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Pacifiers: In or Out?

By Rachel Reiff Ellis
WebMD Feature
Reviewed by Roy Benaroch, MD

Parents have relied on pacifiers for ages to calm crying infants. But are they really best for a baby? Here’s a look at the plusses and pitfalls.

'Paci' Pros

Some of the good things pacifiers can do for your baby -- and you -- include:

  • Lower SIDS risk. Pacifier use during nap or nighttime can prevent sudden infant death syndrome. Doctors aren’t sure how it works, but if you give baby a pacifier while she’s asleep, you might lower her risk of SIDS by more than half.
  • Satisfy the suck reflex. Babies have a natural need to suck. This is mostly met by bottle or breast, but the desire can linger even after the belly is full. A pacifier can help -- just be sure pacifier time doesn’t replace mealtime.
  • Encourage self-soothing. Pacifiers can help babies learn to control their feelings, relax them, and make them feel secure. The comfort factor can be a double win: A calmer baby can mean calmer parents.

Binky’s Bad Side

There are strikes against pacifiers, too:

  • Nipple know-how. Breastfeeding is a natural process, but that doesn’t mean getting the hang of it comes easily for the baby or mom. If you’re a breastfeeding mom, hold off on the pacifier for the first few weeks -- that gives time for your milk to come in, and for you and your baby to get in a good nursing pattern. That way, the baby doesn’t start to prefer pacifiers over the nipple. After that, studies show no link between pacifier use and breastfeeding troubles.
  • Ear issues. According to one study, children who use pacifiers are almost two times more likely to get multiple ear infections than children who don’t use them.
  • Tooth troubles. Some parents wonder if a pacifier will affect their kid’s pearly whites. Just make sure they aren’t using them long-term, say experts. “Before age 2, any problems with growing teeth usually self-correct within 6 months of stopping pacifier use,” says Evelina Weidman Sterling, PhD, MPH. She's the co-author of Your Child's Teeth: A Complete Guide for Parents.

After the 2-year mark, problems can start. It often leads to slanting or tilting the top or bottom front teeth, Sterling says. And the problem can worsen as time goes on.

“Pacifier use after age 4, which is when permanent teeth start to come in, can have major long-lasting effects on adult teeth,” she says.

Pacifier Dos and Don’ts

If pacifying is your plan, follow some guidelines to keep it safe:

  • DO use a pacifier brand that is bisphenol-A (BPA)-free. Studies have raised concerns about its effects on infants.
  • DON’T secure a pacifier to your baby with a cord -- it’s a strangling hazard.
  • DO get the right one. Pacifiers are sized based on your baby’s age to make sure they fit her mouth.
  • DON’T let kids share a pacifier. You don’t want them sharing germs. Also, wash pacifiers in soap and water to keep them clean between uses.
  • DO pick a pacifier with ventilation holes in the shield to let air in.
  • DON’T sweeten a pacifier; it can damage your baby’s teeth.

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