Breast milk is superior to other baby foods in providing balanced nutrition and protection against allergy and infection to newborns. Breastfeeding is recommended by the World Health Organization, exclusively in the first six months and then as a dietary supplement. Breastmilk production and supply are maintained by frequent suckling of the breast and nipple stimulation. A pacifier is a non-nutritive sucking device used to calm an infant that has become a cultural norm in many parts of the world. However there is a widespread belief that pacifiers may interfere with breast milk production and lead to discontinuation of breastfeeding.
Our review concluded that for mothers who are motivated to breastfeed their infants, pacifier use before or after breastfeeding was established did not significantly affect the prevalence or duration of exclusive and partial breastfeeding up to four months of age. The review provided moderate evidence from three randomised controlled trials (involving 1915 babies) comparing unrestricted with restricted pacifier use by healthy, full-term breastfeeding infants; two of the trials (1302 babies) were included in the analysis. However, there is a widespread belief that pacifiers may interfere with breast milk production and lead to discontinuation of breastfeeding.