Thinking of giving baby a pacifier? Find out everything you need to know from when you can first give a pacifier to your newborn to how to wean baby off when it’s time.
It’s just a small piece of molded plastic, and probably the least expensive item on your registry. But a pacifier can be the best thing that ever happened to your fussy baby—or, it can be the beginning of a bad habit that’s hard to break. “There’s a lot of conflicting info out there, so moms can sometimes feel like they’re being told ‘Use a pacifier!’ ‘No, wait, don’t use a pacifier!’” says Wendy Sue Swanson, MD, a pediatrician at Seattle Children’s Hospital. “In the end, it’s all up to what your baby prefers, and what you feel most comfortable with.”
There are several great benefits to using a pacifier. Here are some of the reasons why so many parents choose to give baby that binky.
They can help baby self-soothe
There are lots of wonderful ways to soothe baby—cuddling skin-to-skin, rocking, singing softly—but you’ve probably heard that babies also need to develop ways to soothe themselves, especially for those moments when you can’t always have your hands on them, Swanson says, like in the middle of the night or during car rides. Sucking is a primary reflex in newborns and one of the best ways they know to find comfort. Some babies will reach for their fingers or thumb, but others love a pacifier. “It can help baby fall asleep, and it also helps when baby is fussy, but feeding, swaddling and rocking don’t soothe him entirely,” she says.
They can reduce SIDS risk
Another reason to say yes to baby pacifiers: The American Academy of Pediatrics encourages the use of a pacifier when putting baby down for bed, since researchers have found that using a pacifier can significantly reduce the risk of Sudden Infant Death Syndrome (SIDS). If you do put baby to bed with a pacifier, never attach it to her neck or crib with a strap, which can be a choking hazard, and don’t coat it with anything sweet or sticky, which can cause cavities later on. Honey, in particular, is very dangerous to babies under one year, as it can cause infant botulism, so you never want to feed it to baby.
They can act as a distraction
When baby needs to get through an unpleasant procedure, like getting vaccinations or having blood drawn, a pacifier can be a parent’s best friend and a great distraction for baby. The comfort that babies receive from sucking can even help the tiniest ones thrive: Researchers have found that when preterm babies are given pacifiers, they have shorter hospital stays and do better with bottle-feeding.
They can make travel less stressful
Planning to travel by plane with baby? You might want to tuck several pacifiers into that carry-on. “The sucking motion of the jaw provides a shift in the middle ear, where the baby can feel pressure when the plane is going up or descending,” Swanson says. (What works just as well: breastfeeding or bottle-feeding, which serve the same purpose.)
There are also some pacifier risks you need to consider when making your decision. Here are the most common concerns to think about.
They can interfere with breastfeeding
The biggest question new moms have when wondering whether or not to pack that pacifier in their hospital bag: Will it interfere with breastfeeding? “It’s all about the timing,” Swanson says. “The mechanism of latching on to the nipple is different from the mechanism for sucking on a pacifier, so it’s a good idea to wait until breastfeeding is well established before introducing a pacifier.” She recommends holding off for the first couple of weeks, which means you may have to be firm and ask the nurses in the maternity ward not to automatically give baby a binky. “Weeks two through eight are when the crying and fussing really kick in, so if nursing is going well, that’s an ideal time to introduce the pacifier and see if the baby takes to it,” Swanson says. If, however, you choose to bottle-feed baby, there’s no need to wait to introduce a pacifier, since the nipples on the bottles are so similar.
They can mess with baby’s mouth
Long-term pacifier use can also affect the shape of the teeth and mouth, especially if baby continues to use it well into the toddler years. The jaw and the gum tissue are very malleable, and constantly keeping a pacifier behind the front teeth after age 2, but especially after 4, can create dental problems like an overbite or cross bite, Swanson says. And while there’s little evidence that baby pacifiers lead to speech delays, it can be hard—to say the least—to figure out what a toddler is saying when he’s trying to talk with a piece of plastic in his mouth.
They can lead to more ear infections
Another thing to consider: A study of 500 children in Finland has connected pacifier use to ear infections. Children in the study who never used pacifiers had about 33 percent fewer ear infections than those who did use them. But the study also found a compromise: By limiting pacifier use to just bedtime, rather than letting the baby suck on it all day, ear infections cases went down.
They can get addictive
Of course, another potential downside is that once baby falls in love with a pacifier, they’ll want it—all. The. Time. Which means there will be howling at 2 a.m. when the paci falls out of her mouth, or a meltdown when it drops into a mud puddle while you’re out for a stroll and you forgot to pack an extra. If the fuss caused by these incidents seems to be more trouble than it’s worth, you may want to consider skipping the pacifier phase. And if you’re already well into it, it may be time to think about weaning.
HOW TO PICK A PACIFIER
Once you’ve weighed the pros and cons and decided you’re going to go for it, you’ll find there are a mind-boggling number of brightly colored, cute binkys to choose from. The most important things to consider, Swanson says, are the pacifier’s size and its design. Pacifiers come in a variety of sizes recommended for different ages. “You don’t want a newborn using a toddler-size pacifier, which can be overwhelming in his mouth, or a toddler using an infant pacifier, which will sit directly behind his teeth, pushing them outward and possibly leading to an overbite,” Swanson says. She also recommends choosing a pacifier that’s made of one solid piece, so it can’t break apart in baby’s mouth. (Philips Avent Soothies, Dr. Brown’s One-Piece Pacifiers, and BornFree Bliss Buttons are all great options made of one single piece.)
Beyond that, it’s all a matter of what baby prefers. Some brands, like MAM, offer both silicone and latex pacifiers—because baby may prefer the taste of one material over the other, similar to how some adults are chocolate lovers while others are team vanilla. (A very small percentage of babies—mainly those who have spent time in neonatal intensive care or have already had a lot of operations or medical treatments—may develop an allergy to latex; if you have any concerns, stick with silicone.)
Baby pacifiers also come with different nipple shapes: Some are flatter, which manufacturers claim may be better for orthodontic issues, and some are rounder, shaped more like the nipple on a bottle. Swanson says there’s little evidence the shape makes any difference so, again, it may be a matter of trial and error to see which pacifiers baby loves the most. You may want to buy a pacifier starter kit that includes a variety of different brands so you can see what sticks. Oh, and you’ll also want to look for pacifiers that have ventilation holes—they let air circulate, reducing the chance of a messy red rash developing around baby’s mouth.
“We’re using the Nuk pacifiers, because they’re described as having a natural shape that encourages the correct development of the child’s teeth,” says Jane R. of New York City. “We’ll see if that’s true in about 10 years!” Another mom is sticking with the Soothies her daughter Ellie was given in the hospital. “It’s fun to stick your finger in the hole in the center, and you can also see inside baby’s mouth, which is pretty amusing!” says Julie R. of Cherry Hill, New Jersey.
A few more things to consider: Pacifiers need to be sterilized about once a week (or any time it gets dirty or falls on the floor), especially when baby is under 6 months old and his immune system hasn’t fully kicked in. Silicone pacifiers can go right in the dishwasher, making for easy clean-up, but if you choose latex ones, keep in mind they’ll need to be hand-washed since they can break down from the heat of the dishwasher. And though several years ago a small study out of Sweden showed that cleaning baby’s pacifier off with your own saliva might decrease his risk of developing eczema and asthma, the American Dental Association warns adult saliva contains cavity-causing bacteria that gets passed on to baby, so play it safe and don’t go there. Not to mention it just spreads more germs!
WHAT YOU SHOULD KNOW ABOUT PACIFIER SAFETY
Thanks to all that drool, pacifiers do get a licking (see what we did there?). Replace baby’s pacifiers any time they get rough, cracked, sticky or show other signs of wear and tear, like holes or loose or weak spots where the nipple could break off and become a choking hazard. Depending on how often and how intensely baby sucks on hers, you may need to change them out more often, but since pacifiers won’t break the bank it’s no big deal to stock up periodically on new ones. If in doubt, throw it out and start fresh. It’s also a good idea to keep an eye out for pacifier recalls here: CPSC.gov. And you always want to follow the recommended age range for the pacifier to avoid choking risks.
PACIFIER WEANING: HOW TO HELP BABY BREAK THE HABIT
Sometimes babies decide they’re done with pacifiers and just stop using them on their own. If that happens, consider yourself one very lucky mom! Otherwise, there will come a time when you will have to do the dirty job of taking it away. Swanson recommends starting to wean at 6 months—by that point, baby should be sleeping through the night, and since he’s too young to argue with you, you can easily go cold turkey. But be prepared for baby to have something to “say” (read: possibly scream) about the situation. “He’ll cry for a little while, but after a couple of days, he will adjust and figure out another way to self-soothe,” Swanson promises.
If baby (or let’s be honest, you) is too attached to the pacifier to give it up that early, that’s fine, but keep in mind that weaning gets more complicated once your child starts to talk and express herself. Ideally, for dental development, you want to try and say goodbye to the pacifier by or before your child’s second birthday. Parents have come up with all kinds of creative rituals to help make the transition, including “sending” the pacifier to another baby who needs it, trading them all in for a cool toy baby’s had her eye on, and giving it to Santa, but whichever way you go about it, the key is consistency. “Get rid of every pacifier in the house, stop talking about them and don’t give in!” Swanson says. “If you go back, there’s no clarity and the child won’t learn that she can be fine without it.”
Whatever age baby is when you decide to start the pacifier weaning process, resist the temptation to use a bottle or sippy cup as a pacifier replacement. “Items meant for feeding should only be used for feeding—not soothing,” Swanson says. A better pacifier substitute? A special stuffed animal or lovey that’s reserved just for naps and bedtime.