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May 1, 2012
Questioning The Wisdom of Using Pacifiers


Most babies have a strong sucking reflex. Some babies even suck their thumbs or fingers before they're born. Beyond nutrition, sucking often has a soothing, calming effect. But what should they suckle with? Binkies, corks, soothers. Whatever you call pacifiers, conventional wisdom holds that giving them to newborns can interfere with breastfeeding.


  • Early pacifier use might interfere with breast-feeding. Sucking on a breast is different from sucking on a pacifier or bottle, and some babies are sensitive to those differences. Research suggests that early use of artificial nipples is associated with decreased exclusive breast-feeding and duration of breast-feeding -- although it's not clear if artificial nipples cause breast-feeding problems or serve as a solution to an existing problem.

  • Your baby might become dependent on the pacifier. If your baby uses a pacifier to sleep, you might face frequent middle-of-the-night crying spells when the pacifier falls out of your baby's mouth.

  • Pacifier use might increase the risk of middle ear infections. However, rates of middle ear infections are generally lowest from birth to age 6 months -- when the risk of SIDS is the highest and your baby might be most interested in a pacifier.

  • Prolonged pacifier use might lead to dental problems. Normal pacifier use during the first few years of life doesn't cause long-term dental problems. However, prolonged pacifier use might cause a child's top front teeth to slant outward or not come in properly.

If you must use a pacifier:

  • Wait until breast-feeding is well established. Be patient. It might take a few weeks or more to settle into a regular nursing routine. If you're breast-feeding, the American Academy of Pediatrics recommends waiting to introduce a pacifier until four to six weeks after birth.

  • Don't use a pacifier as a first line of defense. Sometimes a change of position or a rocking session can calm a crying baby. Offer a pacifier to your baby only after or between feedings. Don't allow your child to use the pacifier all day.

  • Choose the silicone one-piece, dishwasher-safe variety. Pacifiers made of two pieces pose a choking hazard if they break. Once you've settled on a favorite pacifier, keep a few identical backups on hand.

  • Let your baby set the pace. If your baby's not interested in the pacifier, don't push it or skip it entirely. If the pacifier falls out of your baby's mouth while he or she is sleeping, don't pop it back in.

  • Don't sugar coat it. Don't put sweet substances on the pacifier.

  • Keep it safe. Replace pacifiers often, use the appropriate size for your baby's age, and watch for loose parts or signs of deterioration. Also use caution with pacifier clips. Never use a string or strap long enough to get caught around your baby's neck.


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