When to introduce a pacifier: Pros and cons

When to introduce a pacifier

Babies can use pacifiers from birth – though if you're breastfeeding, the American Academy of Pediatrics (AAP) suggests waiting to introduce a pacifier until after your baby is breastfeeding well.

Sucking is a natural, soothing instinct that drives your baby to eat. If you're breastfeeding, this sucking reflex also helps to establish your milk supply. So if you're breastfeeding and want to offer your newborn a pacifier, make sure to feed your baby on demand first. (This sometimes means your baby will eat every hour, if they're cluster feeding to boost your milk supply. You can also expect your newborn to eat every few hours throughout the night for the first couple of months.)

When giving your newborn a pacifier, do it at a time when you know they aren't hungry, such as right after a feeding. Try to soothe your baby another way first, such as by switching positions or rocking them. If your baby is still fussy after you've fed, burped, and soothed them, you may want to try a pacifier.

Are pacifiers bad?

Pacifiers aren't inherently bad – in fact, they can be a very useful tool to help calm and soothe a fussy baby. That said, there are a few situations where you might need to avoid using pacifiers:

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 breast milk supply), it's probably best to do without a pacifier for now.

Ear infections: Consider foregoing a pacifier if your baby has had repeated ear infections.

Pacifier pros and cons

Pros of a pacifier

• Self-soothing: Some babies can be soothed with rocking and cuddling and are content to suck only during feedings. Others just can't seem to suckle enough, even when they're not hungry. If your baby still wants to suck after having their fill of breast milk or formula, a pacifier may satisfy this urge. A binky can also help comfort your baby when they're upset – after they get a vaccine, for example.
• Lower SIDS risk: Some studies have shown that babies who use pacifiers at bedtime and nap time are at lower risk of SIDS. 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: After a feeding, your baby may like to suck on the pacifier until they fall asleep.
• Travel aid: Having your baby suck on a pacifier can come in handy if you're in transit and your baby is fussing in a car seat or stroller. Also, sucking can help "pop" your baby's ears on a plane, relieving discomfort from pressure changes.
• Help preterm infants to feed. Pacifiers are sometimes offered to preterm babies in the hospital to establish a sucking reflex, which in turn improves feeding and weight gain.
• Easier 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. This won't work if your baby sucks on their thumb or fingers.

Cons of a pacifier

• Dependence: Children sometimes have a hard time breaking the binky habit. If your child continues to depend on a pacifier as they get older, taking it away could become a battle.
• Possible sleep disturbances: If your baby is dependent on their pacifier to sleep and it falls out of their mouth once they're asleep, they may wake up and need you to retrieve it.
• 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 is about 6 months old (when their need to suck is greatest) and then weaning them from it may be a good strategy if your baby is prone to ear infections.
• Thrush risk: Dirty pacifiers can spread thrush, a fungal infection in the mouth requiring treatment – so it's critical to regularly clean them.
• 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.
• Potential dental problems: If your child uses a pacifier regularly for more than a few years, it could affect the development of their bite and teeth. The American Academy of Pediatric Dentistry recommends stopping pacifier use after a baby is 1 year old, while the AAP suggests pacifier weaning children if they're still using the paci beyond 2 to 4 years of age.

Tips for pacifier use

• Let your baby guide your decision. If your newborn takes to a pacifier right away, fine. But if they resist, don't force it. You can try again another time or just let it go.
• Choose a pacifier with a shield that has air holes and is at least 1 1/2 inches across. You want to prevent your baby from putting the entire paci into their mouth.
• Choose a one-piece model. Two-piece pacifiers could break apart and lead to a choking hazard.
• Try different sizes and nipple shapes. Your baby may prefer a standard, bottle-type paci or an "orthodontic" model. Check out our roundup of the best pacifiers for ideas.
• Buy extras. Binkies are good at disappearing and being dropped, so keep a clean one on hand.
• Never tie a pacifier around your baby's neck or to the crib. Babies can strangle on the cord or ribbon. It's safe to attach the pacifier to baby clothes with a clip made especially for that job, though. Also, don't buy pacifiers attached to circular beads (they're choking hazards).
• Offer the pacifier between feedings when you know your baby isn't hungry. You don't want the pacifier to become a substitute for feeding.
• Don't dip your baby's binky in honey, juice, or sugar. This is bad for your baby's gums and teeth and can lead to cavities (plus, honey isn't safe for babies).
• Keep pacifiers clean. Pacifiers can become a breeding ground for bacteria, viruses, and fungi, so it's essential to clean them regularly. Until your baby is 6 months old, run their pacifiers through the dishwasher or boil them in water frequently (about once per day). After 6 months, you can simply wash them with warm water and soap.
• Don't "clean" a pacifier by putting it in your mouth. Adult saliva contains bacteria that can cause cavities in your baby's teeth, plus you'll just spread more germs to your baby. If you baby's paci falls on the ground, wash it with warm water and soap.
• Inspect for wear and tear. Replace any pacifier that shows small cracks or other signs of wear.
• Check product recalls. Pacifiers are often recalled, so keep an eye on the list from the U.S. Consumer Product Safety Commission.Opens a new window

Should I give my baby a pacifier?

It's your call, but there's no harm in giving your baby a pacifier. A binky is especially helpful during the first six months, when a baby's urge to suck is highest.

Not all babies want a pacifier, and some are able to satisfy their sucking urges with the breast or bottle. Your fussy baby may respond better to other comforting tactics, such as being swaddled or carried. 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 the car seat a few miles from home). In these instances, a pacifier can be a godsend.

Comforting your infant is one of your highest priorities as a new parent. Pacifiers are often one of the most powerful tools to soothe a crying baby – so use them as you see fit.

Learn more:

When your baby should stop using a pacifier

Pet names for the pacifier

Can newborns and babies sleep with pacifiers?