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Nonnutritive Sucking, continued
Pacifiers
After much investigation, the use of pacifiers has been shown to decrease the incidence of Sudden Infant Death Syndrome (SIDS). However, this excitement is balanced against concerns that pacifier use may lower breastfeeding success and the possible long-term effects of pacifier use. The American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome recommendations published in 2005 are as follows:
 
1.
Consider offering a pacifier at nap time and bedtime. Although the mechanism is not known, the reduced risk of SIDS associated with pacifier use during sleep is compelling, and the evidence that pacifier use interferes with breastfeeding or causes later dental complications is not. Unless new evidence dictates otherwise, the task force recommends use of a pacifier throughout the first year of life according to the following procedures:
   
The pacifier should be used when placing the infant down for sleep and not be reinserted once the infant falls asleep. If the infant refuses the pacifier, he or she should not be forced to take it.
   
Pacifiers should not be coated in any sweet solution.
   
Pacifiers should be cleaned often and replaced regularly.
   
For breastfed infants, delay pacifier introduction until 1 month
of age to ensure that breastfeeding is firmly established.
 
2.
Pacifiers should never be used to replace or delay meals and should be offered when the caregiver is certain the child is not hungry.
 
3.
Pacifiers should have ventilation holes and a shield wider than the child’s mouth (at least 1¼ inches in diameter).
 
4.
Pacifiers should be one piece and made of a durable material, replaced when worn, and never tied by a string to the crib or around a child’s neck or hand.
 
5.
Physiologic pacifiers are preferable to conventional pacifiers because they may have less dental effects.
 
6.
For more literature on the risks and benefits of pacifiers, refer to
Pacifier Use in Children: A Review of Recent Literature.
 
 
Pacifier use during sleep is associated with a decreased incidence of SIDS.
 
The AAP recommends that families offer a pacifier for all naps and at bedtime.
 
Pacifier introduction should be delayed in breastfed infants until breastfeeding is firmly established.



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