When preterm infants make the transition from tube feeding to oral feeding, starting them on a bottle seems to interfere with how well they take to breastfeeding later. There has been some concern that giving preemies a pacifier may create the same problem, but that seems to be unfounded.

A new study shows that pacifiers have no effect on the likelihood that preterm infants will be successfully breastfeeding by the time they leave the hospital.

In contrast, using a cup rather than a bottle to feed the baby does seem to increase the odds of full breastfeeding on hospital discharge. However, this practice was also tied to a longer length of stay in the hospital.

The findings, which appear in the British Medical Journal, are based on a study of 319 preterm infants who were randomly assigned to one of four types of feeding when the mother was unavailable for breastfeeding. The babies were either fed by a cup with or without a pacifier, or by bottle with or without a pacifier.

Pacifier use had no effect on the likelihood of babies breastfeeding when they left the hospital or several months later, Carmel T. Collins, from the Women’s and Children’s Hospital in North Adelaide, South Australia, and colleagues report.

Infants in the cup groups were 73 percent more likely to be fully breastfeeding on discharge than infants in the bottle groups, but their average hospital stay was about 11 days longer, the investigators found.

“From our results we cannot support withholding a (pacifier) in preterm infants less than 34 weeks’ gestation as a strategy to increase the prevalence of breastfeeding,” Collins’s group concludes.

SOURCE: British Medical Journal, June 17th online issue, 2004.