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Pacifier Pros and Cons
As a parent, you want to give your baby whatever they need to be comfortable and happy. But you might be unsure about whether to offer your baby a pacifier—after all, there are many opinions out there! Don't worry—we're here to walk you through all the potential benefits and risks associated with using a pacifier so that you can make an informed decision about how best to meet your baby's needs. We’ll also provide guidance on when to introduce one and how long you might want to use it.
In this article:
Reduced risk of sudden infant death syndrome
Tips for weaning your child from a pacifier
The potential risks of pacifier use
Q: Should you remove your baby's pacifier while they're sleeping?
Q: Are pacifiers designed for all sleep times?
Q: Can a newborn sleep with a pacifier?
Q: Are pacifiers ok for breastfed babies?
Q: What is the best pacifier for newborns?
Q: My baby wakes when the pacifier falls out. How do I keep the pacifier in their mouth? What do I do if my baby wakes every time the pacifier falls out?
Q: What if my baby doesn't like using a pacifier?
What is a pacifier?
Whether you call it a paci, binky, nook, or just a pacifier, it's a soothing device designed to imitate the shape of a mother's nipple and provide comfort to babies by appealing to their sucking reflex. Using a pacifier is "non-nutritive sucking"—the baby doesn't receive any nutrition from it.
Pacifier material
The most common materials for pacifiers are latex (rubber) and silicone. Although latex pacifiers are softer and may be more immediately appealing to a baby, they are not dishwasher safe and break down more quickly.
Silicone pacifiers last longer and can be washed in the dishwasher, which is recommended by the American Academy of Pediatrics (AAP) for babies under six months (discussed in more detail below).
Pacifier shape
Pacifiers typically come in three general nipple shapes:
Standard/symmetrical pacifiers have a straight, cylindrical, elongated nipple.
Orthodontic pacifiers have a flat nipple and are designed to encourage natural jaw and tongue movement.
Rounded pacifiers look much like a standard pacifier but have a ball-shaped tip.
Unless your pediatrician or dentist recommends a specific type, the best pacifier for your baby is the type that they like and will use.
The benefits of pacifiers
Pacifiers can have several benefits for babies.
Comfort
The primary reason why parents have been offering their babies pacifiers for decades is right in the name. Pacifiers are designed to soothe and comfort a tired or fussy baby. Babies naturally have a strong sucking reflex—that's why they love to suck on their fists, toys, and anything within reach.
When a baby sucks on a pacifier, it stimulates their brain to release the hormone oxytocin, the "feel-good hormone." Oxytocin can have a calming effect on babies and helps to reduce stress.
Just keep in mind that you shouldn't rely on a pacifier every time your baby fusses. It's important for them to learn and respond to other soothing techniques.
Additionally, if your baby is extremely fussy, you should determine the underlying cause of their discomfort instead of automatically giving them a pacifier.
Improved sleep
Because they provide a sense of comfort, pacifiers can help many babies fall asleep more easily and stay asleep longer.
Additionally, the sucking motion helps to regulate a baby's breathing, leading to a more rhythmic breathing pattern and deeper sleep.
For more information about infant sleep, check out Sleep Basics for Parents.
Pain relief
Sucking on a pacifier can relieve pain in babies, such as pain from shots or other medical procedures, teething, ear infections, and changes in air pressure while flying.
Reduced risk of sudden infant death syndrome
Studies have shown that sucking on a pacifier during sleep—both naps and at night—can lower the risk of sudden infant death syndrome (SIDS).
Pacifiers reduce the risk of SIDS by regulating the baby's breathing, making it more rhythmic and preventing instances where breathing becomes more shallow or stops altogether—both factors that can contribute to SIDS.
However, pacifiers alone do not prevent SIDS. It is also crucial to provide a safe infant sleeping environment by laying your baby on their back for sleep and removing any hazards from their crib.
Ages for pacifier use
Introducing a pacifier
Offering your baby a pacifier too early can make it harder for them to become comfortable with breastfeeding and may affect your milk supply.
If you are breastfeeding, the AAP recommends waiting to introduce a pacifier until breastfeeding is well-established. This generally means that you should wait until:
Your baby is reliably latching onto your breast
You feel confident about your milk supply
Your baby has regained their birth weight and is consistently gaining weight
In most cases, this will be approximately three to four weeks after birth.
If you are exclusively bottle-feeding your baby, you can begin offering a pacifier right after they are born.
Weaning from a pacifier
The AAP recommends weaning a child from a pacifier between two and four years of age because of potential issues associated with long-term pacifier use. The American Academy of Pediatric Dentists recommends stopping pacifier use between one and three years for the same reasons. We discuss these issues under "Risks," below.
Prolonged pacifier use can also make it more difficult for children to break the habit, leading to difficulties with weaning. For this reason, some experts recommend stopping pacifier use earlier, around six or seven months, because the baby won't have become emotionally attached to it yet but will have passed the age of highest SIDS risk.
However, every child is different and many children continue to use pacifiers well past this age with no issues. If you are concerned about your child's pacifier use, you should consult with your pediatrician.
Does your child use a pacifier?
- Yes, they are under 6 months old
- Yes, they are 6 to 12 months
- Yes, they are 1 to 2 years
- Yes, they are 2 to 3 years
Tips for weaning your child from a pacifier
As your child gets older, the risks of using a pacifier begin to outweigh the benefits. Many children independently stop using a pacifier between two to four years old—often due to peer pressure once they begin school. However, some kids need help giving it up.
The following tips can help you through the pacifier weaning process.
Take it slow—your child doesn't have to give up a pacifier cold-turkey! You can gradually reduce the frequency of pacifier use, such as limiting it to nap times and bedtime.
Encourage your child to use other comfort items, such as a stuffed animal or special blanket, when they need to feel comforted and secure.
Be patient and positive. Give your child praise when they don't seek out a pacifier for comfort. Depending on your child's personality, consider sticker charts or rewards. You can even have a special goodbye ceremony to bid farewell to the pacifier, such as "giving" it to a new baby.
Never scold, tease, or punish your child for using a pacifier—always keep your tone positive.
Use fun distractions—your child might be seeking out a pacifier if they feel bored.
Consult with your child's pediatrician or dentist if they are really struggling with giving up their pacifier.
If this process is making your child feel tense or unhappy, stop and wait a couple of months. They will eventually give up their pacifier. Just remember that no child brings a pacifier to college!
The potential risks of pacifier use
While pacifiers can be beneficial for some babies, they can also have potential risks. Not all babies will experience these risks and the severity of any potential issue varies greatly by child.
Dental problems
Prolonged pacifier use (past the first couple of years) can lead to problems with the growth and development of a child's jaw, teeth, and alignment (how the teeth fit and work together). Ultimately, this may make it more likely that a child will need orthodontic treatment at some point.
However, normal use of a pacifier in the early years generally does not cause these problems.
Ear infections
An ear infection occurs when fluids build up behind the eardrum, causing bacterial growth. Pacifiers have been linked to an increased risk of ear infections, possibly because the sucking motion changes the pressure in a child's ears and makes it harder for them to remain clear of fluids. Pacifiers can also transfer germs into a child's mouth.
However, babies under six months generally have lower rates of ear infections. Because this is also the age when the risk of SIDS is the highest, the potential benefits may outweigh the risks for this age group.
Impaired speech development
You may have heard that pacifier use can interfere with the development of speech and language skills. The theory is that frequent daytime pacifier use gives a child less time practice babbling and saying early words.
However, there is little evidence to suggest that this is a significant problem. Using a pacifier for hours each day may contribute to speech errors such as dropping consonant sounds. Many children outgrow these issues.
There is no evidence that nighttime pacifier use has any impact on speech and language development.
To learn about development delays, see When Should You Be Concerned About Your Child's Development?
Pacifier safety
Keep the following safety tips in mind if you offer your baby a pacifier:
Choose a pacifier that is all one piece, not multiple parts that could separate and pose a choking hazard or harbor bacteria. Those cute mustache pacifiers are not safe for your baby!
Make sure you are using the correct size of pacifier for your baby's mouth. A baby could choke on a pacifier that is too small.
Never tie or otherwise attach a pacifier to your baby's clothing or bed. This creates a strangulation hazard.
Check the pacifier regularly for any signs of tearing, holes, or discoloration and replace it immediately if you notice any damage. If the pacifier has an expiration date, replace it by that date.
Clean your baby's pacifier frequently to get rid of germs and prevent bacteria from growing. When your baby is less than 6 months old, it's best to wash it in the dishwasher or boil it to kill germs. When they are older, it's fine to wash with soap and water.
Some parents choose pacifiers that have stuffed animals attached, which make the pacifier easier to hold and harder to lose. You should only offer this type of pacifier when you are watching your baby—never provide it for nighttime sleep or unsupervised naps.