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Two decades ago, the World Health Organization developed 10 steps to promote successful breast-feeding (JW Womens Health May 14 2009). Step 9 advises against giving pacifiers to breast-feeding infants; however, the association between pacifier use and lower risk for sudden infant death syndrome has prompted reconsideration of this recommendation. In a multicenter noninferiority study, investigators in Argentina randomized more than 1000 pairs of infants and mothers (who were highly motivated to breast-feed) into two groups: pacifier offered or pacifier not offered at 2 weeks of age.
Introduction of pacifiers did not alter prevalence or duration of breast-feeding. At 3 months, 85.8% of infants in the pacifier group and 86.2% of infants in the…