When to Give a Breastfed Baby a Bottle

Pacifier apply

Definition

A pacifier is an bogus nipple designed for babies to suck on for condolement.

Purpose

Infants accept an intense demand to suck that is separate from their need to swallow. Fetuses may suck their thumbs earlier they are built-in, and some newborns begin to suck immediately. Infants suck when they are tired, bored, or in demand of condolement. Some babies accept a stronger need to suck than others and—adjacent to eating and existence held—sucking may provide the well-nigh comfort to an infant. Babies who do not suck their thumbs or fingers oft rely on pacifiers.

In Western societies 75 to 85 percent of children apply pacifiers. Hospital nurseries usually give them to newborns. Premature infants seem to grow better when they suck on pacifiers. Professionals refer to a pacifier every bit a transitional object that helps children adjust to new situations and relieves stress.

Most infants cry considering they do non even so have methods for soothing themselves. Some newborns practise not take the coordination to suck their fingers or pollex. Although breastfeeding is the most effective way to calm infants, and their hands or thumbs tin be placed in their mouths, pacifiers can be very helpful for discontented babies who cannot or will not suck their thumbs or fingers.

Arguments for pacifier use

Pacifier use is controversial. Some physicians are completely opposed to pacifier apply, whereas others view pacifiers every bit helpful if used in moderation. Pacifiers tin can exist especially useful for unhappy babies who are difficult to comfort. The child's energy goes into sucking on a pacifier rather than crying. Although pacifiers can requite children a sense of calm and security well into their toddler years, pacifier use may be most effective during the first few months of life when fussiness, colic , and the need to suck are at their peaks.

Pacifiers should only be used to satisfy the need to suck. They should never exist used to delay or replace nurturing or feeding. Every bit a child grows, a pacifier can be taken away, whereas information technology may be harder to discourage thumb sucking . For babies, pacifiers can exist used for the post-obit reasons:

to sooth a baby to slumber
to help a baby to stay comatose when disturbed
to calm a frightened infant
to go on the baby quiet

Arguments against pacifier apply

The World Health Organization recommends confronting pacifier apply. Disadvantages of pacifier use may include:

They may get muddy and thus contribute to poor hygiene.
If lost during sleep, the pacifier's absenteeism may cause the infant to wake and cry.
The pacifier may preclude babies from using their mouths to learn most toys and other objects.
The pacifier may point to a baby that crying is unacceptable even though crying is one of a baby's few means of communication.
The pacifier is an like shooting fish in a barrel fix that may crusade parents not to seek to sympathise what is bothering the baby.
Pacifiers may prevent children from learning how to comfort themselves.
Older siblings may give the baby a pacifier to tranquility a baby in situations where the parents would not use it.
Many adults dislike the sight of babies with pacifiers.

The reward of pollex sucking is that babies can adjust sucking to the feel of their skin. Some people believe that thumb sucking is an easier addiction to interruption than pacifier use. Pollex sucking may be preferable to pacifier apply because thumbs have the following benefits:

Unlike pacifiers, the infant tin can observe his pollex at nighttime.
Thumbs are more hygienic.
Thumbs taste better.

Description

Types of pacifiers

Pacifiers consists of a latex or silicone nipple with a firm plastic shield and handle. Latex pacifiers are softer or more flexible but wear out faster than silicone. Silicone pacifiers are firmer, hold their shapes longer, and are easier to clean. The nipple should exist knotted around the back of the handle and the shield and handle should exist one piece. This prevents the nipple from falling off or the plastic from breaking in two and posing a choking hazard. The shield should be at least one.5 inches (half-dozen cm) across so that it will non fit in the baby's oral cavity. The shield should have air holes or vents to foreclose saliva from collecting behind information technology and causing an irritation or rash. Large circular shields can obstruct an intensely sucking baby's nasal passages. Pacifiers should have piece of cake-to-hold handles, exist dishwasher-safe, and easy to clean.

Pacifiers come in several sizes designed for premature infants, newborns, babies younger than six months, and children older than six months. Pacifier nipples come in various shapes—long, short, flattened, or with a ball-shaped finish. Some are shaped like bottle nipples and others resemble a breast nipple that is existence sucked on. The latter may not e'er fit a baby'southward mouth. There is no prove that one shape is preferable to another, although the baby may prefer a certain type. Some babies gag at the texture, taste, or smell of some pacifiers. A baby bottle nipple should never exist used every bit a pacifier since the nipple could popular out of the ring and choke the baby.

Pacifier care

Infant pacifiers should be cleaned daily by humid or washing in a dishwasher. Once a kid is half-dozen months old, the pacifier tin be washed daily with warm soapy water and rinsed with clean water. Children may be taught to wash their own pacifiers. Pacifiers should never be shared with playmates. They should never be stored in plastic bags where dampness can encourage fungal growth.

Pacifier nipples should be examined regularly for deterioration, including tears, frayed edges, holes, or a change in color. Emerging teeth can tear pacifiers. A worn or damaged pacifier should be replaced immediately. Since pacifiers are lost frequently, several should be kept on mitt.

Precautions

Pacifiers are sometimes fastened to a baby's vesture with a clip and a brusque cord or ribbon to forbid them from becoming lost or dingy. However a child can become entangled in even a curt cord and should never be put to bed with a pacifier attached to a cord. A pacifier that is hung on a cord around the baby'due south neck, tied to the baby'south hand, or attached to a crib tin cause strangulation. Pacifiers should never be sweetened because sweetened pacifiers establish a leading cause of molar disuse in babies under age three.

Pacifiers never should be used to replace a feeding, and children should never be given a pacifier if they are hungry. A hungry baby may become upset when there is no milk in the nipple and could develop feeding problems. Thus pacifiers should only be used between or subsequently feedings.

Terminating pacifier use

Babies demand their mouths for play and exploration. By the time a child is crawling and learning to walk, pacifiers are both unhygienic and limiting. Although many experts still recommend weaning a kid from pacifier apply at near age two, others suggest that six to 10 months is the best time to end pacifier use. Before the age of two, children have short memories and may easily forget almost a pacifier that has been lost for a few days. Pacifier use should not be terminated too presently or too abruptly since a baby may substitute thumb sucking or some other beliefs such every bit hair pulling. A two-year-old is much less likely to revert to thumb sucking.

Sometimes severe stress or emotional upset causes a child to use a pacifier for a very long time. Even children who cease because of peer pressure at school may continue to use a pacifier to at-home down at home or to go to slumber.

Risks

Breastfeeding

Pacifiers should never exist given to a breastfeeding infant unless an efficient nursing routine is well-established. Pacifiers may cause nipple confusion. Newborns must learn to breastfeed effectively, and babies suck on breast nipples differently than on a pacifier. Pacifiers have a narrow base so that infants exercise non have to open up their lips widely. Pacifier use may forestall infants from learning how to latch onto their mother's breast, resulting in poor feedings and sore nipples.

A number of studies accept found that frequent pacifier use reduces the duration of breastfeeding and increases the likelihood that a babe will exist weaned by six months. The earlier a pacifier is introduced the sooner breastfeeding ceases. The reasons for this include the following:

Pacifier use causes babies to breastfeed less.
Mothers may introduce a pacifier because they want to stop breastfeeding.
Infants who are given a pacifier, with or without supplemental food, may lose interest in nursing.
A reduction in breastfeeding decreases the female parent's milk product.
A reduction in nipple stimulation by a nursing infant decreases milk product.

Ear infections

Inquiry has found that pacifier use increases a child's risk of ear infections—acute otitis media , the second most mutual babyhood illness after colds. In 1 study pacifier employ increased the frequency of ear infections by 50 percentage. Another study establish a 33 percent decrease in ear infections when pacifier utilize was express to babies anile six to ten months and only used when they were falling asleep. Information technology may be that pacifier employ spreads infection or that intense sucking on pacifiers hinders proper performance of the eustachian tube that normally keeps the middle ear open and make clean. The studies suggest that pacifiers just be used with babies under x months of age, when the need to suck is strongest and the incidence of ear infection is relatively low.

Dental development

Both dental cavities and misaligned teeth take long been associated with pacifier use. Neither pacifier use nor thumb sucking is likely to interfere with early dental development . Yet, if continued past nigh historic period three, either one can contribute to protruding front teeth and an overbite. Orthodontic pacifiers do not foreclose dental abnormalities. Many dentists believe that neither pacifier utilise nor thumb sucking should proceed once all of the babe teeth have erupted. A dentist may recommend devices that are designed to discourage pacifier use.

Other risks

Pacifiers tin can exacerbate any problems with developing spoken language and language. They have been shown to interfere with normal babbling and spoken language development in babies older than 12 months. A child learning to speak with a pacifier may have distorted speech. The child may supercede "t" and "d" sounds—that crave the front of the natural language to castor against the teeth—with "1000" and "g" sounds that come up from the back of the pharynx. Pacifiers likewise can interfere with children's willingness to talk and the development of their social skills.

Some research has suggested that babies showroom fewer visually exploratory behaviors when using a pacifier; they await around less and tin can seem less warning. Some of these children receive less of the following:

mental stimulation
encouragement to explore and learn
parental attending

Boosted risks of pacifier use include the following:

the transmission of thrush, a yeast infection, that tin can be difficult to eradicate in children with pacifiers
product recall of pacifiers due to rubber concerns
children who are unable to give them upwardly, fifty-fifty after years of use

Normal results

Many babies lose interest in their pacifiers at about four months of age, as the need to suck begins to subside. They suck on it less or spit it out. Failing to replace the pacifier after the baby cries or spits it out can be a good method for breaking the pacifier habit. It is easier to end pacifier use in a younger kid. Past the age of three most children have learned to communicate effectively and take other means of coping with stress. Preschool children may experience pressure from their peers to give up pacifiers. Nevertheless, most children requite up both pacifiers and thumb sucking long before they become social or dental concerns.

Parental concerns

There are numerous ways to panel a crying baby other than using a pacifier. During at least the beginning six months of life, crying should ever be responded to promptly. If infants have been well-fed within the past hour and do not need a diaper alter, parents can comfort them past the following:

Toddler using a pacifier to comfort himself. ( Lawrence Migdale/Photo Researchers, Inc.)

Toddler using a pacifier to condolement himself.

placing their face straight in front end of the infant'due south confront and talking to the child
picking the baby upwardly
rocking the baby
placing a gentle hand on the infant's tummy
swaddling a infant in soft blankets

Parents who cull to give their baby a pacifier should take the following steps:

non use it every time the babe'due south mouth is open
try alternative methods of calming a crying baby
encourage the child to sleep without it
remove it every bit presently equally the need for extra sucking is gone—usually between 12 and xv months of age

It may have several weeks for children to give up their pacifiers. Parents can encourage their children to give them upward gradually by trying the post-obit:

ignoring the behavior
reassuring them with affection
limiting pacifier employ to bedtime or stressful situations
finding them a comforting alternative
providing activities in situations where they are probable to exist bored
helping them to express their emotions in words
gently reminding them to non to use their pacifiers
praising them for not using a pacifier
failing to take the pacifier to daycare or other activities
using a calendar to mark down pacifier-free days
rewarding pacifier-gratis days
dipping the pacifier in pickle juice to brand it is less highly-seasoned
offer to merchandise in the pacifier for a "big kid's" toy
not pressuring the child to requite up their pacifiers
not punishing or humiliating the child for pacifier use

Key TERMS

Otitis media —Inflammation or infection of the middle ear space backside the eardrum. Information technology unremarkably occurs in early babyhood and is characterized by ear pain, fever, and hearing bug.

Overbite —Protrusion of the upper teeth over the lower teeth.

Thrush —An infection of the mouth, acquired by the yeast Candida albicans and characterized past a whitish growth and ulcers.

Tooth eruption —The emergence of a tooth through the gum.

Resource

PERIODICALS

Howard, C. R., et al. "Randomized Clinical Trial of Pacifier Use and Bottle-Feeding or Cup-Feeding and Their Effect on Breastfeeding." Pediatrics 111, no. 3 (2003): 511–18.

Kramer, M. S., et al. "Pacifier Use, Early on Weaning, and Cry/Fuss Beliefs." Journal of the American Medical Association 286, no. 3 (2001): 322—half-dozen.

Meyerhoff, Michael K. "Pacifiers and Breast-Feeding." Pediatrics for Parents 20, no. 8 (2003): 9.

ORGANIZATIONS

American Academy of Pediatric Dentistry. 211 Eastward Chicago Avenue, Suite 700, Chicago, IL 60611–2663. Web site: http://www.aapd.org.

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007–1098. http://world wide web.aap.org.

WEB SITES

Greene, Alan. "Pacifiers." Caring for the Next Generation , February 16, 2001. Available online at http://www.drgreene.org/body.cfm?id=21&action=detail&ref=860 (accessed November 21, 2004).

Greene, Alan, and Khanh-Van Le-Bucklin. "Ear Infections and Pacifiers." Caring for the Next Generation , January 2002. Available online at http://world wide web.drgreene.org/body.cfm?id=21&action=item&ref=303(accessed November 21, 2004).

Hodne, Krista. "Pacifier Use Is Associated with Decreased Duration of Breastfeeding." University of Michigan Department of Pediatrics Evidence-Based Pediatrics Web Site , March 17, 2003. Available online at http://www.med.umich.edu/pediatrics/ebm/cats/bfpaci.htm(accessed November 21, 2004).

"Pacifier Use." BabyCenter. Available online at http://www.babycenter.com/refcap/toddler/toddlerbeahvior/12254.html (accessed November 21, 2004).

"Perils of the Pacifier." Available online at http://www.kidsgrowth.com/resources/articledetail.cfm?id=94 (accessed Nov 21, 2004).

Margaret Alic, PhD