Should My Baby Use a Pacifier?

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When you have a new baby, you will be flooded with all kinds of decisions to make, and many of them won’t feel easy. Should you choose a family name or something more contemporary? Should you use cloth diapers? Breastfeed or formula feed? And of course: Should you give your baby a pacifier?

Pacifiers and babies seem sort of synonymous. If you picture a cute little baby, you may picture them waddling around in a diaper, sucking happily on a binky. But for some parents, deciding whether to use a pacifier might be confusing.

Allowing your baby to use a pacifier is a personal decision—one that only you can make, and one that most certainly should not be judged by others. Much of the opposition to pacifiers stems from perceived issues that were likely overblown.

How Pacifiers Work

All babies are born with a strong desire to suck. In fact, one of your baby’s inborn reflexes is the “sucking reflex,” which means that anytime you place a nipple-shaped object in your baby’s mouth—whether it’s a breast nipple, a bottle nipple, a pacifier, or even a finger—your baby will likely begun sucking, without even thinking about it.

The sucking reflex is part of your baby’s survival instinct. Sucking is how your baby gets all their nutrients in the first few months of life, so it makes sense that they would want to suck on anything they are offered! But sucking is also extremely soothing for your baby. Sucking releases hormones that relax your baby and put them to sleep. When babies suck just for comfort, this is called non-nutritive sucking.

Pacifiers—which come in various shapes and textures, but which are supposed to mimic bottle and breast nipples—are naturally soothing for your baby. A pacifier allows non-nutritive sucking when a baby is done breastfeeding or bottle feeding.

Sucking can be a wonderful way to help babies to relax or fall asleep. For these reasons, most parents use a pacifier at one time or another, though the extent that a parent uses it can vary for just a few times, intermittently when needed, or as a normal part of their baby soothing and caring routine.

Pros and Cons

Ask any parent and they will tell you that there are many obvious benefits to giving their baby a pacifier. Pacifiers may instantly soothe your baby when they are upset, they can help your baby cope during long car rides or anytime you are not able to hold your baby, and they can be helpful in getting your baby to fall asleep.

Pacifiers also have a few drawbacks. Let’s take a look at the pros and cons of pacifier use, along with the supporting research.

Pros

  • Pacifiers can be extremely soothing for babies. They can help when your baby is fussy, and may even help with colic. They can help for times that you are unable to hold or breastfeed your baby, such as when they are getting a medical exam or receiving immunizations. They may also be helpful when your baby has a more intensive sucking reflex than most babies, and seems to want to suck constantly.
  • Pacifiers can help with sleep. Sucking releases hormones that make your baby relaxed and drowsy. Letting your baby suck on a pacifier may help them fall asleep, and may help them stay asleep during the night. Letting your baby nurse to sleep has similar effects.
  • Pacifiers can be specifically helpful during airplane flights. The air pressure during flight may cause your baby to have congestion and pressure in their ear canals. Sucking on a pacifier helps your baby “pop” their ears. However, feeding is more effective for this than pacifiers, since swallowing pops the ears more than sucking.
  • Pacifiers may be protective against sudden infant death syndrome (SIDS), according to recent research. As the Academy of American Pediatrics (AAP) explains, pacifier use during sleep has been shown to reduce your baby’s chances of SIDS. At the same time, the AAP advises that you wait until breastfeeding has been established to introduce a pacifier.
  • Pacifier sucking may have advantages over thumb or finger sucking. First, pacifier use may cause less dental damage than finger or thumb sucking. Second, pacifiers can be withheld from your child, whereas the same can’t be said about their fingers or thumbs.

Cons

  • Pacifiers may cause problems with establishing breastfeeding. If used in place of feeding, they can decrease your milk supply. When your baby seems fussy, first try to soothe them by feeding, changing their position, checking their diaper, and so on. Offer a pacifier if those don't work. This way a pacifier isn't being used when a baby is hungry and really just wants to eat. While the AAP does recommend avoiding pacifiers in the early weeks, research does not support claims that pacifiers cause nipple confusion or otherwise interfere with establishment of breastfeeding. 
  • Pacifiers may cause dental issues down the road. If used beyond age 3 or so, pacifiers can change the shape of your child’s gumline and dental arch. This can lead to gaps between your child’s teeth, misaligned teeth, as well as an overbite. But note that thumb-sucking causes just as many (if not more) dental issues, and a child who really wants to suck and isn't offered a pacifier is likely to suck their fingers or thumb instead. It may not make sense to deny a pacifier to a little baby because of problems that won't crop up for three years.
  • Pacifiers may create habits that are hard to break. Your child may become quite attached to their pacifier. And while it may seem like just taking the pacifier away is a quick way to break the habit, it’s not always that easy! Understanding that weaning from the pacifier may have to be a process is important—although again, thumb- or finger-sucking is often a more difficult habit to break, and the immediate benefits of pacifiers can outweigh the pain of having to take them away a few years from now.
  • Pacifiers were once linked to ear infections. Older research found that if your child is prone to recurring ear infections, their pacifier use may be to blame. But more recent research does not show an association between pacifiers and increased occurrence of ear infections.

Pacifiers and Breastfeeding

One of the most controversial questions about pacifier use is what effect it might have on breastfeeding. All major health organizations recommend your baby breastfeeding for the first year of life, if possible, and so ensuring that breastfeeding goes smoothly is important. Here are the concerns about pacifiers and breastfeeding:

  • Impact on milk supply. One problem with pacifiers is that they are sometimes used in place of feedings, and because maintaining milk supply is a matter of “supply and demand” (i.e., the more often a baby nurses, the more milk the mother produces), there is a concern that pacifier use could drive down a mother’s milk supply. However, if the baby is nursing on demand, this should not be a problem.
  • Nipple confusion. Forming a good latch on the breast requires your baby to open wide and suckle deeply on the breast and areola. Pacifiers don’t require the same wide gap and aren’t the same size and shape as a breast. But research indicates that babies aren't confused by the difference.
  • Weaning. Breastfeeding isn’t just about nutrients—it's also meant to be soothing to your baby in much the same way as pacifiers are. If your baby becomes reliant on pacifiers for soothing, they may not breastfeed as frequently, and may wean from breastfeeding sooner than you expected them to. However, there is no research to support this claim. It's possible that a breastfeeding mother could nurse longer if a pacifier satisfies the baby's need for non-nutritive sucking so the breast does not have to perform this function.

What Experts Say

In order to make sure your baby gets off to a good start with breastfeeding, the AAP recommends that you wait to introduce a pacifier. “If you are breastfeeding, wait until breastfeeding is going well before offering a pacifier,” says AAP. “This usually takes three to four weeks. If you are not breastfeeding, you can start a pacifier as soon as you like.”

Similarly, the Academy of Breastfeeding Medicine (ABM) states that pacifiers should be "used with caution" in newborns. But the group also cites research showing that "pacifier use in healthy term breastfeeding infants, started at birth or after lactation was established, did not significantly affect the prevalence or duration of exclusive and partial breastfeeding up to 4 months of age."

Pacifier Safety

Most of the time, pacifier safety is not an issue, and pacifiers aren’t inherently dangerous. But there are some precautions you should take to ensure that your baby will remain safe while using a pacifier.

  • Don’t substitute your pacifiers for feedings. Always offer the breast if your baby is fussy, as fussiness can be a sign of hunger. Offering a pacifier instead of the breast can decrease your milk supply if you are breastfeeding. You may run the risk of underfeeding your baby, whether you are breastfeeding or bottle feeding. However, it is also easy to overfeed when using bottles, so if your baby refuses a bottle, they may need a pacifier. If your baby is gaining weight appropriately, and especially if they have recently finished eating, see if they are fussy for another reason (they need a diaper change or a burp, want to be held, etc.).
  • The first time you use a pacifier, you should sterilize it by boiling it in water for five minutes. After that, wash it with warm soapy water between uses. If your baby is premature or has other medical vulnerabilities, you may need to use a sterilization method between usages to keep your baby safe.
  • Examine the pacifier before offering it your baby. A pacifier with cracks in it can be dangerous to your baby, or be a choking hazard.
  • Once your baby has teeth, don’t let them chew excessively on their pacifier. This can also cause the pacifier to break down, and for pieces of the pacifier to be swallowed, a potential choking risk.
  • Shy away from pacifiers with more than one part. These types of pacifiers may come apart and become a choking hazard for your baby.
  • Do not dip your baby’s pacifier in sugar water or honey. This is an antiquated tradition that can have detrimental effects on your baby. Both sugar and honey can lead to cavities. And honey can cause botulism—a potentially fatal condition—in babies under the age of 12 months.
  • Don’t use a chain or pacifier necklace. These are choking hazards. Instead, you can use a pacifier clip so that your baby doesn’t lose their pacifier.
  • Don’t attempt to make your own pacifier out of bottle nipples or anything similar.

A Word From Verywell

Some families may decide they would rather try other soothing methods than a pacifier, such as offering the breast for soothing if they are nursing. Other families may decide that they want to use a pacifier, but will use it sparingly. Other families may use a pacifier very often.

And some babies love the pacifier and seem to really find it helpful. Other babies will actually flat out reject it. Keeping in mind that all babies are different, all families are different, and that every family has to do what works best for their particular situation should help you make a decision about pacifier use that you feel confident about.

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