Does the use of pacifiers shorten breast-feeding duration in infants?

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Abstract
Breast-feeding has a number of benefits for both mother and baby, which appear to increase with longer duration of breast-feeding. The use of pacifiers has been negatively associated with shortened breast-feeding duration. The aim of this review was to determine whether the use of pacifiers actually shortens breast-feeding duration in infants. The Cochrane library, Medline, CINAHL and Embase databases were searched for systematic reviews, randomized controlled trials and cohort studies examining the effect of pacifier use on breast-feeding duration. After applying appropriate inclusion criteria only two cohort studies were identified. In one the overall breastfeeding duration was longer in non pacifier-using infants compared to those given pacifiers (10 months vs 7.5 months). The mean breast-feeding duration in children who were given pacifiers before 6 weeks of age months was 168.5 days compared to 196.0 days for children who had a pacifier introduced later or never. However, there is no evidence to suggest any effect of occasional pacifier use, and it remains unclear whether pacifiers are an independent causal factor for reducing breast-feeding duration in infants.