Breastfeeding

BF: Artificial Nipple and Duration of Breastfeeding (2008)

Artificial Nipple and Duration of Breastfeeding

• Intervention
  What are the effects of artificial nipple (pacifier or bottle) on the duration of breastfeeding in healthy term or full term infants?

  • Conclusion

    Pacifier Use in Term or Full-term Infants

    Evidence suggests a negative impact of pacifier use on the duration of all types of breastfeeding (from partial to exclusive). Observational evidence consistently showed an association between use of pacifier before three months of age and shorter breastfeeding duration in healthy term or full-term infants, after controlling for potential confounding. Data are insufficient to determine whether increasing frequencies of pacifier use or introduction of pacifier use beyond three months of age has any differential impact on breastfeeding duration.

    Well-designed RCTs with blinded assessments of breastfeeding outcomes are needed to further support the validity of the findings from the observational studies concerning negative impact of pacifier use on the duration of breastfeeding.

    Supplementary Feeding (Using Bottle or Cup) in Term or Full-term Infants

    • Data from both RCTs and observational studies also consistently suggest that supplementary feedings to term infants, regardless of method (bottle or cup), had a detrimental effect on breastfeeding duration, compared to no supplementary feeding
    • Well-designed RCTs with blinded assessments of breastfeeding outcomes and specifying the amount, frequency and content of supplementary feeding are needed to further examine the independent effect of supplementary formula, water and tea, or expressed breast milk on breastfeeding duration.

    Pre-term Infants

    Data are insufficient to make a conclusion regarding the effects of artificial nipple on the duration of breastfeeding among pre-term infants.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What are the effects of artificial nipple (pacifier or bottle) on the duration of breastfeeding?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Blomquist HK, Jonesbo F, Serenius F, Persson LA. Supplementary feeding in the maternity ward shortens the duration of breastfeeding. Acta Paediatrics 1994; 83: 1,122-1,126.
      • Chaves RG, Lamounler JA, Cesar CC. Factors associated with the duration of breastfeeding, J Pediatr (Rio J) 2007; 83 (3): 241-246. 
      • Cronenwett L, Stukel T, Kearney M, Barrett J, Covington C, Del Montel K, Reinhardt R, Rippe L. Single daily bottle use in the early weeks post-partum and breastfeeding outcomes. Pediatrics 1992; 90: 760-766.
      • Cunha AJ, Leite AM, Machado MM. Breastfeeding and pacifier use in Brazil. Indian J Pediatr. 2005; 72: 209-212.
      • Dulon M, Kersting M, Schach S. Duration of breastfeeding and associated factors in Western and Eastern Germany. Acta Paediatr 2001; 90: 931-935.
      • Howard CR, Howard FM, Lanphear B, Eberly S, deBlieck EA, Oakes D, Lawrence RA.  Randomized clinical trial of pacifier use and bottle-feeding or cupfeeding and their effect on breastfeeding. Pediatrics. 2003, 111: 511-518.
      • Mascarenhas MLW, Albernaz EP, daSilva MB, daSilveira RB. Prevalence of exclusive breastfeeding and its determiners in the first 3 months of life in the South of Brazil. J Pediatr (Rio J). 2006. 26: 82; 289-294.
      • Mosley C, Whittle C, Hicks C. A pilot study to assess the viability of a randomised controlled trial of methods of supplementary feeding of breast-fed pre-term babies. Midwifery, 2001; 17: 150-157.
      • Righard L, Alade MO. Breastfeeding and the Use of Pacifiers. Birth. 1997; 24: 116-120.
      • Santo LC, Oliveira LD, Giugliani ER. Factors associated with low incidence of exclusive breastfeeding for the first six months.  Birth. Sept 2007; 34 (3): 212-219.
      • Schwartz K, D'Arcy HJ, Gillespie B, Bobo J, Longeway M, Foxman B. Factors associated with weaning in the first 3 months postpartum. The Journal of Family Practice, 2002; 51: 439-444.
      • Scott JA, Binns CW, Oddy WH, Graham KI. Predictors of Breastfeeding Duration: Evidence From a Cohort Study. Pediatrics. 2006; 117: e646-e655.
      • Vogel A, Hutchison BL, Mitchell EA. Factors associated with the duration of breastfeeding. Acta Paediatr. 1999; 88: 1,320-1,326.
  • Evidence Summary: What is the association between pacifier use and breast-feeding? A Systematic Review
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Callaghan A, Kendall G, Lock C, Mahony A, Payne J, Verrier L. Association between pacifier use and breastfeeding, sudden infant death syndrome, infection and dental malocclusion. Int J Evid Based Healthc. 2005; 3: 147-167.