It’s no secret that APers don’t like pacifiers. Besides the fact that they’re made out of ‘unnatural’ materials such as plastic or latex, pacifiers serve as ‘mommy substitutes’ for the purpose of non-nutritive sucking, and we know that anything which fills in for Mommy is a bad, bad thing. When the AAP released its 2005 policy statement regarding measures to prevent SIDS, Attachment Parenting International took issue not only with the recommendation against bedsharing, but also because they recommended pacifier use, even though there is quite a bit of evidence to recommend the practice as a SIDS prevention measure ,though the exact mechanism by which this occurs is not known:
The use of a pacifier during the transition-to-sleep is problematic, as this has been shown to undermine breastfeeding. Given that pacifier use can inhibit breastfeeding duration and milk production, API does not support the recommendation of the AAP and recommends that breastfeeding mothers be encouraged to breastfeed during the transition-to-sleep and throughout the night—an activity that promotes sucking and provides important nutrients.
La Leche League does find the use of a pacifier legitimate in some circumstances, but still warns against pacifiers interfering with establishing and maintaining breastfeeding (the AAP also recommends waiting until the baby is 1 month old to prevent this, and to withdraw the use of the paci by the age of a year to prevent dental issues).
However, a recent systematic review in this month’s Archives of Pediatrics and Adolescent Medicine suggests that pacifiers have no adverse effect upon the initiation or the duration of breastfeeding. The apparent effect is seen (in observational studies, but not RCTs) because women who plan to wean anyway use the pacifier to satisfy their infants’ need for non-nutritive sucking, or women use the pacifier as a too to help them wean their infants. The authors state:
In conclusion, the strongest current evidence on pacifiers and breastfeeding indicates that pacifier use is not detrimental to breastfeeding outcomes.
Mind you, I tried very hard to get all 3 of my children on a pacifier. All of them pretty much refused to take it. I think I managed to get Eldest and Youngest hooked on the thing for about 3 weeks in their 8th or 9th month, but that was about it. I even had to use a stock photo above to depict a child with a paci, because the only picture I have of a child of mine with one is the photo below, where a relative is holding my daughter, and also holding the paci she kept spitting out: