Illustration of a mother breastfeeding her baby, with a pacifier transforming into a healthy plant.

Bye-Bye Binky: How Pacifier Use Impacts Breastfeeding Success

Rhea Morgan in Health & Wellness June 2025 • 4 min read.

"Uncover the surprising link between pacifiers and breastfeeding duration in Brazil, and what it means for parents worldwide."

Breastfeeding is globally recognized as the gold standard for infant nutrition, offering a wealth of short- and long-term benefits for both baby and mother. From boosting the infant's immune system to reducing the mother's risk of certain diseases, the advantages are well-documented. Recognizing these benefits, organizations like the World Health Assembly (WHA) have set ambitious targets to increase exclusive breastfeeding rates worldwide.

Exclusive breastfeeding (EBF), defined as providing only breast milk to an infant for the first six months of life, is a key indicator of optimal infant health. While global EBF rates have improved over the past few decades, progress has been uneven, and many countries are still striving to meet the WHA's goal of 50% EBF by 2025. Identifying modifiable factors that can help boost EBF rates is crucial for achieving this target.

One such factor that has garnered increasing attention is pacifier use. While pacifiers can provide comfort to infants, studies have suggested a potential link between pacifier use and reduced breastfeeding duration. However, the precise impact of pacifier use on EBF rates has remained a topic of debate. A groundbreaking study conducted in Brazil sheds new light on this issue, providing compelling evidence of the positive impact of reducing pacifier use on exclusive breastfeeding.

The Brazilian Breastfeeding Breakthrough: Pacifiers Under the Microscope

Illustration of a mother breastfeeding her baby, with a pacifier transforming into a healthy plant.

Researchers in Brazil undertook a comprehensive study to investigate the relationship between pacifier use and exclusive breastfeeding rates. By analyzing data from two large, nationally representative surveys conducted in 1999 and 2008, involving over 42,000 infants, the researchers were able to quantify the impact of pacifier use on breastfeeding practices.

The study revealed a significant increase in exclusive breastfeeding rates in Brazil between 1999 and 2008, rising by an impressive 15.2 percentage points. Over the same period, pacifier use among infants under 6 months of age decreased by approximately 17 percentage points. This initial observation hinted at a possible connection between the two trends.

Pacifier Prevalence: In 1999, 58.5% of infants used pacifiers, which decreased to 41.6% by 2008.
EBF Rates: Exclusive breastfeeding rates rose from 25.1% in 1999 to 40.3% in 2008.
Key Finding: The study estimated that a reduction in pacifier use could account for an increase of approximately 5.5 percentage points in exclusive breastfeeding rates.

To delve deeper into the relationship, the researchers employed a sophisticated statistical technique called multilevel regression analysis. This method allowed them to account for various factors that could influence breastfeeding practices, such as maternal education, socioeconomic status, and access to healthcare. After controlling for these variables, the analysis revealed that reducing pacifier use could explain a significant portion of the increase in exclusive breastfeeding rates.

The Takeaway: Small Changes, Big Impact for Breastfeeding Success

The Brazilian study provides compelling evidence that reducing pacifier use can have a significant positive impact on exclusive breastfeeding rates. By highlighting the importance of this modifiable factor, the study offers valuable insights for healthcare professionals, policymakers, and parents alike. Encouraging mothers to delay or limit pacifier use, while providing support for alternative soothing methods, could be a simple yet effective strategy for promoting optimal infant health and achieving global breastfeeding goals.

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This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0208261, Alternate LINK

Title: Exclusive Breastfeeding Changes In Brazil Attributable To Pacifier Use

Subject: Multidisciplinary

Journal: PLOS ONE

Publisher: Public Library of Science (PLoS)

Authors: Gabriela Buccini, Rafael Pérez-Escamilla, Maria Helena D’Aquino Benicio, Elsa Regina Justo Giugliani, Sonia Isoyama Venancio

Published: 2018-12-19

Everything You Need To Know

What is exclusive breastfeeding, and why is it important?

Exclusive breastfeeding (EBF) is when an infant receives only breast milk for the first six months of life. This means no formula, water, or other foods are given during this period. EBF is considered the gold standard for infant nutrition due to the numerous health benefits it provides, such as boosting the infant's immune system. The World Health Assembly (WHA) has set targets to increase EBF rates globally, making it a crucial focus for public health initiatives.

What are pacifiers, and how do they relate to breastfeeding?

Pacifiers are devices that can provide comfort to infants. However, studies, including the one conducted in Brazil, suggest a potential link between pacifier use and reduced breastfeeding duration. The study found a significant decrease in pacifier use between 1999 and 2008. The research indicates that reducing pacifier use can positively affect exclusive breastfeeding rates, offering insights for healthcare professionals and parents.

What were the key findings of the Brazilian study regarding breastfeeding and pacifier use?

The Brazilian study revealed a significant increase in exclusive breastfeeding rates between 1999 and 2008. During this time, the exclusive breastfeeding rates rose by 15.2 percentage points. This increase coincided with a decrease in pacifier use among infants under 6 months of age. The study estimated that a reduction in pacifier use could account for an increase of approximately 5.5 percentage points in exclusive breastfeeding rates. The research used data from two large nationally representative surveys.

How did the researchers analyze the data to understand the relationship between pacifier use and breastfeeding?

The study employed a statistical technique called multilevel regression analysis. This method allowed researchers to account for factors that could influence breastfeeding practices, such as maternal education, socioeconomic status, and access to healthcare. After controlling for these variables, the analysis confirmed that the decrease in pacifier use was linked to the rise in exclusive breastfeeding rates.

What are the practical implications of these findings for parents and healthcare professionals?

The implications of the study suggest that encouraging mothers to delay or limit pacifier use can improve exclusive breastfeeding rates. This supports promoting optimal infant health and achieving global breastfeeding goals. It highlights a simple yet effective strategy for healthcare professionals, policymakers, and parents. This is especially relevant because the World Health Assembly has set goals for increased exclusive breastfeeding rates worldwide.