A pacifier, also known as a dummy or soother, is a rubber or plastic nipple given to an infant or young child to suck on. Pacifiers are commonly used to soothe or calm babies and toddlers. However, some experts believe pacifier use may interfere with breastfeeding and cause what is known as a shallow latch.
What is a shallow latch?
A shallow latch refers to when a baby does not take enough of the areola and breast tissue into their mouth when breastfeeding. Ideally, a baby should latch deeply onto the breast, taking a large mouthful of breast tissue in addition to the nipple. This allows them to feed more efficiently and stimulate milk production.
With a shallow latch, the baby latches only on the nipple or just behind the nipple. This can make breastfeeding painful for mothers and make it difficult for babies to get enough milk.
Signs of a shallow latch
Here are some signs that a baby has a shallow latch while breastfeeding:
- Breastfeeding is painful for the mother
- The baby makes clicking or smacking noises while feeding
- The mother’s nipples appear compressed or misshapen after feeds
- The baby frequently slips off the breast or needs to re-latch
- Feedings take a long time and the baby seems frustrated
- The mother does not hear or see the baby swallowing regularly
- The mother’s breasts do not feel softer or emptier after feeding
If a mother notices any of these signs, it likely indicates the baby needs to work on achieving a deeper latch while breastfeeding.
How could pacifiers cause a shallow latch?
There are a few ways that using a pacifier could potentially interfere with a baby’s ability to properly latch onto the breast:
- Nipple confusion – Sucking on an artificial nipple like a pacifier requires a different mouth and tongue position than breastfeeding directly from the breast. Babies who get used to sucking on pacifiers may get confused and start using those same motions while breastfeeding, rather than opening their mouth wide to take in a large mouthful of breast.
- Reduced breast stimulation – When babies breastfeed frequently and effectively, they are stimulating the breast to produce more milk for the future. Pacifier use can reduce breast stimulation and milk production if babies start substituting pacifiers for nursing sessions.
- Impact on suck strength – Some studies have found that excessive pacifier use in the first two weeks can interfere with the natural development of a baby’s sucking skills. This could make it harder for them to create an effective latch.
Evidence for pacifiers causing breastfeeding issues
There are a handful of studies that have looked at the impact of pacifiers on breastfeeding:
- A 2016 meta-analysis found pacifier use decreased the duration of exclusive and partial breastfeeding before 6 months of age.
- A 2015 study found mothers who introduced pacifiers before 1 month of age were 2.3 times more likely to stop breastfeeding early than those who did not use pacifiers.
- A 2013 study found pacifier use was associated with a significant reduction in breastfeeding frequency for babies 2 weeks to 4 months old.
However, the effect seems to depend on the timing and frequency of pacifier use. Some analyses have found that pacifiers do not seem to cause problems when introduced after breastfeeding is well established, after 3-4 weeks of age.
How to improve breastfeeding with a shallow latch
If a pacifier seems to be causing breastfeeding difficulties like a shallow latch, there are some steps mothers can take:
- Limit or stop pacifier use for a period of time to see if latch improves.
- Work with a lactation consultant to troubleshoot latch and get baby used to taking a large mouthful of breast.
- Try different nursing positions to help baby open wider to take in more breast tissue.
- Express a little breastmilk and rub it on the nipple so baby opens mouth wider while rooting.
- Try using a nipple shield temporarily to help baby latch deeper.
- Pump to keep up breastmilk supply if baby is unable to transfer milk well.
In many cases, reducing pacifier use and working on latch techniques enables babies to develop a deeper, more effective latch at the breast again.
When to avoid pacifiers
To reduce the risk of shallow latch or breastfeeding difficulties, many lactation experts recommend avoiding pacifiers or limiting use during:
- The first 3-4 weeks while establishing breastfeeding
- Any time mom notices signs of shallow latch or reduced milk transfer
- When baby is not gaining weight well or mom’s supply seems low
- When mother or baby has recurrent plugged ducts or breast infections
Once breastfeeding is going well, many babies can handle occasional pacifier use without problems. But frequent pacifier use should still be avoided until breastfeeding is well established, which takes 2-3 months.
Alternatives to pacifiers
For babies who want to suck for comfort, there are some alternatives to try instead of pacifiers:
- Let baby suckle at the breast when not actively feeding
- Allow baby to suck on your clean finger
- Offer a teething toy made for sucking
- Swaddle baby to provide comfort through touch
- Hold and rock baby close to provide comfort through movement
- Play white noise or lullabies to soothe baby
Providing other forms of comfort may help satisfy baby’s sucking needs outside of feeding times without interfering with breastfeeding technique.
Conclusion
Frequent pacifier use, especially in the early weeks and months, can sometimes contribute to breastfeeding difficulties like shallow latch. The artificial nipple can interfere with proper latch technique. Limiting pacifier use and focusing on improving latch is usually an effective solution. While pacifiers can disrupt breastfeeding when overused, occasional pacifier use after breastfeeding is established is generally not problematic.
Mothers should pay attention to signs of shallow latch and reduce pacifier use if issues arise. With patience and practice, babies can learn to latch deeply again for effective, pain-free breastfeeding. Consulting a lactation specialist can also help troubleshoot pacifier-related breastfeeding challenges.