Context: Exclusive breast feeding, (EBF) protects young infants from infectious illnesses; various factors, including pacifier use, may adversely affect the initiation and duration of breast feeding. Evidence Acquisition: Mesh terms relating to EBF were used to search articles published in PubMed between 2000 and 2014. In addition to studies done outside Iran, articles from Iran addressing the issue of pacifier use in infants that had not been published in the PubMed, but were collected from Iranian journals, were also included. Regarding pacifier use, search was limited to papers published during the last 5 years.
Results:Rates of breastfeeding at 6 months were reported to vary from 3% to 95% and EBF from less than 1% to 33% in different parts of the world. A negative association between pacifier use and duration of breastfeeding was reported by 10 authors, with a meta-analysis from Turkey reporting a Risk Ratio of 1.952, 95% CI: 1.662 -2.293. Some researchers, although observed an association between pacifier use and early cessation of EBF, but refuted a causal relationship. Conclusions: As available data on the effect of pacifier use is conflicting, and continuation of breast feeding till 6 months of age is crucial for optimal health outcomes in infants, it is prudent to avoid pacifier use totally or at least till breast feeding is established.