Many parents wonder if they should introduce a pacifier to their baby. Will it become a bad habit? Is it safe? Will it mess up my baby’s teeth? Does it ultimately help or hinder sleep? How will I remove it? These are questions I get all the time. 

There are many benefits to pacifier use: reduced risk of SIDS, it satisfies the non-nutritive sucking need (the sucking reflex that is not associated with hunger), ease of soothing and comfort in times of distress (doctor visits, car rides, travel, etc), encourages sleep, promotes relaxation, and can become a great tool for self-soothing as a baby gets older. 

The way I see it: you’ll need to set some limits around pacifier use so that it doesn’t become a bad habit and eventually you’ll need to remove it, but- in my opinion- the short and long-term benefits of pacifier use far outweigh the negatives. But if your baby doesn’t like the pacifier, don’t fret- pacifiers are completely optional. 

Topics covered: 

• When can I give my newborn a pacifier? 
• My baby doesn’t like the pacifier. How can I encourage my baby to take a pacifier? 
• Can I sleep train and allow my baby to have a pacifier? 
• When does pacifier use become a bad habit?
  
• When and how can the pacifier be removed? 

Pacifiers and Newborns: 

You can introduce a pacifier to your newborn as soon as breastfeeding is well-established (this is usually within the first two weeks when your baby has exceeded their birth weight and there are no concerns about milk supply; bottom line: in the early days, if a baby wants to suck, it best that the baby is at the breast). 

If your newborn has nursed for 20 minutes (ideally 10 minutes on each breast), you are seeing lots of wet diapers, and you don’t have concerns about your milk supply, it is okay to offer the pacifier in the early days as some newborns have a very strong non-nutritive sucking reflex, which basically means the desire to suck without the need for milk. The benefits of non-nutritive sucking include the release of endorphins, relaxation, increased comfort, and the promotion of sleep. If your baby spits out the pacifier or is not easily pacified by it, that could be an indicator that they may be hungry. In these cases, be sure to offer the baby a feeding as they may be hungry or want to cluster feed. 

The American Academy of Pediatrics recommends offering pacifiers to babies for sleep to help reduce the risk of SIDS (sudden infant death syndrome). Pacifiers help reduce the risk of SIDS by increasing arousal states and by keeping the tongue forward and preventing it from blocking the airway. 

Introducing the Pacifier: 

Some babies naturally take to the pacifier while others may struggle to accept it. It can take a bit of coaxing. Pacifiers that put pressure on the baby’s palate will activate their sucking reflex, so it’s best to find pacifiers with the correct shape (BIBS or Natursutten are good brands). 

When you give your baby the pacifier, make sure that it is touching the roof of their mouth so that the suck reflex is activated (if your baby is not feeling that stimulation, they may not realize that something is in their mouth that they are supposed to suck on). Apply pressure in the middle of the baby’s tongue and move the pacifier in circles around their mouth, encouraging them to suck. 

It is best to offer the pacifier when the baby is calm and not hungry. If your baby becomes frustrated, stop and try again later- don’t force it! 

But is it a bad habit? 

During the newborn phase (the first 3 months), no, it’s not considered a bad habit. However, as your baby gets older (4-5 months), the pacifier can become a bad habit if your baby cries for you to replace it every time it falls out. I call this “pacifier ping-pong.” This can lead to frequent night wakings and can become a sleep crutch. 

To avoid a bad habit and dependency from developing, you can offer the pacifier to help calm your baby and help them fall asleep but try to avoid replacing it throughout the night. 

Pacifier Teaching:

The pincer grasp, which is the ability to pick something small up with intention, develops around 6 months. As your baby approaches 6 months, you can practice with pacifiers during the day (giving them lots of praise if they are able to grasp one and even more praise if they bring it to their mouth). During sleep time, leave a bunch of pacifiers in their crib increasing the chances they’ll find one on their own. 

Around 5 months, you can begin to “teach the pacifier,” helping your baby learn how to replace the pacifier on their own by following these steps: 

• Step 1: Put the pacifier in their hand (but not in their mouth). Guide their hand to their mouth as needed. 
• Step 2: Put the pacifier in their hand and let them bring it to their mouth. 
• Step 3: Lay the baby down in the crib without a pacifier so they can practice finding it on their own. Don’t give it to them. Instead, show them where it is and encourage them to grab it. 
• Step 4: Once they get better at looking and grabbing it, stop helping them find it. 

6 months and on, especially if you have sleep trained or are in the process of sleep training, it’s best not to assist your baby at all. If you give them the space to self-soothe, they will either find the pacifier on their own or they will discover they can suck on their fingers, hands, or PJs! 

Looking for support with the sleep training process? You can learn more about our sleep support services here. 

When & How to Remove the Pacifier: 

Some parents will remove the pacifier around 4-6 months to avoid having to teach a baby to replace it on their own and to simply eliminate the pacifier ping pong that many parents find themselves playing all night long. You can simply remove it from one day to the next. It will likely take some time for the baby to find an alternative way to fall asleep but they will (again, sleep training can be a key component here; teaching your baby to learn how to sleep without relying on your support). 

Most dentists recommend limiting a child’s use of pacifiers around age two and eliminating it by age four, or earlier, to avoid dental problems. To be prudent, it’s best to limit pacifier use to sleep only by 12 months (or those desperate moments where you need a “mute button”- like car rides, doctor offices, travel, or super fussy times). It can be helpful to have a rule where the pacifiers stay in the crib only. 

When you are ready to remove the pacifier, it can be really helpful to have an alternative attachment object, like a lovey. 

A month or so (ideally longer!) before you remove the pacifier, you can introduce a lovey. A lovey can be a great tool for self-soothing and comfort. To introduce a lovey, every time you feed and cuddle your baby, put the lovey between you and them (overtime they will make the connection that they can receive the feeling of comfort from the object because they will come to associate it with you). Show it lots of love yourself, stroke it, rub it on your face and on their face- modeling a loving attachment- and encourage them to snuggle with it. At nap time and bedtime, snuggle the lovey next to them. They may ignore it or even toss it out of the crib. That’s ok! Stick with it. It can take a month or so before the attachment develops. 

If your child is older than two-years-old, you can encourage them to trade it in for a new toy, have a little ceremony to send it off in a package to a relative or friend or “donate” it to a baby who needs it, or even create a little baby box with keepsakes from their babyhood, including the pacifier. Ideally you get your child’s buy-in by including them in the process, explaining to them why it’s important to say goodbye (such as, “You’re such a big kid now! Big kids don’t need pacifiers!”). Allow big emotions to come, validate that it’s hard to say goodbye, and know they will have some mourning to experience if they have been very attached to it.

 

If you choose to offer your baby a pacifier, be sure to follow these safety guidelines from the AAP: https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Pacifier-Safety.aspx