Giving Baby a Pacifier

A pacifier can seem like magic: It’s easy, quick and for many babies it turns on the comfort and turns off the tears.

There's no denying that pacifiers can work remarkably well at comforting your baby, especially if she has a strong need to suck but hasn't yet figured out how to get her fingers in her mouth. But there are some potential pitfalls to be aware of before introducing your baby to a pacifier. Here's what you need to know about giving your baby a pacifier.

Should you give your baby a pacifier?

Yes, you can definitely try giving your baby a pacifier. Whether your baby is fussy or she needs some help getting to sleep at bedtime, pacifiers can be an essential component of reducing the fuss factor.

Pacifiers can also come in handy if your little one needs a distraction at the doctor's office or if her ears start popping on an airplane.

On the other hand, some babies show little interest in them, especially if they find their thumb or their fingers first. And pacifiers do have some downsides, so weigh both the positives and negatives to make a decision that's best for your baby. 

When should you introduce a pacifier to your baby?

It’s best to ensure that your baby has gotten the hang of breastfeeding (by around 3 or 4 weeks old) before you introduce a pacifier. That's because the sucking mechanism for breastfeeding is different from that used for sucking on a pacifier.

Pacifier pros and cons

Should you pop that binky into your baby’s mouth at the first whimper? Here are some pacifier pros and cons to take into consideration:

Pros of pacifiers

• Using a pacifier decreases the risk of sudden infant death syndrome (SIDS). One theory as to why is that sucking on a pacifier might help open up air space around a baby's mouth and nose, which ensures she gets enough oxygen. 
• The pacifier is in your control. That can be a good thing when nothing but plunking that pacifier in your baby’s mouth will generate calm. Plus, unlike the thumb (which is in baby’s control) you decide when it’s time for your baby to give up the binky, though whether your baby will put up a fight is another issue. In fact, research has shown that finger- and thumb-sucking can be a harder habit to break.
• Pacifiers can serve as a necessary distraction in a pinch. They're an easy way to soothe your baby if her ears start popping on a flight or if she’s about to get a shot at the doctor. Many parents rely on them to calm crying babies down quickly.
• Pacifiers can help babies learn to self-soothe, including at naptime and bedtime. They can help your baby get to sleep faster and learn how to fall asleep on her own.

Cons of pacifiers

• Your baby may get attached to the pacifier. It can be a tough habit to break, especially once your baby turns into a more strong-willed toddler.
• It can become a bad habit for you too. If you plunk in the pacifier at the first sign of a squall, you might overlook the real reasons for baby's tears (a tummy ache, an uncomfortable diaper). The result may be a baby who can only be happy with something in her mouth, and who is unable to comfort herself in any other way.
• It could result in less sleep for everyone. Babies who regularly use a pacifier to go to sleep might not learn how to fall asleep on their own — and they might put up a sniffly fuss when the binky gets lost in the middle of the night (requiring you to get up and get it for her … each time she wakes up). Of course, though inconvenient, this is a pretty minor downside compared with the significant pro of safer sleep for pacifier-using newborns, and it can actually help babies learn to self-soothe and sleep better.
• Pacifiers might increase the risk of ear infections. But this isn’t the case before 6 months, when the risk of ear infections is at its lowest.

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Pacifiers and breastfeeding

Despite what you might have heard, there's not much evidence that pacifiers cause nipple confusion. And as far as throwing a monkey wrench into long-term nursing patterns or cutting the duration of breastfeeding short, the data doesn’t bear that out either.

But just in case, it’s best to wait until your baby is around 3 weeks or a month old to introduce it. There’s no doubt that your milk supply is dependent on your baby’s suckling — which means that spending too much time with a pacifier in the mouth means less time at the breast, and that, in turn, can mean too little stimulation for your milk supply.

Types of pacifiers

There are plenty of styles and sizes to choose from, and different babies show a preference for different pacifiers — so be prepared to switch around to find your little one’s favorite. (And once you find it, buy a few! It's always good to have backups on hand.)

Here are the basics to consider when buying a binky:

• Nipple shape: Standard-shaped pacifiers have a straight, elongated nipple. Orthodontic pacifiers have a rounded top and a flat bottom. "Cherry" nipples have a trunk that becomes ball-shaped toward the end.
• Latex vs. silicone: You may want to opt for silicone because it’s sturdier, longer-lasting, doesn’t retain odors and is top-rack-dishwasher-safe. Latex, while softer and more flexible, deteriorates faster, wears out sooner, can be chomped through by baby teeth and isn’t dishwasher-safe. Plus, babies can be sensitive or allergic to latex just like adults.
• Shields: Some pacifiers are one-piece and made entirely of latex. Most, however, have plastic shields (which should always have ventilation holes), in different colors (or transparent) with different shapes (butterfly, oval, round, etc.). Some shields curve toward the mouth, while others are flat. Just make sure it's large enough — 1 1/2 inches across — that your baby can't fit it into her mouth. 
• Rings vs. buttons: Some pacifiers have rings on the back, while others have "buttons." Ring handles make the paci easier to retrieve, while button handles may be easier for your baby to grasp. Some handles even glow in the dark, so they're easily found at night.
• Nipple covers: Some pacifiers have a cover that automatically snaps closed if the pacifier is dropped. Others have snap-on caps to help the paci stay clean (though a cap is another thing to keep track of, plus you need to keep it away from your baby because it’s a choking hazard).

Are pacifiers bad for baby’s teeth?

Pacifiers really only become a concern for your baby's dental health once she turns into a toddler, when the continuing use of pacifiers is linked to recurrent ear infections (specifically inner-ear infections between the ages of 6 months and 2 years), misaligned teeth and changes in the roof of the mouth — especially if baby is still reliant on a pacifier past 2 years old.

The most common dental effect in older children is an anterior open bite, or a gap between the front upper and lower teeth. Kids are also at risk of maxillary constriction (crooked, crowded and protruding teeth). Your best bet is to wean your baby off the pacifier by the time she turns 2.

Pacifier safety tips

A few safety tips to keep in mind with your baby’s pacifier:

• Give your baby a pacifier when you put her in her crib, but don’t reinsert it once she’s asleep.
• Never attach a pacifier to her crib, carriage, playpen or stroller, or hang it around your baby’s neck or wrist with a ribbon, string or cord that’s longer than 6 inches. Babies can be strangled this way. Clips and shorter tethers designed for pacifiers are fine to use when your baby is awake, but never when she's sleeping. 
• Don’t use pacifiers with attached parts (like those homemade pacifiers with glued-on mustaches or other small pieces). While they can be adorable, if that 'stach isn’t built-in to the paci it can fall off and pose a choking hazard.
• Clean the pacifier frequently, and at a minimum daily, with soap and hot water, rinsing thoroughly. Replace regularly.
• Never dip a pacifier in a sugary substance (like sugar or honey, which is off-limits to babies under 1 year of age anyway), as it's bad for baby’s gums and developing teeth.
• Be sure your child isn’t hungry before offering a pacifier. It should never be used to delay or replace a meal.
• Never use a bottle nipple as a pacifier. It’s possible that the nipple could separate from the ring, which could pose a choking hazard. 

When and how should you wean baby off the pacifier?

From the start, it’s a good idea to have a plan to ditch the pacifier down the road, once your baby is approaching her second birthday. At this point, the cons will start to outweigh by the pros — and your little one will be better off learning new ways to self-soothe.

The bottom line on binkies? Make moderation your motto. If a pacifier works for you and your baby, don't hesitate to use it, especially at sleep times as recommended and at fussy times, when your baby really seems to need relief ... and so do you.

Give one a try, too, if your little one has such a strong need for sucking that your nipples have become human pacifiers, or if your baby is taking too much formula because she’s not happy without a nipple in her mouth.