SBU:s upplysningstjänst
Publikation nr: ut202114
Publicerad: 29 juni 2021
Nedladdad: 22 maj 2025
Påverkan på amning av tidig nappanvändning
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Amning etableras oftast under barnets första levnadsveckor. Det är oklart om napp inverkar negativt på amning under etableringsfasen.
Vilka vetenskapliga studier finns om effekten på etablering av amning vid introduktion av napp under de första två levnadsveckorna?
Frågeställare: Socialstyrelsen
Tidig introduktion av napp har lyfts fram som en möjlig orsak till problem vid amningsetablering. Ingen systematisk översikt har identifierats som undersökt effekten av tidig användning av napp på amningsetablering. Upplysningstjänsten har identifierat 13 primärstudier där sambandet mellan nappintroduktion under de första levnadsveckorna och amning under etableringsfas upp till de första tre månaderna var en av de aspekter som analyserats. Av dessa är elva studier observationsstudier, där studiedesignen gör det svårt att fastslå om det rör sig om orsakssamband mellan tidig nappintroduktion och amningsetablering. Amningsetableringen kan ha påverkats av andra faktorer än introduktion av napp.
Primärstudier granskas inte med avseende på risk för bias av Upplysningstjänsten så inga resultat eller slutsatser har redovisats i svaret, men studierna finns i tabellform i Bilaga 3 för den som önskar läsa mer.
På SBU:s upplysningstjänst identifierar och redovisar vi sammanställd forskning (systematiska översikter) eller identifierar vetenskapliga studier som svar på en avgränsad fråga. Vi bedömer risken för bias (överskattning eller underskattning av resultat) i systematiska översikter och presenterar författarnas slutsatser från systematiska översikter med låg eller måttlig risk för bias. I vetenskapliga primärstudier bedömer vi inte risken för bias och därför presenteras de bara som referenser. Vid behov bedömer vi kvalitet avseende ekonomiska aspekter och överförbarhet av resultat i hälsoekonomiska studier och presenterar författarnas slutsatser från de studier som bedöms ha minst medelhög kvalitet och överförbarhet. I svaren väger vi inte samman resultaten eller bedömer graden av vetenskaplig tillförlitlighet.
Bröstmjölken innehåller den näring som behövs för spädbarn och ger ett visst skydd mot infektionssjukdomar [1]. År 2018 ammades 94 procent av barnen i Sverige vid en veckas ålder och 83 procent vid två månaders ålder [2]. WHO rekommenderar att amning inleds under den första levnadstimmen och upprätthålls under minst 6 månader [3].
Napp används för att tillfredsställa sugreflexen hos små barn och kan trösta och lugna barnen, framför allt vid insomning. Det finns en misstanke att tidig introduktion av napp, när introduktionen sker under de första levnadsveckorna, skulle kunna störa etablering av amningen. Orsaker skulle exempelvis kunna vara att det försvårar för föräldrarna att avläsa och svara på barnens amningssignaler, skapar förvirring kring sugteknik hos barnet eller stör mjölkproduktionen om barnet suger mindre vid bröstet.
Detta svar har tagits fram efter förfrågan från Socialstyrelsen i samband med arbetet med att uppdatera den gällande översättningen ”10 steg som främjar amning” från 2014 [4]. SBU:s upplysningstjänst publicerar två svar på denna fråga, detta svar samt svaret ”Napp mot plötslig spädbarnsdöd”.
Vi har gjort sökningar i databaserna i databaserna MedLine (Ovid), Embase, CINAHL och Scopus (se Bilaga 1).
Vi har formulerat frågan enligt följande PICO1:
För att vi skulle inkludera en artikel i svaret krävde vi att den var publicerad på engelska eller ett av de skandinaviska språken.
1. PICO är ett sätt att strukturera upp en frågeställning för att underlätta sökning och granskning. PICO är en förkortning för patient/population/problem, intervention/index test, comparison/control (jämförelseintervention) och outcome (utfallsmått).
Primärstudier bedöms inte för risk för bias av SBU:s upplysningstjänst eftersom det ställer krav på sakkunskap inom forskningsområdet. Det är därför möjligt att flera av studierna kan ha haft högre risk för bias än de studier som SBU inkluderar i andra rapporter.
Upplysningstjänstens litteratursökning genererade totalt 929 artikelsammanfattningar (abstrakt) efter dubblettkontroll. Ett flödesschema för urvalsprocessen visas i Bilaga 2. Två utredare på SBU läste alla artikelsammanfattningar och bedömde att 91 kunde vara relevanta. Dessa artiklar lästes i fulltext av två utredare och de artiklar som inte var relevanta för frågan exkluderades. Exkluderade artiklar finns listade i Bilaga 4.
Upplysningstjänsten identifierade ingen översikt som var relevant för frågan. 13 primärstudier bedömdes som relevanta och inkluderades.
SBU:s upplysningstjänst identifierade 13 primärstudier [5–17], och dessa finns beskrivna i Bilaga 3. För primärstudier bedöms inte risken för bias och av det skälet finns inte resultat eller slutsatser beskrivna i text eller tabell.
Av de 13 inkluderade primärstudierna var 11 observationsstudier [5,6,8–16]. En svensk studie designades som en RCT, men analyserades även som en observationsstudie eftersom studiedeltagarna i de båda grupperna i hög grad avvek från den nappanvändning som föreskrevs i den studiegrupp de randomiserats till [7]. En äldre randomiserad studie jämförde en grupp där användning av alla sorters nappar och flaskor begränsades under BB-vistelsen med en grupp där nappar erbjöds alla barn och inga begränsningar kring flaskmatning gjordes [17].
Fyra primärstudier motsvarade inte frågeställningen med avseende på tidpunkt för nappintroduktion eller uppföljningstid, men bedöms ändå vara intressanta.
I en svensk kohortstudie från år 2012 analyserade Almquist-Tangen och medarbetare vilka faktorer som inverkade på att amning upphörde under de första fyra levnadsveckorna [18].
Jakaité och medarbetare undersökte i en nyligen publicerad observationsstudie från år 2021 faktorer för helamning vid sex månader, bland annat tidig introduktion av napp [19].
Vogel och medarbetare fokuserar i en kohortstudie från år 2001 på hur nappanvändning påverkar flera olika amningsutfall [20].
En dansk observationsstudie från år 2009 av Kronborg och medarbetare undersökte nappanvändning och amningsteknik och dess påverkan på hur länge mödrarna ammade sina spädbarn [21].
Detta svar är sammanställt av Emma Palmqvist Wojda (utredare), Idha Kurtsdotter (utredare), Lisa Forsberg (utredare), Sara Fundell (projektadministratör), Irene Edebert (produktsamordnare), Per Lytsy (medicinskt sakkunnig) samt Pernilla Östlund (avdelningschef) vid SBU.
Association between dummy use and breastfeeding
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| Search terms | Items found | |
| Population | ||
| 1. | TI ( newborn OR neonate* OR infant* ) OR AB ( newborn OR neonate* OR infant* ) OR SU ( newborn OR neonate* OR infant* ) | 319 040 |
| Intervention/Exposure | ||
| 2. | TI ( pacifier* OR comforter* OR soother* OR dummy OR dummies OR (non N1 nutri* N1 sucking) ) OR AB ( pacifier* OR comforter* OR soother* OR dummy OR dummies OR (non N1 nutri* N1 sucking) ) OR SU ( pacifier* OR comforter* OR soother* OR dummy OR dummies OR (non N1 nutri* N1 sucking) ) | 2 644 |
| Outcome | ||
| 3. | TI ( breastfeed* OR ‘breast feed*’ OR breastfed OR ‘breast fed’ OR wean* OR lactat* OR (nurs* N1 (newborn OR infant* OR mother*)) ) OR AB ( breastfeed* OR ‘breast feed*’ OR breastfed OR ‘breast fed’ OR wean* OR lactat* OR (nurs* N1 (newborn OR infant* OR mother*)) ) OR SU ( breastfeed* OR ‘breast feed*’ OR breastfed OR ‘breast fed’ OR wean* OR lactat* OR (nurs* N1 (newborn OR infant* OR mother*)) ) | 59 353 |
| Combined sets | ||
| 4. | 1 AND 2 AND 3 | 381 |
| Limits | ||
| 5. | Academic journals | |
| Final result | ||
| 4 AND 5 | 333 | |
Association between dummy use and breastfeeding
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| Search terms | Items found | |
| Population | ||
| 1. | ’newborn’/exp | 618 595 |
| 2. | (newborn OR neonate* OR infant*):ti,ab,kw | 715 116 |
| 3. | 1 OR 2 | 1 063 443 |
| Intervention/Exposure | ||
| 4. | ‘pacifier’/exp | 908 |
| 5. | (pacifier* OR comforter* OR soother* OR dummy OR dummies OR (non NEAR/2 nutri* NEAR/2 sucking)):ti,ab.kw | 9 912 |
| 6. | 4 OR 5 | 10 103 |
| Outcome | ||
| 7. | ‘breast feeding’/exp OR ‘breast milk’/exp OR ‘lactation’/exp | 126 809 |
| 8. | (breastfeed* OR ‘breast feed*’ OR breastfed OR ‘breast fed’ OR wean* OR lactat*):ti,ab,kw | 62 628 |
| 9. | (nurs* NEAR/2 (newborn OR infant* OR mother*)):ti,ab,kw | 4 725 |
| 10. | 7 OR 8 OR 9 | 143 191 |
| Limits: | ||
| 11. | (‘article’/it OR ‘article in press’ OR ‘review’/it) | |
| Combined sets | ||
| 12. | 3 AND 6 AND 10 | 651 |
| Final result | ||
| 11 AND 12 | 539 | |
Association between dummy use and breastfeeding
| .ab. = Abstract; .ab,ti. = Abstract or title; .af. = All fields; Exp = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; .sh. = Term from the Medline controlled vocabulary; .ti. = Title; / = Term from the Medline controlled vocabulary, but does not include terms found below this term in the MeSH hierarchy; * = Focus (if found in front of a MeSH-term); * or $ = Truncation (if found at the end of a free text term); .mp = Text, heading word, subject area node, title; “ “ = Citation Marks; searches for an exact phrase; ADJn = Positional operator that lets you retrieve records that contain your terms (in any order) within a specified number (n) of words of each other. | ||
| Search terms | Items found | |
| Population | ||
| 1. | infant, newborn/ | 619 168 |
| 2. | (newborn or infant* or neonat*).ab,kf,ti. | 724 224 |
| 3. | 1 or 2 | 1 036 640 |
| Intervention/Exposure | ||
| 4. | Pacifiers/ | 501 |
| 5. | (pacifier* or soother* or comforter* or dummy or dummies or (non adj1 nutriti* adj1 sucking)).ab,kf,ti. | 7 410 |
| 6. | 4 or 5 | |
| Outcome | ||
| 7. | Breast Feeding/ or Lactation/ or Lactation Disorders/ | 79 612 |
| 8. | (breastfeed* or breast feed* or breastfed or breast fed or wean* or lactat*).ab,kf,ti. | 211 289 |
| 9. | (nurs* adj2 (newborn or infant* or mother*)).ab,kf,ti. | 4 848 |
| 10. | 7 or 8 or 9 | |
| Combined sets | ||
| 11. | 3 and 6 and 10 | 529 |
| Final result | ||
| 529 | ||
Association between dummy use and breastfeeding
| TITLE-ABS-KEY = Title or abstract or keywords; ALL = All fields; PRE/n = "precedes by". The first term in the search must precede the second by a specified number of terms (n).; W/n = "Within". The terms in the search must be within a specified number of terms (n) in any order.; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; LIMIT-TO (SRCTYPE, "j" = Limit to source type journal; LIMIT-TO (DOCTYPE, "ar" = Limit to document type article; LIMIT-TO (DOCTYPE, "re" = Limit to document type review | ||
| Search terms | Items found | |
| Population | ||
| 1. | TITLE-ABS-KEY(infant OR newborn OR neonate) | 1 651 439 |
| Intervention/Exposure | ||
| 2. | TITLE-ABS-KEY(pacifier or dummy or comforter or soother or (non W/1 nutri* W/1 sucking)) | 24 419 |
| Outcome: Breast feeding | ||
| 3. | TITLE-ABS-KEY(breastfeed* OR “breast feed*” OR breastfed OR “breast fed” OR wean* OR lactat* OR (nurs* W/1 (newborn OR infant OR baby OR mother)) | 397 754 |
| Combined sets | ||
| 4. | 1 AND 2 AND 3 | 753 |
| Limits: | ||
| 5. | Limit to: article, review, letter | |
| Final result | ||
| 4 AND 5 | 711 | |
| Included studies/ setting | Population/ Exposure | Measured outcome |
| Carbonell X et al, 1998 The incidence of breastfeeding in our environment. [5] |
||
| Study type: Observational Setting: Barcelona, Spain Maternity clinic in hospital |
Population: 329 mothers and infants born during the study period Exposure: Early pacifier, during the first days of life |
Measured outcome of interest: Breastfeeding at 3 months |
| Declercq E et al, 2009 Hospital practices and women's likelihood of fulfilling their intention to exclusively breastfeed. [6] |
||
| Study type: National survey (Listening to Mothers II) Setting: USA |
Population: 915 women aged 18 to 45 years who had given birth in 2005 in a hospital to a singleton, still-living infant and were non-Hispanic Black or Hispanic Exposure: Hospital practice – the baby was given a pacifier in the hospital |
Measured outcome of interest: Exclusive breastfeeding at 1 week, stratified by parity |
| Hermanson Å et al, 2020 The effects of early pacifier use on breastfeeding: A randomised controlled trial. [7] |
||
| Study type: Designed as RCT, also analysed on exposure as an observation study. Setting: Sweden, Linköping University hospital |
Population: 239 mother-infant pairs. Mothers were primiparous; intended to breastfeed their infants for at least four months and gave birth to healthy full-term infants (>37 weeks of gestation, birth weight >2500 g). Intervention: Recommendation to offer a pacifier to their newborn child from the first day of life. Control: Recommendation to avoid pacifier to their newborn child during the first two weeks. |
Measured outcome of interest: Exclusive and partial breastfeeding at 2 months Primary outcome: Full and partial breastfeeding at 6 months |
| Howard CR et al, 1999 The effects of early pacifier use on breastfeeding duration. [8] |
||
| Study type: Prospective cohort Data from a larger RCT Setting: USA Three independent, obstetric practices in six clinical offices in and around the Greater Rochester, NY, area. |
Population: 265 breastfeeding mother–infant dyads Exposure of interest: |
Measured outcome of interest: Breastfeeding at 2 and 3 months |
| Huang YY et al, 2011 The study of pacifier use in relation to infant sucking, maternal perception of milk supply and breastfeeding duration. [16] |
||
| Study type: Longitudinal Setting: Taiwan |
Population: 241 mother-infant pairs Exposure of interest: Pacifier use at day 3 and at 2 weeks after birth |
Measured outcome of interest: Infant sucking technique Exclusive breastfeeding at 3 days and two weeks |
| Ingram J et al, 2002 Breastfeeding in Bristol: teaching good positioning, and support from fathers and families. [9] |
||
| Study type: Non-randomised prospective cohort Setting: One postnatal hospital ward. |
Population: 1325 mothers that were breastfeeding Exposure: Dummy by 2 weeks |
Measured outcome of interest: Any breastfeeding at 2 weeks |
| Kair LR et al, 2013 Pacifier restriction and exclusive breastfeeding. [11] |
||
| Study type: Retrospective before and after study Setting: USA |
Population: 2249 infants admitted to the mother-baby unit at a university teaching hospital Exposure: Hospital practice – restricted routine pacifier distribution |
Measured outcome of interest: Exclusive breastfeeding in the hospital Exclusive formula-feeding in the hospital |
| Kair LR et al, 2017 Association Between In-Hospital Pacifier Use and Breastfeeding Continuation and Exclusivity: Neonatal Intensive Care Unit Admission as a Possible Effect Modifier. [10] |
||
| Study type: Cross-sectional survey CDC Pregnancy Risk Assessment Monitoring System (PRAMS) Survey at 4 months postpartum Setting: USA, 10 states |
Population: 37628 mothers who were chosen by random birth certificate sampling Exposure: Pacifier use during the birth hospitalization |
Measured outcome of interest: Exclusive breastfeeding ≥10 weeks Any breastfeeding ≥10 weeks |
| Marques NM et al, 2001 Breastfeeding and early weaning practices in northeast Brazil: a longitudinal study. [12] |
||
| Study type: Observational Setting: Hospitals, multicentre, Pernambuco state, Brazil |
Population: Mothers of infants with a birth weight of >2500 g (n=364) Exposure of interest:: Pacifier introduction ≥7 days of age. |
Measured outcome of interest: Introduction of other milk in first month of life |
| Pineda R et al, 2018 Pacifier use in newborns: related to socioeconomic status but not to early feeding performance. [13] |
||
| Study type: Observational; survey and feeding assessment Setting: Single hospital, United States |
Population: Mother-infant dyads (n=51). Infants born >37 weeks of gestation. Exposure: Pacifier use at hospital. |
Measured outcome of interest: Exclusively breastfed at hospital |
| Schliep KC et al, 2019 Factors in the Hospital Experience Associated with Postpartum Breastfeeding Success. [14] |
||
| Study type: Survey, Utah Pregnancy Risk Assessment Monitoring System (UT PRAMS) Setting: Hospitals, multicentre, Utah, United States |
Population: Mothers who gave birth in hospital (n=5501) Exposure of interest: Pacifier given by hospital staff |
Measured outcome of interest: Breastfeeding <2 months |
| Schubiger G et al, 1997 UNICEF/WHO baby-friendly hospital initiative: does the use of bottles and pacifiers in the neonatal nursery prevent successful breastfeeding? [17] |
||
| Study type: Multicentre prospective randomized trial. Setting: Maternity services at 10 hospitals, Switzerland. Included hospitals had established functioning breastfeeding programmes with early initiation of breastfeeding, lactation consultants, unrestricted rooming-in and policy of restricted infant formula use |
Population: 602 healthy newborns >37 weeks of gestation with mothers intending to stay at hospital for 5 days postpartum and planning to breast-feed for ≥3 months. Intervention/control:UNICEF group [adhering to step six and nine in Baby-friendly hospital initiative]: Bottles, teats and pacifiers strictly forbidden; supplements, administered by cup or spoon, only given if medically indicated. Standard group: Pacifiers offered to all infants without restriction; supplements conventionally offered by bottle after breastfeeding. |
Measured outcome of interest: Breastfeeding at day 5 and 2 months. |
| Sipsma HL et al, 2017 Pacifiers and Exclusive Breastfeeding: Does Risk for Postpartum Depression Modify the Association? [15] |
||
| Study type:: National survey Setting: Hospitals, multicentre, United States |
Population: Mothers of healthy singleton babies >37 weeks of gestation, planning to breastfeed exclusively or in combination with formula (n=1349) High risk for postpartum depression: 6.7% (n=91) Lower risk for postpartum depression: 93.3% (n=1258) Exposure: Receiving pacifier in hospital |
Measured outcome of interest: Exclusive breastfeeding at one week Exclusive breastfeeding at three weeks |
| Exkluderade studier | Kommentar | |
| Systematiska översikter | ||
| Nasjonalt kunnskapssenter for helsetjenesten. Samsoving, smokk, amming og krybbedød – finnes det en sammenheng? 2005. | Fel napp-exponering och amningsutfall | |
| Buccini GDS, Pérez-Escamilla R, Paulino LM, Araújo CL, Venancio SI. Pacifier use and interruption of exclusive breastfeeding: Systematic review and meta-analysis. Matern Child Nutr. 2017;13(3). Available from: https://doi.org/10.1111/mcn.12384. | Fel napp-exponering och amningsutfall | |
| Callaghan A, Kendall G, Lock C, Mahony A, Payne J, Verrier L. Association between pacifier use and breast-feeding, sudden infant death syndrome, infection and dental malocclusion. Int J Evid Based Healthc. 2005;3(6):147-67. Available from: https://doi.org/10.1111/j.1479-6988.2005.00024.x. | Fel napp-exponering och amningsutfall | |
| Hewitt K, Binns C, Scott J, Forbes D. Pacifier use, breastfeeding and sudden infant death syndrome. Curr Pediatr Rev. 2012;8(4):285-91. Available from: https://doi.org/10.2174/157339612803307697. | Fel napp-exponering och amningsutfall | |
| Jaafar SH, Ho JJ, Jahanfar S, Angolkar M. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2016;2016(8). Available from: https://doi.org/10.1002/14651858.CD007202.pub4. | Fel napp-exponering och amningsutfall | |
| Jaafar SH, Jahanfar S, Angolkar M, Ho JJ. Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding. The Cochrane database of systematic reviews. 2011(3):CD007202. Available from: https://doi.org/https://dx.doi.org/10.1002/14651858.CD007202.pub2. | Uppdaterad I Jaafar 2016 | |
| Jaafar SH, Jahanfar S, Angolkar M, Ho JJ. Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2011(3):CD007202. Available from: https://doi.org/10.1002/14651858.CD007202.pub2. | Uppdaterad I Jaafar 2016 | |
| Jaafar SH, Jahanfar S, Angolkar M, Ho JJ. Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Evid Based Child Health. 2012;7(3):1157-79. Available from: https://doi.org/10.1002/ebch.1853. | Parallellpublikation till Jaafar 2012 som uppdateras i Jaafar 2016 | |
| Kair LR, Jaffe AC, Phillipi CA. In healthy term infants, does restriction from pacifiers in the first two to four weeks of life increase breastfeeding duration? Paediatr Child Health. 2013;18(9):473-4. | Fel publikationstyp, ej systematisk översikt | |
| O'Connor NR, Tanabe KO, Siadaty MS, Hauck FR. Pacifiers and breastfeeding: A systematic review. Arch Pediatr Adolesc Med. 2009;163(4):378-82. Available from: https://doi.org/10.1001/archpediatrics.2008.578. | 4 inkluderade RCT. Två relevanta för vårt PICO, men utan särredovisning eller summering | |
| Renfrew MJ, Craig D, Dyson L, McCormick F, Rice S, King SE, et al. Breastfeeding promotion for infants in neonatal units: A systematic review and economic analysis. Health Technol Assess. 2009;13(40):ix-170. Available from: https://doi.org/10.3310/hta13400. | HTA rapport. Fel napp-exponering och amningsutfall | |
| Ullah S, Griffiths P. Does the use of pacifiers shorten breastfeeding duration in infants? Br J Community Nurs. 2003;8(10):458-63. Available from: https://doi.org/10.12968/bjcn.2003.8.10.11699. | Fel publikationstyp, ej systematisk översikt | |
| Primärstudier | ||
| Aarts C, Hornell A, Kylberg E, Hofv, er Y, Gebre-Medhin M. Breastfeeding patterns in relation to thumb sucking and pacifier use. Pediatrics. 1999;104(4):e50. | Fel amningsutfall | |
| Al-Hafidh NM, Al-Sawaf FB, Khalaf RH. Effect of pacifier use on feeding practice in early infancy. Ann Trop Med Public Health. 2020;23(19). Available from: https://doi.org/10.36295/ASRO.2020.232104. | Fel amningsutfall | |
| Almquist-Tangen G, Bergman S, Dahlgren J, Roswall J, Alm B. Factors associated with discontinuation of breastfeeding before 1 month of age. Acta paediatrica (Oslo, Norway : 1992). 2012;101(1):55-60. Available from: https://doi.org/https://dx.doi.org/10.1111/j.1651-2227.2011.02405.x. | Fel napp-exponering och amningsutfall. Inkluderad som lästips |
|
| Ayton J, Van Der Mei I, Wills K, Hansen E, Nelson M. Cumulative risks and cessation of exclusive breast feeding: Australian cross-sectional survey. Arch Dis in Child. 2015;100(9):863-8. Available from: https://doi.org/https://dx.doi.org/10.1136/archdischild-2014-307833. | Fel napp-exponering och amningsutfall | |
| WHO. Multicentre Growth Reference Study Group. Breastfeeding in the WHO Multicentre Growth Reference Study. Acta Paediatr Suppl. 2006;450:16-26. | Fel amningsutfall | |
| Batista CLC, Ribeiro VS, Nascimento MDDSB, Rodrigues VP. Association between pacifier use and bottle-feeding and unfavorable behaviors during breastfeeding. J Pediatr. 2018;94(6):596-601. Available from: https://doi.org/10.1016/j.jped.2017.10.005. | Fel napp-exponering och amningsutfall | |
| Binns CW, Scott JA. Using pacifiers: what are breastfeeding mothers doing? Breastfeed Rev. 2002;10(2):21-5. | Fel utfall | |
| Boccolini CS, de Carvalho ML, Couto de Oliveira MI. Factors associated with exclusive breastfeeding in the first six months of life in Brazil: A systematic review. Rev Saude Publica. 2015;49. Available from: https://doi.org/10.1590/S0034-8910.2015049005971. | Fel napp-exponering | |
| Buccini GDS, Pérez-Escamilla R, Venancio SI. Pacifier Use and Exclusive Breastfeeding in Brazil. J Human Lactation. 2016;32(3):NP52-NP60. Available from: https://doi.org/10.1177/0890334415609611. | Fel napp-exponering och amningsutfall | |
| Butler S, Williams M, Tukuitonga C, Paterson J. Factors associated with not breastfeeding exclusively among mothers of a cohort of Pacific infants in New Zealand. New Zealand Med J. 2004;117(1195). | Fel napp-exponering | |
| Carvalho CAd, Fonseca PCdA, Nobre LN, Silva MA, Pessoa MC, Ribeiro AQ, et al. Sociodemographic, perinatal and behavioral factors associated to types of milk consumed by children under in six months: birth coort. Fatores sociodemograficos, perinatais e comportamentais associados aos tipos de leite consumidos por criancas menores de seis meses: coorte de nascimento. 2017;22(11):3699-710. Available from: https://doi.org/https://dx.doi.org/10.1590/1413-812320172211.28482015. | Fel napp-exponering | |
| de Carvalho CA, Fonsêca PCA, Nobre LN, Silva MA, Pessoa MC, Ribeiro AQ, et al. Sociodemographic, perinatal and behavioral factors associated to types of milk consumed by children under in six months: Birth coort. Cien Saude Colet. 2017;22(11):3699-709. | Dubblett | |
| Callendret M, Gelbert-Baudino N, Raskovalova T, Piskunov D, Schelstraëte C, Durand M, et al. Hospital practices and breastfeeding cessation risk within 6 months of delivery. Arch Pediatr. 2015;22(9):924-31. Available from: https://doi.org/10.1016/j.arcped.2015.06.017. | Språk, franska | |
| Castilho SD, Casagrande RC, Rached CR, Nucci LB. Prevalence of pacifier among breastfed and not breastfed infants attending a university hospital. Rev Paul Pediatr. 2012;30(2):166-72. Available from: https://doi.org/10.1590/S0103-05822012000200003. | Fel amningsutfall | |
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