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Pacifiers: to use or not to use? This question unfortunately comes with some controversy, like lots of parenting decisions in the 21st century. If you choose not to use a pacifier, that is totally fine! If you do choose to use one, that is also fine, and you're in good company; 75-85% of babies in Western countries use a pacifier at least some of the time. Just keep in mind the latest evidence and tips on pacifier usage below.
What we know:
No good evidence supports nipple confusion warnings
The best randomized controlled trials (RCTs) show pacifier use does not have a statistically significant impact on success breastfeeding; any correlation that non-RCTs show is likely due to other variables
However, AAP & lactation consultants still recommend waiting 2-4 weeks to establish breastfeeding first as a precaution to be sure nothing gets in the way of establishing a good latch
The bottom line:
Nursing moms can use pacifiers and have breastfeeding success
Still, consider waiting 2-4 weeks to establish breastfeeding first
What we know:
Pacifiers can be a useful tool in helping newborns calm down and fall asleep, which can help establish good sleep habits in the early days by helping keep baby from getting overtired
Some evidence also shows pacifier use at sleep onset reduces the risk of SIDS, though the reason is not well understood
As babies get older, sleep props like pacifiers may need to be eliminated for baby to sleep independently through the night
The bottom line:
Pacifiers can be useful calming & sleep tools
But, pacifier reliance can make it harder to teach older babies to sleep independently
What we know:
When baby is awake, alert, and happy, try to avoid using pacifier so baby can freely babble and coo, which is important for speech development
Using pacifier all the time can also make it hard to detect baby’s “hunger cues”
The bottom line:
It's best to avoid constant pacifier use
Try limiting to sleep time and ‘high-need’ situations like car or plane rides
What we know:
Dental problems related to mouth and teeth formation have only been shown to be associated with prolonged (>age 4) or inappropriate (sweetening w/ honey or sugar) pacifier use
If you wean your child off the pacifier early enough, risks of negative impact on dental formation are not relevant
The bottom line:
Try to avoid prolonging pacifier use into the toddler years
Ideally, try to end when your baby is 6-12 months old
What we know:
Some evidence shows an association between ear infections and pacifier use
But, ear infection risk <6 months is low vs pacifier benefits, according to AAP/AAFP
This risk-benefit ratio changes as babies get older (especially ~2 years old)
The bottom line:
Again, try to avoid prolonging pacifier use into the toddler years
Ideally, try to end when your baby is 6-12 months old
Avoid having to wean later
Avoid potential ear infection and dental challenges if you're not able to wean before toddler years
Preempt potential obstacle to teaching independent sleep
And any hesitation you may have – you're the parent, you decide!
