Abstract 27

Background. The use of pacifiers has been associated to early weaning in developing countries. Aim. To evaluate the association between use of the pacifier in the first months of life and duration of breastfeeding in Italy. Subjects and methods. Out of a sample of 1601 mothers randomly selected from all deliveries in Italy, November 1995, 1365 (85.3%) initiated breastfeeding and were prospectively followed-up with a scanner-ready questionnaire periodically administered by telephone up to 12 months of life. Results. Among mothers, 369 (27.0%) started to regularly use pacifiers for their babies within the first month of life. At 1, 2 and 3 months of life breastfeeding was reported in 83.0%, 63.4% and 49.6% among pacifier non-users and in 64.2%, 54.2% and 47.4% among pacifier-users respectively. The Cox-regression analysis showed a significantly shorter breastfeeding duration for infants using pacifiers(median 2.6 vs. 3.0 months, rate ratio = 1.62, 95% confidence interval 1.40-1.88). Conclusions. The early use of the pacifier is associated with a drastic reduction of the breastfeeding rate at 1 month even in a well-developed environment (such as Italy) and should be discouraged.