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#31 of 63 Old 11-22-2007, 03:00 PM
 
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Originally Posted by alegna View Post
Any artificial nipple *can* interfere with breastfeeding. Do they always? Of course not. Is it a risk every time you choose one? Yes.

-Angela
This is very true, just ask the many women who I help to get their baby to bf again after being given artificial nipple. Some babies are never going to have a problem, for others once is all it's takes, that is not a chance I am willing to take. Bfing to too important to me.

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#32 of 63 Old 11-22-2007, 03:29 PM
 
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Especially in the early going I am of the opinion that the mama is the pacifier. That's why slings and co-sleeping are so great. You can be available for the non-nutritive suckling as needed.

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#33 of 63 Old 11-22-2007, 03:39 PM
 
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I agree that it *can* cause problems, so why take that risk? I also agree that non-nutritive suckling is a normal instinct and that a pacifier is a substitute for the breast. I haven't used pacifiers in the past and would only introduce one if I saw a real need for a substitute.

I did have a moment of insanity with DS2 - he sucked his fists a lot (never was a comfort nurser until he was older) and I thought "hey, he likes to suck a lot, wonder if he'd like a pacifier." He didn't want the pacifier. Silly me, why did he need a substitute when he had his own perfectly good fists?

I hate it when people say to me, "he's using you as a pacifier." No, he's not. He's using my breast as a breast. Pacifiers are the substitute, mothers are the biological default.

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#34 of 63 Old 11-22-2007, 04:08 PM
 
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Originally Posted by alegna View Post
#1. It's a different sucking motion
#2. Sucking NOT at the breast can lead to a reduction in supply

There's tons of research- go read any breastfeeding-friendly source. This is well accepted.

-Angela
http://www.kellymom.com/bf/start/concerns/pacifier.html


I have read studies. If you follow some of the links above, you will find the pacifiers have been shown to be related to breastfeeding problems with babies who are also using bottles or are being given pacis too early. Also, this study

http://pediatrics.aappublications.or...tract/99/3/445

says

Quote:
Pacifiers may be an effective weaning mechanism used by mothers who have explicit or implicit difficulties in breastfeeding, but they are much less likely to affect infants whose mothers are confident about nursing. Breastfeeding promotion campaigns aimed specifically at reducing pacifier use will fail unless they also help women face the challenges of nursing and address their anxieties.
I think this is significant.

In this study, you can see that the problem is incorrect technique and that can be associated with paci use but not blamed on it.

http://www.blackwell-synergy.com/doi...x.1998.00040.x


Quote:
In most cases the nursing problems were related to incorrect sucking technique. The difference in technique of the study group compared with the control group was significant (p = 0.0001). The continuation of breastfeeding was poorer if the infant already had become used to bottle-feeding. Pacifier use was more common in conjunction with breastfeeding problems and in cases with a faulty superficial nipple-sucking technique.
This study' results are telling:

http://www.ncbi.nlm.nih.gov/sites/en...t=AbstractPlus

Quote:
Insufficient data are provided by a review of the pros and the cons of dummy use to encourage or discourage this habit. However, there are sufficient data on which to base firm recommendations such as not starting their use in the first days of life, restricting use after the age of 8 months and withdrawing these objects at the age of 1 year.
I was very worried about pacis and yet had a baby who needed to suckle all the time. I was ready to give up breastfeeding all together because it was excrutiating. If someone had convinced me that pacis were bad, I probably would have given up on nursing rather than nurse my child 24-7 because it caused me so much pain. In cases like mine, it is inappropriate, I believe, to convince a frustrated mother that it is better to nurse 24-7 than give a paci IF the mother is at wits end and ready to give up. It is better to establish the nursing relationship the first few weeks but after that an attached mother is capable of knowing the difference between suckling for food and suckling for comfort. And, pacis can help mama get a bit of relief if you have a heavy duty suckler. That is why they were invented.

It is important that pacis not take the place of nursing but that can be monitored. It is important the the breastfeeding relationship be established before pacis are introduced. After it is, then pacis can be introduced by a knowledgeable and competent mother. It is important that they not take the place of nursing.

It is very important to help mama as much as it is to help baby.
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#35 of 63 Old 11-22-2007, 04:08 PM
 
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totally in my case. i blame the hospital for giving my son a pacifier against my request, resulting in him not bf. it still makse me sad that that was the first thing in his mouth and that he never took to my breast. i wish i knew then what i know now and refused them taking him, he was in no real danger. his body temp was a little low due to being whisked off to the hospital in mid dec in no more than a towel right after a wonderful un planned semi uc birth. if they had just given me a warm blanket and some time alone with my son it would have been so different. still makes me upset and it was almost 2 years ago! i doubt i'll ever be completley over it. however if you've already established bf i'm not sure how much it would interfere, i guess it depends on the baby and what you're using the pacifier for. if you use it to calm them down and you used to ues your breast they may reject the breats for their new comfort (the pacifier) when up set. i'd use it sparingly if you feel you need to (once bf is established), let your baby be your guide
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#36 of 63 Old 11-22-2007, 04:42 PM
 
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I was totally against the pacifier but my daughter's stubborn father bought one anyway...and showed up to the hospital with it...no flowers for me but a pacifier for the baby...argh..anyway..she used it for a month or 2 and then I mysteriously lost it...didn't have an effect on her breastfeeding but like has been already said...every child is different and every parent's use of it is different...my daughter only got t as a very last resort after everything including offering my breast was tried. Truthfully I believe when a child is crying there is a reason and we as parents need to figure out what it is before just trying to shut them up. But that's just my opinion and obviously everybody has one.

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#37 of 63 Old 11-22-2007, 06:56 PM
 
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Originally Posted by yellowpansy View Post
I honestly do not understand how a silicone or rubber nipple that does not produce milk can interfere with a warm booby that does. That makes no sense to me.
Many, many women are told that baby "shouldn't" nurse any more often than X hours... by their own moms, by pediatricians, by the people who delivered the baby, the nurses in the hospital... by everyone. Thing is, if a baby wants to suckle more often than whatever time frame these experts dicatate, they will SCREAM unless they get what they want.

Well, if you give them a pacifier, it can do exactly that: pacify them.

It's true that some babies comfort-nurse to an even greater extent than "normal", due to gastrointestinal discomfort, reflux, and so on. For these babies, a pacifier may be beneficial in some ways; however, again, you're disguising the symptoms of a problem. Dietary changes for the nursing mom can frequently solve these issues without medication, surgery, or pacifiers for baby.

My own son could nurse for HOURS at a stretch when he was small. I had an oversupply issue, which made things worse; he'd nurse nurse nurse, spit up, and go back to nursing again, trying to get down to the hindmilk. We did try a pacifier, and he didn't like it (though he was happy to suck on a pinky finger). When he was 9 months old, we figured out he was reacting to wheat; I cut it out of my diet, and a week later he was a whole new baby. At 13 months we figured out dairy was also a problem and entered a new phase of life. Much later, I learned that many women find that oversupply disappears within a month of cutting dairy out of their own diet.

I'll never know what my son's newborn days would have been like if I'd been off of gluten and dairy to begin with... though this time around, I'm already off gluten, dairy, and soy, and will also drop corn during the third trimester. Then (assuming DS isn't nursing anymore) I can test them one by one after 3 months of age or so. (I react to soy, but it's a fairly mild reaction, so I may test that one.... or I may skip it.)

In short, pacifiers are not always the death of breastfeeding, but they can be part of a constellation of problems that interfere with breastfeeding and overall infant health. If one decides to use them, I hope it's with the understanding that they're a temporary symptom remedy, and a more complete solution should still be looked for.
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#38 of 63 Old 11-22-2007, 10:15 PM
 
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Originally Posted by yellowpansy View Post

I was very worried about pacis and yet had a baby who needed to suckle all the time. I was ready to give up breastfeeding all together because it was excrutiating. If someone had convinced me that pacis were bad, I probably would have given up on nursing rather than nurse my child 24-7 because it caused me so much pain.
So, if someone convinced you that artificial nipples were bad, you would have stopped nursing and....... given bottles AND paci's? :

Your research is useless to many.... **artificial nipple** instantly clues me in on the fact that my child does not need it... i have two perfectly natural nipples for her use... to people that do not let their children play with plastic toys, you can bet we dont let our children suck on plastic nipples.

Also, nursing is not just nutritive, it is for bonding as well....possibly way more than that....
Showing studies that say that your milk supply will not suffer due to artificial nipple use tells me nothing of what will happen when I start encouraging my child to bond with a piece of plastic.

So I guess if the main concern is TRUELY with milk supply. Follow all the research you want.

But to look at how pacifiers interfere with breastfeeding, to me, is looking at the entire breastfeeding relationship, not just the supply and demand aspect.

Although, I am firm in my belief that it cannot be great for supply either. I wonder how many pacifier babies nurse exclusively the first year. We didn't start any solids at all until dd was about a year, I wonder if pacifier use hinders the supply at that point as well.

I should add that Im exhausted, rambling and thinking as I type, so... take it for what its worth.

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#39 of 63 Old 11-23-2007, 01:40 AM
 
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Originally Posted by Ironica View Post
It's true that some babies comfort-nurse to an even greater extent than "normal", due to gastrointestinal discomfort, reflux, and so on. For these babies, a pacifier may be beneficial in some ways; however, again, you're disguising the symptoms of a problem. Dietary changes for the nursing mom can frequently solve these issues without medication, surgery, or pacifiers for baby.
I'm sorry, but I think the implication that reflux and other serious medical gastrointestinal issues can "frequently" solve these problems is BS. And I think it's dangerous BS. For babies who are having reactions to something in their mother's diet, removing that something will help them get better. Babies who have *reflux* will NOT get better, no matter what their mamas cut out of their diets. And telling new mamas that they will starts them down a BAD path and may interfere with getting them and their babies the help they need. It's a really terrible thing to see new mamas who have cut out nearly everything in their diet to the point that it's causing supply issues and weight loss and depression trying to cope with a baby who is terribly unhappy and in pain a lot of the time because this is the only advice they've received. It sucks even more to be one.

Quote:
Originally Posted by inchijen View Post
The extra non nutritive suckling at the breast has a purpose, releases hormones in mama, stimulates more supply, comforts and nurtures the newborn.
Believe it or not, there are mamas who really, really DON'T need to stimulate more supply! If you've already got and oversupply that is contributing to breastfeeding problems, or you have a baby who wants to suck and does not want the milk, you've got a limited set of options, you know? Pacifier, your finger or...? While I admire mamas who are committed enough to not using pacis that they're willing to spend a couple of hours with the baby sucking on their finger, that isn't me. With a toddler at home, that would be a recipe for chaos.


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#40 of 63 Old 11-23-2007, 03:08 AM
 
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from belleweather----Believe it or not, there are mamas who really, really DON'T need to stimulate more supply! If you've already got and oversupply that is contributing to breastfeeding problems, or you have a baby who wants to suck and does not want the milk, you've got a limited set of options, you know? Pacifier, your finger or...? While I admire mamas who are committed enough to not using pacis that they're willing to spend a couple of hours with the baby sucking on their finger, that isn't me. With a toddler at home, that would be a recipe for chaos.


OR when a mama is dealing with oversupply, she can use other methods to control it.... many of which allow the baby to continue non-nutritive sucking on the emptied breast.

http://www.kellymom.com/bf/supply/fast-letdown.html

I think there are always more options than using a pacifier.

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#41 of 63 Old 11-23-2007, 03:32 AM
 
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I'm sorry, but I think the implication that reflux and other serious medical gastrointestinal issues can "frequently" solve these problems is BS. And I think it's dangerous BS. For babies who are having reactions to something in their mother's diet, removing that something will help them get better. Babies who have *reflux* will NOT get better, no matter what their mamas cut out of their diets.
I'm sorry you weren't able to remedy your child's reflux through a TED. But I know a lot of women for whom it *has* worked, so saying that they will NOT get better isn't true. Some of them were able to avoid meds entirely; others were able to wean their child off of meds after identifying the offending foods. Others may have reduced but not eliminated the problem.

There are physiological issues that can cause reflux, but in a LOT of cases, it's a food reaction. I'm sorry it wasn't the case for you and your baby. I'm surprised you got *no* other advice; I hear all the time from women who get *only* meds and NO suggestion that there's any other way to approach things.
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#42 of 63 Old 11-23-2007, 04:18 AM
 
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I was very lucky at my hospital that the lactation consultants and nurses were all supportive of my learning to breastfeed - my baby had no bottles and no pacifiers in the hospital. That said, I have used one at home. She is very good about letting me know what she wants, and because we waited a little bit to use them, it did not affect my supply. Sometimes, she would pull off after nursing, cry, latch back on, pull off and cry - it seemed she wanted to suck, but did not want any more milk. I offer her a pacifier on those occasions. If she is hungry, I don't have to worry - she spits out the pacifier and looks at me like "You have GOT to be kidding me. I don't want THIS!"

I think they can have their place, as long as you are careful - I don't offer her one except as a last resort, anyway.
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#43 of 63 Old 11-23-2007, 12:17 PM
 
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Originally Posted by inchijen View Post

OR when a mama is dealing with oversupply, she can use other methods to control it.... many of which allow the baby to continue non-nutritive sucking on the emptied breast.

http://www.kellymom.com/bf/supply/fast-letdown.html

I think there are always more options than using a pacifier.
That is helpful but for many women (me included) struggling to get breastfeeding "down" it is very difficult to change positions as suggested here and still get a good latch. I held DS the same way for the first couple of months because any time I changed positions, it hurt like hell (I have a funny nipple that points off kilter, it made it a real pain to figure out where to position him).

When DS didn't want to nurse, he just didn't want to, there was no convincing him that he should latch on for comfort (though he is more than willing to do that now, I am pregnant and there's no milk left, LOL!). But he wanted something in his mouth. This seems to be repeated amongst many posts here...sometimes pacifiers work, you just have to use extreme caution and not introduce them too early, IMO. This is coming from someone who made it clear to every friend and relative NOT to give me any pacifiers for shower gifts because I was definitely NOT going to use one. That was the one thing I didn't follow the plan for, I guess. Sometimes you just have to be flexible.
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#44 of 63 Old 11-23-2007, 12:28 PM
 
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The other reason that a pacifier can interefere with breastfeeding, is that it can change your babies latch.

We started giving my DS a "sooky" when we was 5 weeks old. By 6 weeks my nipples felt like they were going to fall off. I was lucky, he was still young and I have MDC on my side. We dropped the pacifier and worked hard to get the good latch back. (I've since realized that DS is a lazy latcher. Our good latch disappears frequently.)

However, what would have happened if I didn't know that pacifiers could cause problems? I would have continued using one, and tried to keep nursing. Eventually, the nursing would have become too painful and I would have slipped in a bottle here and there, "to give my nipples a rest". Any bets on what would have happened to my breastfeeding relationship then?

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#45 of 63 Old 11-23-2007, 12:34 PM
 
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Besides the copious research, I have seen pacifiers interfere with breastfeeding many times in my breasteeding peer support job.

Like alegna says, it won't necessarily interfere with breastfeeding, but it is a potential issue. To dismiss it because it is not your experience is ridiculous.

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#46 of 63 Old 11-23-2007, 12:53 PM
 
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We used a pacifier with nursing. No problems. The Mooch knew when he wanted to eat, and afterwards, if he wanted to just suck and I wanted to do something frivalous...like bathe, catch up on some sleep or eat , it was a handy tool.

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#47 of 63 Old 11-23-2007, 02:42 PM
 
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We introduced a paci to DD around 6 weeks. DD hated being a baby. She screamed from the moment she was born until about 4-5 months. She was dx with reflux and was what most would call a high-needs baby. DD would NOT comfort nurse - in fact she had a serious nursing aversion due to her reflux. I also had OALD so that complicated matters. It would take hours upon hours to get her latched on at times. The paci was a last resort for us before leaving her at the fire station. Seriously, I had major regrets about having a child at that time. It was horrible. The paci really helped us. We only used it when thing were really bad, just to help get her calmed down. It actually was a useful nursing tool. We could get her to suck on the paci and then DH would pull it out quickly and I could latch her on. All that said, had DD not been a baby in pain we never would have used one. I felt the extreme circumstances necessitated such an intervention.

The first time DD nursed after using the paci, her latch was different. My nipples became sore again when they had already been feeling better. In fact for about 4-5 days she had a hard time adjusting her suckle between breast and paci. She was plenty efficient at the breast but I suffered for it. Eventually she worked things out. I definitely was clear at that point, however, that had we introduced a paci from the very beginning, there is no way I would have known that the latch issues were actually from the paci and not something else. To support the research, I can certainly see from personal experience how a paci could be extremely detrimental to a nursing relationship and would wait to introduce one until as late as possible, if at all.

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#48 of 63 Old 11-23-2007, 04:34 PM
 
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In theory, I think they are best avoided for the numerous reasons already stated.

In practice, however, my DD got one at 3 days old to help with breastfeeding. She wouldn't latch because she stuck her tongue to the roof of her mouth all the time. We tried using our fingers to push her tongue down, but it wasn't all that effective. What ended up working was giving her a pacifier when she wasn't nursing -- it really took hours and hours of having something pushing her tongue down before she got the message. She started latching with a nipple shield, and then we were able to get rid of that, too.

Although my DD got a pacifier in her first days of life, I really do think it had a very positive impact on our nursing relationship. I was EPing until she decided to latch with the nipple shield and I don't think I could have kept that up for very long.

She continued getting the binky after learning to latch because she absolutely would not comfort nurse (hated getting milk when she didn't want it). It hasn't had any negative impact on our nursing relationship at all.

But, if the new babe has no latching issues and no real other reason for a binky, we'll just skip it entirely. I have no problem with round-the-clock nursing so if this one will be up for it, so will I!

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#49 of 63 Old 11-23-2007, 05:07 PM
 
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I was very afraid of artificial nipples in the beginning. We had tongue tie, and I fed him via a cup instead of a bottle to prevent any chance of nipple confusion.

He used me for all his sucking needs until somewhere around 6 weeks, when he started only using me for nutrition. During the next 3 weeks he was miserable. He was having so much trouble falling asleep, even with every soothing trick. He was cranky and irritable. Nothing brought him pleasure. We tried a paci, and it worked wonders. That was at 9 weeks. It still took about a week of that to get him caught up on sleep enough that he was himself again. He is 15 weeks now, and will sometimes comfort nurse on me. He is a very happy baby. I just wish i could nurse him to sleep.

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#50 of 63 Old 11-23-2007, 05:25 PM
 
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Originally Posted by inchijen View Post
I belive that the strong sucking reflex is instinctual in babies for a reason, and it certainly hasnt developed so that they can suck on plastic.

The extra non nutritive suckling at the breast has a purpose, releases hormones in mama, stimulates more supply, comforts and nurtures the newborn.

so for that reason alone, we do not use pacifiers. I don't think theyare cute, I dont like plastic artificial nipples, not for us.
Thanks for this point of view!

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#51 of 63 Old 11-23-2007, 09:00 PM - Thread Starter
 
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Thanks so much ladies for the input and advice!!!!!!!!!!

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#52 of 63 Old 11-23-2007, 10:52 PM
 
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I do have a pretty intense letdown, but he likes it. He gets angry before the letdown, and when the flow slows later, he will get angry again and refuse to keep sucking. He only wants me when the flow is fast. The rest of the time he wants the paci.

Leigh, mama to Rostislav homeborn Aug 9 2007, and Oksana homeborn Feb 24 2011.
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#53 of 63 Old 11-26-2007, 12:27 AM - Thread Starter
 
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Thanks for your advice, now I have amo to bring to the discussions of "pacifiers".


Quote:
Originally Posted by yellowpansy View Post
http://www.kellymom.com/bf/start/concerns/pacifier.html


I have read studies. If you follow some of the links above, you will find the pacifiers have been shown to be related to breastfeeding problems with babies who are also using bottles or are being given pacis too early. Also, this study

http://pediatrics.aappublications.or...tract/99/3/445

says



I think this is significant.

In this study, you can see that the problem is incorrect technique and that can be associated with paci use but not blamed on it.

http://www.blackwell-synergy.com/doi...x.1998.00040.x




This study' results are telling:

http://www.ncbi.nlm.nih.gov/sites/en...t=AbstractPlus



I was very worried about pacis and yet had a baby who needed to suckle all the time. I was ready to give up breastfeeding all together because it was excrutiating. If someone had convinced me that pacis were bad, I probably would have given up on nursing rather than nurse my child 24-7 because it caused me so much pain. In cases like mine, it is inappropriate, I believe, to convince a frustrated mother that it is better to nurse 24-7 than give a paci IF the mother is at wits end and ready to give up. It is better to establish the nursing relationship the first few weeks but after that an attached mother is capable of knowing the difference between suckling for food and suckling for comfort. And, pacis can help mama get a bit of relief if you have a heavy duty suckler. That is why they were invented.

It is important that pacis not take the place of nursing but that can be monitored. It is important the the breastfeeding relationship be established before pacis are introduced. After it is, then pacis can be introduced by a knowledgeable and competent mother. It is important that they not take the place of nursing.

It is very important to help mama as much as it is to help baby.

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#54 of 63 Old 11-26-2007, 05:52 AM
 
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And, pacis can help mama get a bit of relief if you have a heavy duty suckler. That is why they were invented.
Are you sure pacifiers weren't invented to give bottle fed babies a sucking outlet?
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#55 of 63 Old 11-26-2007, 05:54 AM
 
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Believe it or not, there are mamas who really, really DON'T need to stimulate more supply! If you've already got and oversupply that is contributing to breastfeeding problems, or you have a baby who wants to suck and does not want the milk, you've got a limited set of options, you know? Pacifier, your finger or...? While I admire mamas who are committed enough to not using pacis that they're willing to spend a couple of hours with the baby sucking on their finger, that isn't me. With a toddler at home, that would be a recipe for chaos.
You can block feed and your baby will get more time without stimulating milk supply. It is possible to comfort nurse with oversupply and no pacifiers.
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#56 of 63 Old 11-26-2007, 05:41 PM
 
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i was totally paranoid about nipple confusion and after his birth, : my milk took a while to come in, my colostrum was little at best and for the first few days I was exhausted, in pain and basically keeping him at the breast 24/7. They gave us a gumdrop pacifier and he really liked it. Once my milk came in, I had no trouble breastfeeding. He still likes his pacifier, he'll sleep with it in and we've still got a great breastfeeding relationship and I have no intention of stopping it anytime soon. Nor do I intend to take away his pacifier. Especially since he tends to go to his thumb now!! I'd much rather deal with a paci then a thumb. I sucked mine for over 5 years. NO GOOD!

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#57 of 63 Old 11-26-2007, 05:56 PM
 
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I haven't seen anyone advocate taking away a pacifier if it isn't causing problems.

I'm the opposite. I would much rather a thumb than a paci. I sucked my thumb until I was 11. My brother and my MIL until mid teens and my SIL until her 20s.

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#58 of 63 Old 11-26-2007, 06:13 PM
 
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Ds all out refused them from birth on. He would spit it out immediately and look at me like "WTF is that?!"
Both of my kids did the exact same thing. When DD2 was in and out of the hospital, the doctors/nurses would try to give her a paci dipped in the sugar water, and it STILL wouldn't work, and they were all shocked.

Single WAHM to 5yo DD, 2yo DS, and forever 7 week old angel DD.
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#59 of 63 Old 11-26-2007, 06:32 PM
 
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i was totally paranoid about nipple confusion and after his birth, : my milk took a while to come in, my colostrum was little at best and for the first few days I was exhausted, in pain and basically keeping him at the breast 24/7. They gave us a gumdrop pacifier and he really liked it. Once my milk came in, I had no trouble breastfeeding. He still likes his pacifier, he'll sleep with it in and we've still got a great breastfeeding relationship and I have no intention of stopping it anytime soon. Nor do I intend to take away his pacifier. Especially since he tends to go to his thumb now!! I'd much rather deal with a paci then a thumb. I sucked mine for over 5 years. NO GOOD!
Just to warn you, I know three different children who were on paci's and when they were 2-3 years old and the parents took them away, the started sucking their thumb! so i'm not sure you can prevent it by using paci's...

me, dh and 2 boys = our family (oh and a cat...who is also a male...lol)
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#60 of 63 Old 11-28-2007, 02:21 AM
 
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I used to be against them with my 2 oldest, who screamed bloody murder when I attempted giving one to them.

But with my son I have used Soothies. Not often, he will only take them under certain conditions. I find them useful at diaper changing time to keep him calmed down. Also, after he's eaten and has started doing that latch/pull off (he's practicing now that he realized he can do this himself), and if we are in public and I just need to calm him until I can feed him.

I had SUCH HORRIBLE pain with my 2 girls, and found out through him that it was a latch issue. The rolled their tongues, and so did he. The Soothie helped him learn not to do this, and when he was a newborn I would put it in his mouth for a few sucks before latching him. It was SUCH a relief to my pain and I did not have the problem with him that I had with my daughters. Because of less pain, I nursed more and longer, and have had no milk issues with him.

So I think it depends on how/why you use a pacifier, and maybe which type you use. There are a lot of different shapes and sizes out there.
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