Pacifier and bottle nipples: the targets for poor breastfeeding outcomes.

The act of feeding an infant is extremely complex. Feeding requires the infant to coordinate five cranial nerves, multiple spinal segments in the chest wall, and 30 pairs of muscles across several physiological systems (oral, pharyngeal, laryngeal, and respiratory). In addition, successful feeding is dependent on optimal infant state and positive caregiver interactions. Recently, Goldfield, Perez, and Engsteler described newborn feeding as a complex dynamical system given all the critical components it entails. This complex dynamic system is especially at play during the most challenging of the infant feeding tasks, breastfeeding. Breastfeeding is considered the gold standard for infant feeding, as it provides ideal nutrition. In fact, the World Health Organization recommends exclusive breastfeeding from birth until six months of life. Given the many benefits for mother and baby afforded by breastfeeding, there have been several campaigns to increase breastfeeding rates in women. One such campaign was the ‘‘Breast is Best,’’ which was designed to educate communities on the importance of breastfeeding; its signage has been widely advertised in doctor offices and across literature directed toward mothers. In response to this movement, many women reported feeling