Few things elicit such divided opinions as the pacifier. Some love it, some hate it, some resort to it out of sheer desperation. Others assume it’s a necessary part of parenting. And like many other aspects of parenting, the decision on whether or not to use a pacifier will be different for every family.

There are pros and cons to pacifiers. They can provide coveted rest and quiet to overwrought mothers and sucking stimulation to needy babies. But they can also put a baby at risk of inadequate physical and emotional nourishment.

For Some, Pacifiers Can Be Lifesavers
Exhaustion, a continuously crying infant and the agony of painful, sensitive nipples loom gigantic when compared to a tiny bit of silicone and plastic. Not all mothers choose to be tied to their infants in the way nature has designed the system. For these mothers, pacifiers can be lifesavers which, when used for short periods of time and on limited occasions, provide valuable respite to a weary mother.

Nadine Knelson of Abbotsford, British Columbia, loves the pacifier. "The ‘Wonder-Plug,’ we called it," she says with a laugh. "Both my kids used it, and I’m sure the baby will, too." Pregnant with her third child, Nadine remembers the peace brought by the soother. "I wasn’t the kind of nursing mother to let them nurse every time they wanted something to suck, so the pacifier worked well for us."

The Womanly Art of Breastfeeding, published by La Leche League International, suggests that the pacifier is best considered a short-term substitute until the breast can be offered again, an emergency measure rather than an item of daily use.

Ending pacifier use can be easier than getting children to give up other soothing methods. "My children were ready to give up their soothers around age 2, more easily than kids I’ve seen who are thumb or blanket suckers," recalls Nadine.

Shelley Hibbs of Codroy Valley, Newfoundland couldn’t find her son Jadian’s pacifier one night, and was amazed to find he didn’t need it. "At that point I realized he could live without it, so at 8 months I took it away. He didn’t even miss it."

Reasons to Skip the Pacifier
Nursing mothers need to think twice about using pacifiers, because they can interfere with breastfeeding. "Babies tend to wean from the breast substantially earlier when they receive soothers," says Kathleen G. Auerbach, Ph.D., an international board certified lactation consultant, co-author of several books on breastfeeding and editor-in-chief of Current Issues in Clinical Lactation.

She encourages parents to examine the research into the effects of pacifier use. "Babies given pacifiers tend to suckle less frequently than those not given pacifiers," she says. "Less frequent sucking can result in a reduction of milk production." Frequent pacifier use can even result in babies with slower growth rates, compared to babies who nurse frequently at the breast. There is also increased incidence of thrush (an oral yeast infection) and middle ear infections among babies using pacifiers.

Another problem for many babies is what Auerbach calls "nipple preference." Switching between breast and pacifier is difficult for many babies. It’s easier to suck from an artificial nipple because it requires less tongue movement and energy, but when the baby tries to use the same motion at the breast, it results in little milk and a mother with sore nipples. "After the sucking action on breast is well-established, nipple preference seems to be less problematic," Auerbach says.

Nadine’s babies continued nursing with no problems from pacifier use, but she was careful. "They were about 4 months old before they would take the pacifier, and I think that’s why it worked so well for us." Waiting until the milk supply is established and the baby has learned to latch on properly may help prevent pacifier use from interfering with breastfeeding.

But desperation can drive the best intentions underground. Shelley wishes she hadn’t introduced the pacifier to her son. "I regret pushing Jadian to use it," she says. "He didn’t want it, and he wasn’t a fussy baby, but my in-laws said I had to give him one. Eventually he started to depend on it and every time he let out the slightest cry someone would poke the pacifier into his mouth."

There is No Substitute for Mom
Auerbach reminds mothers that women have dealt with maternal exhaustion without pacifiers for thousands of years. "Mothers whose babies use pacifiers often think that their babies need them because of a sucking need. This need has a clear survival function because sucking is designed to obtain food, something a baby needs frequently! Our species depends on frequent feedings to fill those tiny stomachs with milk designed to be used quickly."

In cultures where attachment parenting is the norm, pacifiers and mother substitutes are much less common -- and so are fussy babies. It’s simple, explains Auerbach. "Babies whose needs are met quickly do not cry much." But in other cultures, women have far more community support than most North American mothers do. The intense closeness between mother and baby is celebrated instead of tolerated, and extended breastfeeding is assumed.

Everything else aside, babies need to be held. Whether or not their sucking needs are satisfied at the breast or the pacifier, their emotional needs demand contact with loving parents. Mothers are sometimes warned against "spoiling" their babies by holding them too much, or nursing them too often. "Wrong!" says Auerbach. "It’s impossible to give a baby too much attention."

The desire for closeness isn’t only felt by babies, as many mothers find. The need to be needed is part of what bonds parents to their children, and being indispensable is not a weight, it’s a reward. "I spent hours rocking Celina, holding her while she sucked her soother," recalls Nadine. "She had to be close to me."

The Womanly Art of Breastfeeding reminds mothers not to sell themselves short: "While a pacifier can sometimes substitute for mother’s breast, it is never a substitute for mother."