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Should I give my baby a pacifier?
Your call, but there's usually no harm in giving a baby a pacifier. Comforting your infant is one of your highest priorities as a new parent, and offering a pacifier may be a good option. Made of a rubber, plastic, or silicone nipple with a shield to prevent swallowing, a binky is especially helpful during the first six months when the urge to suck is highest.
If your baby is still fussy after you've fed, burped, cuddled, rocked, and played with her, you might want to see if a pacifier will calm her.
Avoid using a pacifier to delay feedings or as a substitute for attention. That said, sometimes your baby will have to wait to be fed or comforted (for example, in the checkout line at the grocery store or in her car seat a few miles from home). In these instances, a pacifier can be a godsend.
Can a pacifier interfere with breastfeeding?
Sucking on a pacifier and sucking on a breast are different actions, and the American Academy of Pediatrics (AAP) recommends that you wait until your baby is breastfeeding well before offering a pacifier to avoid interfering with early feeding.
The AAP suggests waiting until your breastfed baby is 3 or 4 weeks old, though that's just a guideline. If your baby is nursing well, gaining weight, and has settled into a routine feeding schedule, your baby's doctor may say you can start earlier.
However, it's especially important to delay introducing a pacifier if your baby is having trouble latching or if you're concerned about low milk supply. And be careful not to offer your baby a binky when he might be hungry. Give him the pacifier after his regular feedings to make sure he gets all the nourishment he needs first.
- Self-soothing: Some babies can be soothed with rocking and cuddling, and are content to suck only during feedings, but others just can't seem to suckle enough, even when they're not hungry. If your baby still wants to suck after having her fill of breast milk or formula, a pacifier may satisfy this urge. A binky can also help comfort your baby when she's upset – after she gets a shot, for example.
- Lower SIDS risk: Some studies have shown that babies who use pacifiers at bedtime and nap time have a lower risk of SIDS (sudden infant death syndrome). These studies don't show that the pacifier itself prevents SIDS, just that there's a strong association between pacifier use and a lower risk of SIDS.
- Sleep aid: Once fed and burped, your baby may like to suck on the pacifier until he falls asleep.
- Travel aid: Having your baby suck on a pacifier during a flight can help with ear pain from the changes in air pressure. It might also come in handy if you're in transit and your baby is fussing in a car seat or stroller.
- Easy(ish) to discontinue: Some parents like the idea that when they decide it's time for their baby to stop using a pacifier, they can take it away. For babies who suck on fingers instead, you don't get to call the shots.
- Dependence: If your baby is dependent on her binky to go to sleep and it falls out of her mouth, she may be upset until you retrieve it. If your child continues to depend on a pacifier as she gets older, taking it away could become even more upsetting for her.
- Ear infection concerns: Pacifier use may increase the risk of middle ear infections in babies and young children. Because the risk of these infections is generally lower in young babies, using a pacifier until your baby's about 6 months old (when his need to suck is greatest) and then weaning him from it may be a good strategy if your baby is prone to ear infections.
- Potential feeding problems: Introducing a pacifier (or a bottle) too early when you're breastfeeding can cause some babies to become content to suck on a binky and not feed when they need to. (See "Can a pacifier interfere with breastfeeding?" above.)
- Potential dental problems: If your child uses his binky regularly for more than a few years, it could affect the development of his bite and teeth. (See "Can a pacifier harm my baby's teeth?" below.)
Will my baby have a hard time giving up a pacifier and get upset when I take her binky away?
It depends on your baby. Sucking on a pacifier can easily become a habit. Being careful not to overuse the pacifier by first trying to comfort your baby in other ways can reduce the chance that your child will become dependent on it. Instead, when your baby's fussy, first try to comfort her in other ways, such as cuddling, rocking, or singing.
Many parents don't introduce a pacifier because they don't want to deal with having to take a binky away later. If you allow your child to use a pacifier but want to avoid binky battles later, consider weaning your child away from it around 1 year. (For support, here are 10 ways to help your child give up the pacifier.)
Tips for smart pacifier use
- Tell the hospital your preference up front. If you don't want your newborn to have a pacifier at the hospital, tell the nurses ahead of time – especially if you intend to breastfeed. Although a day or two of pacifier use in the hospital won't be habit forming, it doesn't make sense to introduce something you aren't going to use at home.
- Let your baby guide your decision. If she takes to it right away, fine. But if she resists, don't force it. You can try again another time or just respect her preference and let it go.
- Try different sizes and nipple shapes. Your baby may prefer a standard, bottle-type paci or an "orthodontic" model. Read our article on how to buy a pacifier.
- Offer the pacifier between feedings when you know he's not hungry. See "Pacifier cons" above.
- Try giving your baby the binky at nap time and bedtime. But if it falls out of her mouth while she's sleeping, don't put it back in.
- Buy extras. Binkies are good at disappearing and being dropped, so keep a clean one on hand.
Safety tips for pacifiers
- Keep pacifiers clean. See our detailed instructions on how to clean pacifiers.
- Don't "clean" a pacifier by putting it in your mouth. The American Dental Association says adult saliva contains bacteria that can cause cavities in your baby's teeth as soon as they begin to erupt from her gums.
- Don't tie a pacifier around your baby's neck or to his crib. He could strangle in the cord or ribbon. It's safe to attach the pacifier to his clothes with a clip made especially for the job.
- Choose a pacifier with a shield that has air holes and is at least 1 ½ inches across. You want to prevent your baby from putting the entire paci into his mouth.
- Don't use a pacifier with added decorative parts. One-piece models are best, but otherwise choose a paci without any loose parts, which are choking hazards. If any parts become loose, discard the pacifier.
- Never substitute a bottle nipple for a pacifier. Your baby can suck the nipple out of the cap and choke on it.
- Inspect for wear and tear. Replace any pacifier that shows small cracks or other signs of wear.
- Take away a pacifier if your baby is chewing on it. Chewing breaks down the material and leads to little pieces breaking off, which become choking hazards.
- Don't dip your baby's binky in honey, juice, or sugar to "sweeten the deal." Sweets are terrible for your baby's gums and teeth. (You should never give a baby younger than 1 year old honey in any form.)
- Check product recalls. Pacifiers are often recalled, so keep an eye on the list from the U.S. Consumer Product Safety Commission.
When not to give a pacifier to a baby
Weight gain problems: Don't give a pacifier to a baby who's having problems gaining weight.
Breastfeeding problems: If your baby is having difficulty nursing (or if you're having trouble maintaining your milk supply), it's probably best to do without a pacifier, at least for now.
Ear infections: Consider foregoing a pacifier if your baby has had repeated ear infections (see "Pacifier cons" above).
Can a pacifier harm my baby's teeth?
Probably not. During the years when most kids use a pacifier, they have only their baby teeth. (Permanent teeth typically start appearing by age 6.)
That said, the longer your child uses a pacifier, the greater the chance it will affect dental development. (Strong sucking can change the palate or jaw shape, which may affect the way adult teeth come in later.) The American Academy of Pediatrics advises that you have your child's dentist evaluate her jaw and teeth if your child is still using his paci when he's 3 years old.