Q: But what about pacifiers and nipple confusion?
A: I’m not sure where the theory of nipple confusion came from. One day all babies were given pacifiers and the next we had to be afraid that they would prefer a plastic nipple so much that they would refuse the real thing. Or even worse, forget how to nurse.
No professional I know has ever had a baby turn down breastfeeding because they enjoyed their pacifier too much. I don’t want to completely debunk nipple confusion because I don’t have a lab and a team of scientists to back me up. What I do have is empirical evidence from hundreds and hundreds of babies that have had zero issue going from pacifier to breast, and back to pacifier.
In fact we find that pacifiers strengthen the breastfeeding relationship. Babies have an innate urge to suck. Not just for nourishment but for comfort and soothing as well. Pacifiers allow a breastfeeding parent’s sore nipples to have a break, and also allow another caregiver to have a turn at soothing the baby.
In addition to soothing, pacifiers have been shown effective at reducing SIDS. They are recommended from birth by the AAP!
There will be moments in your baby’s life like when they are in the car or getting their first shots when you can’t safely be nursing them- and pacifiers can feel like a godsend. Because of this nipple confusion propaganda, many parents wait a few weeks to introduce a pacifier and it’s often too late. Babies offered a pacifier later on will usually refuse to latch onto it.
On the contrary, nipple confusion with bottles IS a thing. It’s not actually nipple confusion though. What happens is that bottles are much easier to get milk out of than breasts. Especially in the first five days when the breastfeeding parent may literally be producing drops at a time. So a baby that has just been given 2 oz out of a bottle will cry in frustration when milk doesn’t immediately come out of the breast when they start suckling. This is the reason in our Essential Guide that we recommend if you need to supplement in the first 2 weeks that you use a syringe or a cup instead of an artificial nipple.
If for whatever reason your baby does need to take a bottle, utilize the slowest nipple possible, usually preemie, in conjunction with paced feeding.
So in conclusion, if you want to breastfeed your child, absolutely give them a paci right away but hold off on the bottle [if you can] until week three.