Abstract
Abstract
The purpose of this study is to assess whether pacifier use is associated with breastfeeding success in term and preterm newborns and whether it influences hospitalization time in preterm newborns. Four databases were searched for randomized controlled trials (RCTs), and a systematic review and meta-analysis were conducted. The risk of bias and evidence quality, according to the GRADE methodology, were analyzed. Risk ratios with 95% confidence intervals (CI) for dichotomous outcomes and mean difference (MD) for continuous outcomes were used. The random effect model was used if heterogeneity was high (I2 over 40%). We screened 772 abstracts, assessed 44 full texts, and included 10 studies, of which 5 focused on term and 5 on preterm newborns. There were a few concerns about the risk of bias in 9 of the 10 studies. Breastfeeding rates were analyzed at 2, 3, 4, and 6 months, and the success rates were similar between the restricted and free pacifier use groups (evidence quality was moderate to high). In preterm neonates, the use of a pacifier shortened the duration of hospitalization by 7 days (MD 7.23, CI 3.98–10.48) and the time from gavage to total oral feeding by more than 3 days (MD 3.21 days, CI 1.19–5.24) (evidence quality was ranked as moderate). Conclusions: Based on our meta-analysis, pacifier use should not be restricted in term newborns, as it is not associated with lower breastfeeding success rates. Furthermore, introducing pacifiers to preterm newborns should be considered, as it seems to shorten the time to discharge as well as the transition time from gavage to total oral feeding.
What is Known:• Observational studies show that infants who use a pacifier are weaned from breastfeeding earlier.• Previous randomized studies have not presented such results, and there have been no differences in the successful breastfeeding rates regardless of the use of pacifier.
What is New:• Term and preterm newborns do not have worse breastfeeding outcomes if a pacifier is introduced to them, and additionally preterm newborns have shorter hospitalization times.• The decision to offer a pacifier should depend on the caregivers instead of hospital policy or staff recommendation, as there is no evidence to support the prohibition or restriction.
Funder
University of Eastern Finland (UEF) including Kuopio University Hospital
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology and Child Health
Reference24 articles.
1. Grummer-Strawn LM, Rollins N (2015) Summarising the health effects of breastfeeding. Acta Paediatr 104:1–2. https://doi.org/10.1111/apa.13136
2. Righard L, Alade MO (1992) Sucking technique and its effect on success of breastfeeding. Birth 19:185–189
3. World Health Organization (2018) Ten steps to successful breastfeeding. Available from: https://www.who.int/teams/nutrition-and-food-safety/food-and-nutrition-actions-in-health-systems/ten-steps-to-successful-breastfeeding
4. World Health Organization (2018) Implementation guidance: protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative. Available from: https://www.who.int/publications/i/item/9789241513807
5. Victora CG, Tomasi E, Olinto MT et al (1993) Use of pacifiers and breastfeeding duration. Lancet 341(8842):404–6. https://doi.org/10.1016/0140-6736(93)92991-2 (PMID: 8094171)
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