Abstract
Background
The majority of observational studies have found associations between pacifier use
and shorter breastfeeding duration. Results from four randomised controlled trials
did not reveal any difference in breastfeeding outcomes. The relationship between
early pacifier use and breastfeeding outcomes remains unclear.
Aim
To investigate whether a recommendation of early pacifier use affects the proportion
of breastfeeding at six months compared to a recommendation to avoid pacifier use
during the first two weeks.
Methods
An open, randomised controlled trial with parallel group design; 239 primiparous mothers
and their term infants were randomly assigned to an intervention group or a control
group. The primary outcome was the proportion of breastfeeding at six months. Secondary
outcomes were the proportions of breastfeeding and breastfeeding problems at two and
four months. To investigate factors which may influence breastfeeding, a multivariate
logistic regressions analysis was performed.
Findings
A total of 209 participants (87.5%) completed the study. There were no significant
differences between the groups with respect to breastfeeding at six months. No negative
association for breastfeeding between early versus late introduction of pacifier was
found. Factors significantly associated with cessation of breastfeeding at six months
were: use of nipple shield, intention to breastfeed, severe breastfeeding problems
at two weeks, pacifier use at two months and lower educational level.
Conclusion
Early versus late recommendation of pacifier introduction did not affect the proportion
of breastfeeding at six months. However, the compliance to the randomised group was
insufficient. No negative association was found in the observational analysis.
Keywords
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Article info
Publication history
Published online: November 05, 2019
Accepted:
October 3,
2019
Received in revised form:
October 3,
2019
Received:
June 8,
2018
Identification
Copyright
© 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
