LLLI. London: Pinter & Martin, 2010.
- Righard, L and Alade, M. Breastfeeding and the use of pacifiers. Birth 1997; 24(2): 116-20.
- Victoria, C et al. Pacifier use and short breastfeeding duration. Cause, Consequence or Coincidence. Pediatrics 1997; 99(3): 445-453.
- Warren, JJ et al. Pacifier use and the occurrence of otitis media in the first year of life. Pediatric Dentistry 2001; 23(2): 103-07.
- Palmer, B. Breastfeeding: Reducing the Risk for Obstructive Sleep Apnea. Breastfeeding Abstracts. 1999 Feb 18(3): 19-20.
- Viggiano, D, et al. Breastfeeding, bottlefeeding, and non-nutritive sucking: Effects on occlusion in deciduous dentition. Arch Dis Child 2005; 89: 1121-23.
- Hauck, FR et al. Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics. 2005 Nov; 116(5): e716-23.
- Li, DK et al. Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based casecontrol study. BMJ 2006 Jan 7; 332(7532): 18-22.
- Blair, PS and Fleming, PJ. Dummies and SIDS: Causality has not been established. BMJ 2006; 332: 178.
- Fleming, PJ et al. Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study .CESDI SUDI research team. Arch Dis Child 1999; 81: 112-6.
- Weiss, P and Kerbl, R. The relatively short duration that a child retains a pacifier in the mouth during sleep: implications for sudden infant death syndrome. Eur J Pediatr. 2001; 160: 60-70.
- Moon, RY et al. Sudden infant death syndrome. Lancet. 2007 Nov 3; 370(9598): 1578-87.
- NICE Clinical Guideline CG 37: Postnatal care: Postnatal care up to 8 weeks after birth National Collaborating
- Centre for Primary Care and Royal College of General Practitioners, 2006. http://www.nice.org.uk/guidance/cg37/chapter/1-recommendations#infant-feeding http://www.nice.org.uk/CG037
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