There are negative effects from using a pacifier during breastfeeding for healthy babies. The AAP suggests avoiding pacifiers for the first month. Introducing a pacifier can lead to the infant ineffectively sucking at the breast and causing "nipple confusion". Babies will take their suck out on the pacifier instead of nursing or comfort nursing at the breast which is good for the infant's brain development and the mother's supply. Evidence in premature infants or infants that are not healthy is lacking but shows that it can have benefits. It may have clinical benefits for preterm babies, such as helping them progress from tube to bottle feeding.