把乳房當安撫奶嘴是什麼意思? What Does It Mean to 'Use Your Breast as a Pacifier?'
翻譯：IBCLC簡世華
*相信寶寶沒有心機，一直吸吮表示他就是需要妳
*密集吸吮--是寶寶自己增加奶量的方式
*天然的尚好！乳房會自動調控奶速，寶寶吃得剛剛好
*奶嘴是配合奶瓶而來，預防過度餵食的危險
*相信寶寶沒有心機，一直吸吮表示他就是需要妳
*密集吸吮--是寶寶自己增加奶量的方式
*天然的尚好！乳房會自動調控奶速，寶寶吃得剛剛好
*奶嘴是配合奶瓶而來，預防過度餵食的危險
哺乳母親常被警告說:"別讓寶寶把妳的乳房當作安撫奶嘴"。這真是令人難以置信的一句話，即使經常有人這麼說。是先有乳房？還是先有奶嘴？ 當然乳房早於奶嘴。奶嘴（又名"模仿物"），是在近代人類歷史上被設計代替乳房來安撫嬰兒的人造品。
Nursing mothers are commonly warned: “Don’t let your baby use your breast as a pacifier.” Although often said, this is an incredibly curious statement. After all, which came first, the breast or the pacifier? The breast, of course, long predates the pacifier (aka “dummy”), a man-made device designed late in human history to soothe babies as a breast substitute.
如果奶嘴是乳房的替代品，到底讓寶寶“用你的乳房作為安撫奶嘴？”是什麼意思?
If the pacifier is indeed a breast substitute, then what on earth could it possibly mean to let your baby “use your breast as a pacifier?”
真相是什麼？
這個建議是假設寶寶對乳房的慾望是不合理的。畢竟，如果嬰兒對乳汁的需要是合理的，用奶嘴絕對行不通。根據定義，奶嘴不會有乳汁流出來。重點是，如果嬰兒哺乳的"時間夠久"（建議的分鐘數因人而異），嬰兒不再需要乳汁，所以吸吮奶嘴就夠了。然而，根據文章所述，有些孩子喝得很快，有些則是慢慢喝。寶寶哺乳的分鐘數無法告訴我們她喝到了多少。
What Is the Real Message?
The assumption underlying this advice is that baby’s desire for the breast is unreasonable. After all, if the baby’s need for milk was legitimate, the pacifier would never do. By definition, no milk flows from a pacifier. The point seems to be that if the baby nursed “long enough” (and the number of acceptable minutes varies by adviser), the baby no longer needs milk, so sucking on a pacifier should be good enough. However, as explained in THIS POST, some babies are fast feeders and others are slow feeders. The number of minutes a baby nurses tells us nothing about the volume of milk consumed.
有時嬰兒吸吮母乳卻沒喝到奶嗎？確實有。你可能會注意到寶寶常常輕輕含你的乳房，大多時候是睡著了。在這種情況下，您的寶寶的確可能在吸吮但不是在喝奶。這就是所謂的"別讓寶寶把乳房當作安撫奶嘴"嗎？
Do babies sometimes breastfeed without taking milk? It does happen. Every so often you may notice your baby softly mouthing your breast while mostly asleep. In this case, your baby may indeed be sucking but not drinking. Is this what those who say “Don’t let your baby use your breast as a pacifier” are referring to?
我不這麼認為。當疲憊的母親報告她的馬拉松式哺乳之後，通常得到此建議，然而這在最初的頭幾個星期是個普遍的現象。 "密集哺乳"，或哺乳集中在一天內某些時段，是快速增長的嬰兒提高奶量的方式。這樣做是因為"排空的乳房使乳汁更快充盈"。
I don’t think so. This advice usually follows a weary mother’s report of a marathon nursing session, a common occurrence in the early weeks. “Cluster nursing,” or bunching feedings close together during part of the day, is a fast-growing baby’s way of boosting milk production when needed. This works because “drained breasts make milk faster.”
然而，如果母親在這時候規律的以奶嘴代替她的乳房，會打斷她孩子在增加奶量上的努力。這是為什麼美國兒科學會 (AAP) 建議母親按照線索餵嬰兒 （見 2012 AAP 政策聲明）。AAP 鼓勵父母每當孩子表現出餵養線索時，就哺餵他們（活動力增加，尋根反射，動嘴），無論這些線索多麼頻繁出現。
However, if a mother regularly substitutes a pacifier for her breast at these times, this can short-circuit her baby’s efforts to increase her milk. That’s why the American Academy of Pediatrics (AAP) recommends babies be breastfed on cue (see the 2012 AAP policy statement HERE). The AAP encourages parents to feed their babies whenever they show feeding cues (increased activity, rooting, mouthing), no matter how often these cues appear.
根據美國兒科學會所述，嬰兒的餵養線索永遠不會不合理。事實上，在第一個月，當奶量供應正在建立期間，AAP 具體建議避免使用安撫奶嘴，正是因為過於頻繁使用這個"乳房替代品"，會破壞健康奶量供應的建立。
Babies’ feeding cues are never unreasonable, according to the AAP. In fact, during the first month, while milk supply is being established, the AAP specifically recommends avoiding pacifier use precisely because too-frequent use of this “breast substitute” can undermine the establishment of a healthy milk supply.
你的寶寶可以信任嗎？
另一方面這個"別讓寶寶把乳房當作安撫奶嘴"的建議，是暗藏傷害的。母親必須小心，“防範孩子利用她"的這種想法，有可能破壞她對寶寶的信任，損壞她們之間的關係，阻止她們獲得保持同步的自然狀態。此奇怪的警告是站不住腳的西方神話的親戚: 「新生兒可以在他們有心智能力這樣做之前，"操縱"他們的父母。」
Can Your Baby Be Trusted?
But there’s another aspect to this “Don’t let your baby use your breast as a pacifier” advice that is positively insidious. The idea that a mother must be careful not to let her baby “use her” has the potential to undermine her trust in her baby, driving a wedge between them and preventing them from getting in sync the way nature intended. This curious warning is the not-too-distant cousin of the indefensible Western myth that newborns can “manipulate” their parents, even before they have the mental ability to do so.
舉個例子，在最近一次母親支持聚會上有位母親對我說，每當她的寶貝女兒表現出餵養線索時，其實不需要喝奶，因為她只想做"非營養性吸吮"。這位母親已經在孩子體重增加緩慢上掙扎，最近開始更頻繁哺餵，而不堅持她原本的餵養時程表了。因為這個寶寶更頻繁哺乳，她的體重增加得到了改善。
As a case in point, a mother recently said to me at a mother-support meeting that her baby girl didn’t really need to nurse whenever she showed feeding cues because she was mostly doing “non-nutritive sucking.” This mother had been struggling with her baby’s slow weight gain and had recently started nursing more often instead of sticking to the feeding schedule she had first adopted. Because this baby was breastfeeding more, her weight gain had improved.
我問這位母親，她是怎麼知道她的孩子在她乳房上的時間 （這是"非營養性吸吮"會發生的） 越來越沒有奶。我發現她才恍然大悟，這位母親微笑著承認，其實她真的不知道。 我告訴她，我總是假設在懷中吃奶的嬰兒喝得到奶。
I asked this mother how she knew her baby was getting no milk during her time at the breast (which is what happens during “non-nutritive sucking”). I could see the realization dawn in her eyes. Smiling, this mother admitted that she really didn’t know that. I told her that I always assume a baby nursing at breast is getting milk.
在那一刻，這位母親意識到事後批評她的寶寶已經對兩者產生反作用。她理解為了充分解決她寶寶的體重增加的問題，她必須相信她的寶寶知道自己需要什麼，需要多長的時間。（她的寶寶是健康足月兒，所以她可以充滿信心接受孩子的引導）。當她決定相信寶寶時，什麼時候該哺乳，成了她寶寶的工作，不是她的 。當她想通時，她終於放鬆下來，感到重擔解除了。
At that moment, this mother realized that second-guessing her baby had been counterproductive for them both. She understood that to fully resolve her baby’s weight-gain issues she had to trust her baby to know what she needed, when she needed it, and for how long. (Her baby was full term and healthy, so she could follow her baby’s lead with confidence.) When she made the decision to trust her baby, it became her baby’s job—not hers—to know when to nurse. While I watched these mental wheels turn, this mother visibly relaxed as she felt her burden lifted.
誰想要傷害的世界呢？您的寶寶“用你的乳房作為安撫奶嘴”是什麼意思? 當你從母乳哺餵是如何進行的方向來思考，就知道這是胡說八道。但如果母親採納了基於此假設的建議，將帶她走向一個傷害的世界。她若相信必須防範寶寶"利用她"可能會破壞母乳餵養，她與嬰兒的關係，和她對整個母職的看法。誰需要這種對孩子的負面看法？當新手媽媽已經夠艱鉅了，不需要再有這些。
Who Needs This World of Hurt?
What does it mean for your baby to “use your breast as a pacifier?” When you think it through in terms of how breastfeeding works, it is actually total nonsense. But if a mother buys into the assumptions that underlie this advice, it opens her up to a world of hurt. Believing that she has to guard against her baby “using her” has the potential to undermine breastfeeding, her relationship with her baby, and indeed her whole outlook on motherhood. Who needs this kind of negative take on their baby? Even without it, new motherhood is challenging enough.
這種奇怪的觀點又是從哪裡來的？我猜它源於配方餵養的準則。畢竟，用奶瓶哺餵嬰兒時，過量是真正的風險。從奶瓶流出的奶，又快速又連續，嬰兒幾乎無法自行控制攝取奶量。另一方面，由於噴乳反射造成乳房奶速快慢交替，母乳餵養會自動教孩子健康的自我管理。（更多關於乳房和奶瓶如何影響過度餵食和肥胖的風險，見這 2012年的研究）。
Where did this odd outlook come from? I’m guessing it stems from formula-feeding norms. After all, when babies are bottle-fed, overfeeding is a genuine risk. Milk from a bottle flows so fast and consistently that babies have little control over their milk intake. At the breast, on the other hand, due to the alternating fast-then-slow milk flow from letdowns, breastfeeding automatically teaches our babies healthy self-regulation. (For more on how breast and bottle affect risk of overfeeding and obesity, see THIS 2012 study.)
為了防止奶瓶餵養期間過度餵食，可以在嬰兒看來喝飽時停止，給他吸乳房代替品(奶嘴)，讓他的食慾控制機制有機會啟動。（讓寶寶在快速奶流中規律休息，正是節奏式奶瓶餵食所描述的）。在奶瓶餵養過程中，使用奶嘴是一個好策略，但在哺餵母乳時則絕對不是。
To prevent overfeeding during bottle-feeding, it may actually make sense to stop a feed before baby appears to be done and give him a breast substitute to suck on so that his appetite control mechanism has a chance to activate. (Giving a baby regular breaks from fast milk flow while being bottle-fed is one way to prevent overfeeding and is one aspect of the paced bottle-feeding described HERE.) But even though this strategy may be good during bottle-feeding, it is definitely not good when breastfeeding.
嬰兒知道他們需要什麼。快樂和滿足的母乳餵養關係，建立在母親對她孩子的信任。只有在常規餵配方奶還活躍在文化記憶裡的地方，"不要讓寶寶用妳的乳房作為安撫奶嘴"這樣的建議才能生根和具有吸引力。如果我們希望我們的世界對母乳餵養更友善，應該導正這種誤導性的建議。
Babies know what they need. A happy and satisfying breastfeeding relationship is built on a mother’s trust in her baby. Only in places where formula-feeding norms are still alive in the cultural memory could the “Don’t let your baby use your breast as a pacifier” advice take root and gain traction. If we want to make our world more breastfeeding friendly, part of our job must be to discredit this kind of misguided advice.
Nursing mothers are commonly warned: “Don’t let your baby use your breast as a pacifier.” Although often said, this is an incredibly curious statement. After all, which came first, the breast or the pacifier? The breast, of course, long predates the pacifier (aka “dummy”), a man-made device designed late in human history to soothe babies as a breast substitute.
如果奶嘴是乳房的替代品，到底讓寶寶“用你的乳房作為安撫奶嘴？”是什麼意思?
If the pacifier is indeed a breast substitute, then what on earth could it possibly mean to let your baby “use your breast as a pacifier?”
真相是什麼？
這個建議是假設寶寶對乳房的慾望是不合理的。畢竟，如果嬰兒對乳汁的需要是合理的，用奶嘴絕對行不通。根據定義，奶嘴不會有乳汁流出來。重點是，如果嬰兒哺乳的"時間夠久"（建議的分鐘數因人而異），嬰兒不再需要乳汁，所以吸吮奶嘴就夠了。然而，根據文章所述，有些孩子喝得很快，有些則是慢慢喝。寶寶哺乳的分鐘數無法告訴我們她喝到了多少。
What Is the Real Message?
The assumption underlying this advice is that baby’s desire for the breast is unreasonable. After all, if the baby’s need for milk was legitimate, the pacifier would never do. By definition, no milk flows from a pacifier. The point seems to be that if the baby nursed “long enough” (and the number of acceptable minutes varies by adviser), the baby no longer needs milk, so sucking on a pacifier should be good enough. However, as explained in THIS POST, some babies are fast feeders and others are slow feeders. The number of minutes a baby nurses tells us nothing about the volume of milk consumed.
有時嬰兒吸吮母乳卻沒喝到奶嗎？確實有。你可能會注意到寶寶常常輕輕含你的乳房，大多時候是睡著了。在這種情況下，您的寶寶的確可能在吸吮但不是在喝奶。這就是所謂的"別讓寶寶把乳房當作安撫奶嘴"嗎？
Do babies sometimes breastfeed without taking milk? It does happen. Every so often you may notice your baby softly mouthing your breast while mostly asleep. In this case, your baby may indeed be sucking but not drinking. Is this what those who say “Don’t let your baby use your breast as a pacifier” are referring to?
我不這麼認為。當疲憊的母親報告她的馬拉松式哺乳之後，通常得到此建議，然而這在最初的頭幾個星期是個普遍的現象。 "密集哺乳"，或哺乳集中在一天內某些時段，是快速增長的嬰兒提高奶量的方式。這樣做是因為"排空的乳房使乳汁更快充盈"。
I don’t think so. This advice usually follows a weary mother’s report of a marathon nursing session, a common occurrence in the early weeks. “Cluster nursing,” or bunching feedings close together during part of the day, is a fast-growing baby’s way of boosting milk production when needed. This works because “drained breasts make milk faster.”
然而，如果母親在這時候規律的以奶嘴代替她的乳房，會打斷她孩子在增加奶量上的努力。這是為什麼美國兒科學會 (AAP) 建議母親按照線索餵嬰兒 （見 2012 AAP 政策聲明）。AAP 鼓勵父母每當孩子表現出餵養線索時，就哺餵他們（活動力增加，尋根反射，動嘴），無論這些線索多麼頻繁出現。
However, if a mother regularly substitutes a pacifier for her breast at these times, this can short-circuit her baby’s efforts to increase her milk. That’s why the American Academy of Pediatrics (AAP) recommends babies be breastfed on cue (see the 2012 AAP policy statement HERE). The AAP encourages parents to feed their babies whenever they show feeding cues (increased activity, rooting, mouthing), no matter how often these cues appear.
根據美國兒科學會所述，嬰兒的餵養線索永遠不會不合理。事實上，在第一個月，當奶量供應正在建立期間，AAP 具體建議避免使用安撫奶嘴，正是因為過於頻繁使用這個"乳房替代品"，會破壞健康奶量供應的建立。
Babies’ feeding cues are never unreasonable, according to the AAP. In fact, during the first month, while milk supply is being established, the AAP specifically recommends avoiding pacifier use precisely because too-frequent use of this “breast substitute” can undermine the establishment of a healthy milk supply.
你的寶寶可以信任嗎？
另一方面這個"別讓寶寶把乳房當作安撫奶嘴"的建議，是暗藏傷害的。母親必須小心，“防範孩子利用她"的這種想法，有可能破壞她對寶寶的信任，損壞她們之間的關係，阻止她們獲得保持同步的自然狀態。此奇怪的警告是站不住腳的西方神話的親戚: 「新生兒可以在他們有心智能力這樣做之前，"操縱"他們的父母。」
Can Your Baby Be Trusted?
But there’s another aspect to this “Don’t let your baby use your breast as a pacifier” advice that is positively insidious. The idea that a mother must be careful not to let her baby “use her” has the potential to undermine her trust in her baby, driving a wedge between them and preventing them from getting in sync the way nature intended. This curious warning is the not-too-distant cousin of the indefensible Western myth that newborns can “manipulate” their parents, even before they have the mental ability to do so.
舉個例子，在最近一次母親支持聚會上有位母親對我說，每當她的寶貝女兒表現出餵養線索時，其實不需要喝奶，因為她只想做"非營養性吸吮"。這位母親已經在孩子體重增加緩慢上掙扎，最近開始更頻繁哺餵，而不堅持她原本的餵養時程表了。因為這個寶寶更頻繁哺乳，她的體重增加得到了改善。
As a case in point, a mother recently said to me at a mother-support meeting that her baby girl didn’t really need to nurse whenever she showed feeding cues because she was mostly doing “non-nutritive sucking.” This mother had been struggling with her baby’s slow weight gain and had recently started nursing more often instead of sticking to the feeding schedule she had first adopted. Because this baby was breastfeeding more, her weight gain had improved.
我問這位母親，她是怎麼知道她的孩子在她乳房上的時間 （這是"非營養性吸吮"會發生的） 越來越沒有奶。我發現她才恍然大悟，這位母親微笑著承認，其實她真的不知道。 我告訴她，我總是假設在懷中吃奶的嬰兒喝得到奶。
I asked this mother how she knew her baby was getting no milk during her time at the breast (which is what happens during “non-nutritive sucking”). I could see the realization dawn in her eyes. Smiling, this mother admitted that she really didn’t know that. I told her that I always assume a baby nursing at breast is getting milk.
在那一刻，這位母親意識到事後批評她的寶寶已經對兩者產生反作用。她理解為了充分解決她寶寶的體重增加的問題，她必須相信她的寶寶知道自己需要什麼，需要多長的時間。（她的寶寶是健康足月兒，所以她可以充滿信心接受孩子的引導）。當她決定相信寶寶時，什麼時候該哺乳，成了她寶寶的工作，不是她的 。當她想通時，她終於放鬆下來，感到重擔解除了。
At that moment, this mother realized that second-guessing her baby had been counterproductive for them both. She understood that to fully resolve her baby’s weight-gain issues she had to trust her baby to know what she needed, when she needed it, and for how long. (Her baby was full term and healthy, so she could follow her baby’s lead with confidence.) When she made the decision to trust her baby, it became her baby’s job—not hers—to know when to nurse. While I watched these mental wheels turn, this mother visibly relaxed as she felt her burden lifted.
誰想要傷害的世界呢？您的寶寶“用你的乳房作為安撫奶嘴”是什麼意思? 當你從母乳哺餵是如何進行的方向來思考，就知道這是胡說八道。但如果母親採納了基於此假設的建議，將帶她走向一個傷害的世界。她若相信必須防範寶寶"利用她"可能會破壞母乳餵養，她與嬰兒的關係，和她對整個母職的看法。誰需要這種對孩子的負面看法？當新手媽媽已經夠艱鉅了，不需要再有這些。
Who Needs This World of Hurt?
What does it mean for your baby to “use your breast as a pacifier?” When you think it through in terms of how breastfeeding works, it is actually total nonsense. But if a mother buys into the assumptions that underlie this advice, it opens her up to a world of hurt. Believing that she has to guard against her baby “using her” has the potential to undermine breastfeeding, her relationship with her baby, and indeed her whole outlook on motherhood. Who needs this kind of negative take on their baby? Even without it, new motherhood is challenging enough.
這種奇怪的觀點又是從哪裡來的？我猜它源於配方餵養的準則。畢竟，用奶瓶哺餵嬰兒時，過量是真正的風險。從奶瓶流出的奶，又快速又連續，嬰兒幾乎無法自行控制攝取奶量。另一方面，由於噴乳反射造成乳房奶速快慢交替，母乳餵養會自動教孩子健康的自我管理。（更多關於乳房和奶瓶如何影響過度餵食和肥胖的風險，見這 2012年的研究）。
Where did this odd outlook come from? I’m guessing it stems from formula-feeding norms. After all, when babies are bottle-fed, overfeeding is a genuine risk. Milk from a bottle flows so fast and consistently that babies have little control over their milk intake. At the breast, on the other hand, due to the alternating fast-then-slow milk flow from letdowns, breastfeeding automatically teaches our babies healthy self-regulation. (For more on how breast and bottle affect risk of overfeeding and obesity, see THIS 2012 study.)
為了防止奶瓶餵養期間過度餵食，可以在嬰兒看來喝飽時停止，給他吸乳房代替品(奶嘴)，讓他的食慾控制機制有機會啟動。（讓寶寶在快速奶流中規律休息，正是節奏式奶瓶餵食所描述的）。在奶瓶餵養過程中，使用奶嘴是一個好策略，但在哺餵母乳時則絕對不是。
To prevent overfeeding during bottle-feeding, it may actually make sense to stop a feed before baby appears to be done and give him a breast substitute to suck on so that his appetite control mechanism has a chance to activate. (Giving a baby regular breaks from fast milk flow while being bottle-fed is one way to prevent overfeeding and is one aspect of the paced bottle-feeding described HERE.) But even though this strategy may be good during bottle-feeding, it is definitely not good when breastfeeding.
嬰兒知道他們需要什麼。快樂和滿足的母乳餵養關係，建立在母親對她孩子的信任。只有在常規餵配方奶還活躍在文化記憶裡的地方，"不要讓寶寶用妳的乳房作為安撫奶嘴"這樣的建議才能生根和具有吸引力。如果我們希望我們的世界對母乳餵養更友善，應該導正這種誤導性的建議。
Babies know what they need. A happy and satisfying breastfeeding relationship is built on a mother’s trust in her baby. Only in places where formula-feeding norms are still alive in the cultural memory could the “Don’t let your baby use your breast as a pacifier” advice take root and gain traction. If we want to make our world more breastfeeding friendly, part of our job must be to discredit this kind of misguided advice.
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