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Literature review for - Flourish Paediatrics

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Results<br />

Pacifiers reduced Any BF<br />

HR 1.22 (1.03, 1.44)<br />

Daily pacifier use and<br />

duration of full<br />

breastfeeding RR 1.35<br />

(1.05, 1.74)<br />

Overall no effect of<br />

pacifiers on breastfeeding<br />

duration<br />

(RCTs had no effect, cohort<br />

studies showed some effect)<br />

See critique by Kronborg<br />

2009 Birth<br />

Effect on risk Negative Negative None Negative<br />

Clinical 1 1 0 1<br />

importance<br />

Clinical 1 1 1 1<br />

relevance<br />

Generalisability Y to USA ? Aust Y N Y<br />

Applicability Y Y N Y<br />

Pacifiers reduced duration<br />

of EBF and ABF<br />

EBF 1.79 (1.45,2.21)<br />

ABF 1.95 (1.66-2.29)<br />

Reference Kronborg 2009 Birth Butler S, Williams M,<br />

Tukuitonga C & Paterson J<br />

The New Zealand Medical<br />

Journal 2004; 117.<br />

Scott JA, Binns CW, Oddy<br />

WH, Graham KI, Pediatrics<br />

2006; 117 e643-e655<br />

Clements et al Acta<br />

Paediatr, 1997; 86:51-56<br />

Type of study Cohort Prospective cohort Prospective cohort study Prospective cohort study<br />

Level of evidence II (aetiology) II (aetiology) II (aetiology) II (aetiology)<br />

Definition of<br />

breastfeeding<br />

Any breastfeeding<br />

duration<br />

Intervention<br />

Comparator<br />

EBF –defined as a child<br />

being fed only on mother’s<br />

milk<br />

Pacifier be<strong>for</strong>e 2 weeks<br />

v’s none or later<br />

Exclusive breastfeeding –<br />

other (includes water)<br />

Not breastfeeding exclusively<br />

Dummy used yes vs no<br />

(reference)<br />

Discontinuation of any be<strong>for</strong>e<br />

12 months and full<br />

breastfeeding be<strong>for</strong>e 6 months<br />

(WHO)<br />

Pacifier introduced<br />

< 4 wk<br />

4-10wk<br />

>10 wk<br />

Mot using a pacifier at 12 mo<br />

Pacifier use in last 2 weeks<br />

Yes vs no (ref)<br />

149

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