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Journal of Human Lactation, Vol. 21, No. 3, 289-295 (2005)
DOI: 10.1177/0890334405278489
© 2005 International Lactation Consultant Association

International Child Care Practices Study: Breastfeeding and Pacifier Use

E. A.S. Nelson, MBChB, MD

Department of Paediatrics, The Chinese University of Hong Kong

Ly-Mee Yu, MSc

Centre for Clinical Trials and Epidemiological Research, The Chinese University of Hong Kong

Sheila Williams, DSc

Department of Preventive & Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

and the International Child Care Practices Study Group Members

Although the Baby-Friendly Hospital Initiative advises that no pacifiers be given to breastfeeding infants, both breastfeeding and pacifier use may protect against sudden infant death syndrome. The International Child Care Practice Study data set on child care practices associated with sudden infant death syndrome risk from 21 centers in 17 countries was used to describe infant-feeding practices and pacifier use and assess factors associated with breastfeeding. At approximately 3 months of age, rates of breastfeeding only (4%-80%) and pacifier use(12.5%-71%) varied between centers. Pacifier use was negatively associated with breastfeeding, and a dose-response effect was noted. Other negative (multiple birth, smoking by mother) and positive (intention to breastfeed, bed sharing, mothers’ education) associations with breastfeeding only were identified. Although causality should not be inferred, these associations are consistent with previous studies. Advice on pacifiers should include potential benefits as well as risks.

Key Words: breastfeeding • bottle feeding • pacifiers • infant care • sudden infant death




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