The binky vs. the breast (USATODAY.com)

Should you give your baby a binky at bedtime?
The American Academy of Pediatrics (AAP) says yes: In new guidelines on preventing sudden infant death syndrome (SIDS), the group urges parents to offer pacifiers at nap and bedtimes. The academy cites research showing babies who nod off with pacifiers are 61% less likely to die of SIDS than otherwise similar babies who don't. The doctors speculate that pacifiers may help keep airways clear or may keep babies from sleeping too deeply or rolling onto tummies.

Contrary to popular belief, the academy says, pacifiers don't ruin teeth and don't cause enough infant ear infections to negate their benefits. And, the doctors say there isn't compelling evidence that pacifiers inhibit breast-feeding.

Case closed? Not for everyone. In fact, some advocates of breast-feeding and "attachment parenting" are aghast at the pacifier advice and are urging parents to disregard it (along with another recommendation that discourages sharing a bed with a baby).

"The breast-feeding community is very upset," says Katy Lebbing, a spokeswoman for La Leche League International. "Basically, they are telling us to use an artificial substitute for something a mother usually does."

To be well-nourished — and keep up a mother's milk supply — a baby must nurse often, including at bedtime, advocates say. They say the academy ignored studies suggesting babies who use pacifiers nurse less. But they are as worried about nurturing as they are about nutrition.



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