Furthermore, the American Academy of Pediatric (AAP) has published recommendations on the use of pacifiers in healthy infants associated with a reduction in the risk of sudden infant death syndrome (SIDS). Non-nutritive sucking (NNS), or sucking not for the purpose of feeding, is a precursor to nutritive sucking, and holds various physiological benefits including improved digestion, behavioural organisation, pain management, and prevention of aspiration. Sucking is an important milestone for every newborn infant to master to ensure exclusive breastfeeding after birth, and it also contributes to self-regulatory behaviour and bonding. Guidelines are presented for assessing and guiding safe pacifier use, for specific design to ensure safety, and for cessation of use to ensure normal childhood development.Įxclusive breastfeeding in newborn infants is well researched and agreed upon as an essential aspect of newborn care as is evident from guidelines by the World Health Organization (WHO). Medical benefits associated with the use of pacifiers include providing comfort, contributing towards neurobehavioural organisation, and reducing the risk of sudden infant death syndrome. Justifiable conditions have been identified as: low-birth weight and premature infants infants at risk for hypoglyceamia infants in need of oral stimulation to develop, maintain and mature the sucking reflex in preterm infants and the achievement of neurobehavioural organisation. The use of pacifiers is justifiable in certain situations and will support breastfeeding rather than interfere with it. This article provides a summary of the evidence on the benefits of non-nutritive sucking, risks associated with pacifier use, an identification of the implications regarded as ‘justifiable’ in the clinical use of pacifiers and a comprehensive discussion to support the recommendations for safe pacifier use in healthy, full-term, and ill and preterm infants. The Ten Steps to Successful Breastfeeding as embedded in the Baby-Friendly Hospital Initiative initially prohibited the use of pacifiers in a breastfeeding friendly environment to prevent potential associated risks. The argument opposing pacifier use, however, is based on potential risks such as nipple confusion and early cessation of breastfeeding. In such situations the use of pacifiers can be considered therapeutic and even provide medical benefits to infants, including reducing the risk of sudden infant death syndrome. In most cases the development and maintenance of the sucking reflex is not a problem, but sometimes the skill may be compromised due to factors such as mother–infant separation or medical conditions. Suck-swallow-breathe coordination is an important skill that every newborn must acquire for feeding success. ![]() ![]() We discuss the current literature available on pacifier use to enable critical decision-making regarding justifiable use of pacifiers, especially in the Baby-Friendly Hospital Initiative context, and we provide practical guidelines for clinicians. ![]() ![]() The use of pacifiers is an ancient practice, but often becomes a point of debate when parents and professionals aim to protect and promote breastfeeding as most appropriately for nurturing infants.
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