breastfed newborns (36-42 weeks gestation, birth weight = 2200 g) were
randomly assigned to 1 of 4 intervention groups: bottle/early pacifier
(n=169), bottle/late pacifier (n=167), cup/early pacifier (n=185), or
cup/late pacifier (n=179). Cup/bottle intervention was invoked for infants
who received supplemental feedings: cup (n=251), bottle (n=251).1
feedings, regardless of method (cup or bottle), had a detrimental effect
on exclusive (HR 1.49, 95% CI 1.23-1.80), full (HR 1.50, 95% CI 1.24-1.81),
and overall (HR 1.53, 95% CI 1.24-1.89) breastfeeding duration.
was no significant difference between cupfeeding or bottle feeding on
were modified by the number of supplements. Exclusive (p < 0.0001)
and full (p = 0.0002) breastfeeding were prolonged by cupfeeding in
infants requiring > 3 supplements.
infants delivered by cesarean, cupfeeding significantly prolonged exclusive
(10 days, p = 0.04), full (5 weeks, p = 0.02), and overall (10 weeks,
p = 0.04) breastfeeding.
breastfeeding at 4 months postpartum was less likely among infants exposed
to pacifiers. (early pacifier group; OR 1.5, 95% CI 1.0-2.0).
(2-5 days), as compared to late (4 weeks), pacifier introduction shortened
overall (adjusted HR 1.22; 95% CI 1.03-1.44), but not exclusive or full
was no significant effect of the cup or bottle intervention on the frequency
of breastfeeding in the hospital or the occurrence of early breastfeeding
problems (maternal nipple trauma, infant weight loss, latch problems,
peripartum breastfeeding cessation, peak bilirubin level).
- In the first 6
months postpartum, there was no significant effect of the pacifier intervention
of breastfeeding frequency or in the occurrence of problems (maternal
nipple trauma, refusal of infant to nurse, chances of mother seeking
help for breastfeeding problems, development of low milk supple, occurrence
of jaundice, or time until infant regained its birth weight.)