Pros and Cons of Using a Pacifier

Medically Reviewed by Poonam Sachdev on October 12, 2023
5 min read

For many parents, a pacifier tops the list of must-have items for a new baby. Babies naturally have the desire to suck, since it's the motion they use for nursing or taking a bottle.

A pacifier does exactly what the name implies – it serves to pacify and comfort your baby. But how much should your baby depend on a pacifier – and is it safe at all? Here’s a breakdown of the pros and cons of pacifiers and their safety concerns. 

Pacifiers are popular for a few reasons. They: 

Offer comfort. Everything is new to your baby, and that can overwhelm them at times. A pacifier offers your baby the chance to suckle, one of the first self-soothing tools they may learn.

Help with feeding.Premature babies (those born before their due date) need oral stimulation to help improve breastfeeding and bottle feeding skills. Giving a pacifier to babies who aren't yet breastfeeding or bottle feeding benefits their development. 

Lower the chance of SIDS. SIDS (sudden infant death syndrome) is the leading cause of death in babies under 1 year of age. Studies have shown that using a pacifier reduces the risk of SIDS during sleep.

Help your baby fall asleep. While a pacifier may not improve the quality of your baby's sleep, it may help them fall asleep faster. Whether bottle-fed or breastfed, your baby has a natural desire to suck. Breastfeeding infants often want to nurse when falling asleep because it's comforting.

Offering a pacifier may allow you to lay your baby down to fall asleep alone without rocking or nursing for comfort. If your baby’s pacifier falls out during sleep, you don’t have to put it back in their mouth unless they wake up crying for it.

Ease pain. Pacifiers can help soothe pain for your baby during minor procedures such as having blood drawn. One study of babies who had their blood drawn found that they had less pain while sucking a pacifier vs. drinking a sugary drink

Can be a short-term habit. Unlike thumb sucking, sucking on a pacifier is an easier habit to break.
 

While a pacifier offers your baby some much needed comfort, there are some downsides to relying on one:

Nipple confusion. If you choose to breastfeed, it's important to wait to introduce a pacifier until nursing is well established. Your baby uses a different suckling technique when using a pacifier or bottle vs. nursing at the breast. 

Suckling on the pacifier is much easier than breastfeeding, which requires more effort and a particular technique to draw milk from the breast. If you introduce a pacifier too soon, your baby may turn away from nursing because of the effort it requires. 

Habit-forming. Your baby may grow to rely on the pacifier to stay asleep. If it falls out of their mouth in the middle of the night, they may wake up crying. You might get less sleep because you keep getting up to give your baby the pacifier.  

Dental development. Most babies don’t have teeth yet, but the use of a pacifier can impact the spacing and straightness of their teeth once they do begin to come in. If you can, plan for your baby to stop using a pacifier before it has too much of an impact on their teeth. While some babies are born with their first teeth, most start teething around 6 months.

If your baby develops an overbite as a result of pacifier use, you may need to invest in braces later on. Some babies will suck their thumb if a pacifier isn’t available, which has similar impacts on their teeth.

Higher chance of ear infections. Studies have shown that children who go without pacifiers have 33% fewer ear infections than kids who do. Too much pacifier sucking causes the tubes in your baby's ears to open more than they should. When these tubes are open, they allow bacteria in secretions from the throat to get into the ear, causing an ear infection. Babies who get more than two ear infections in a year might have trouble forming words and understanding sounds. 

Choking. Be sure to choose a pacifier with a base that's at least an inch and a half across. This size prevents your baby from getting the pacifier stuck in their mouth or throat. Also, look for a pacifier that has ventilation holes in the base just in case it ever gets trapped in your baby's mouth.

Make sure the pacifier is one complete piece. If your baby sucks hard enough on a two-piece pacifier, it may come apart and pose a choking risk. Since pacifiers get worn down over time, make sure you check them regularly and buy more as needed. If the pacifier material becomes weak and breaks off, your baby could swallow a piece of it. 

If you decide to use a pacifier with your baby, here are some tips to help you avoid the pitfalls: 

Best way to introduce a pacifier. When you're ready to introduce the pacifier, try doing the following: 

  • Make sure you use the right-sized pacifier. There are two sizes, one for newborn babies through 6 months old, and the other for kids 6 months and older.
  • If your baby resists taking a pacifier, wait until they're in a better mood. As they get older, babies learn to self-soothe in other ways, like the use of white noise and a consistent sleep routine.

Use a one-piece pacifier. Choose a pacifier that's a single piece and dishwasher safe. A two-piece pacifier may come apart and be a choking hazard. 

Clean it often. Make it a habit to boil your baby's pacifier or run it through the dishwasher often to sterilize it. Once your baby's immune system matures (usually around 6 months in full-term babies), you can wash it with soap and water. But don't "wash" the pacifier by sticking it in your mouth first. Doing this will only spread more germs. 

Don't use a pacifier with a hungry baby. You don't want a pacifier to interfere with your baby's nutrition, so only use a pacifier when your baby isn't hungry.

Avoid cords or strings. Never place a pacifier on a cord or string around your baby's neck. This is a choking hazard.

Know when to stop. As your baby ages, the cons of using a pacifier outweigh the pros. Try phasing the pacifiers out after 6 months. Many children will stop using a pacifier on their own between the ages of 2 and 4. But if your baby has trouble giving up the pacifier when it's time, talk to their doctor or dentist about it.

Many children will give up their pacifiers easily with a little coaxing. Follow these tips for an easy transition:

  • Avoid using harsh words or teasing that can upset your child. There's no need to bully or punish them to break this habit.
  • Once you begin trying to break the habit of using a pacifier, praise your baby's efforts.
  • Start a sticker chart to track your baby's progress. 
  • If your child goes from a pacifier to using their fingers for sucking, distract them or keep their hands busy throughout the day.