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    There are some aspects of child rearing which are hardy perennials; they include teething, circumcision, thumb sucking, and dummies (pacifiers). Dummies have attracted their fair share of emotion, being regarded by some with disdain or even disgust. The World Health Organisation is against them on the grounds that they lead to early weaning. Observational studies have shown that babies with dummies are weaned earlier but cannot demonstrate cause and effect. Now a randomised trial in Montreal (Michael S Kramer.Journal of the American Medical Association2001;286:322–6) has suggested that dummy use does not cause early weaning.

    They studied 281 healthy, breast-feeding, mother–singleton infant pairs who were randomised to receive nurse counselling with (experimental) or without (control) advice on avoiding use of a dummy and on the use of alternative comforting methods (breastfeeding, carrying, rocking). Two hundred and fifty eight mother–infant pairs completed the study.

    Dummy use was decreased in the experimental group (total avoidance 39%v 16%, daily use 41%v 56%). The rate of weaning by 3 months, however, was not significantly different between the two groups (18.9%v 18.3%) and dummy use had no significant effect on daily duration of crying or fussing at 4, 6, or 9 weeks. When randomised group allocation was ignored, dummy use was strongly associated with earlier weaning (weaning by 3 months: 35% (daily dummy users) v 13% (nonusers)).

    Counselling can reduce the rate of dummy use but does not affect the rate of early weaning. It seems likely that mothers who use dummies may be more inclined to wean early but that dummy use is a consequence rather than a cause of this inclination.

    Parents like dummies. Even in the group counselled against using them, over 60% of mothers used them. This study suggests that dummy use may be a predictor but not a cause of early weaning. The authors write that breastfeeding promotion programmes and international agencies should re-examine their staunch opposition to dummies.

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