Pacifiers: In or Out?

From the WebMD Archives

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

Pacifier Pros

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

  • Lower risk of SIDS. Pacifier use during naps or nighttime can prevent sudden infant death syndrome. Doctors aren’t sure how it works, but if you give your baby a pacifier while they are asleep, you might lower their risk of SIDS by more than half.
  • Satisfy the suck reflex. Babies have a natural need to suck. The bottle or breast usually meets this need, but the desire can linger even after the belly is full. A pacifier can help. Just be sure it doesn’t replace mealtime.
  • Encourage baby to self-soothe. 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 it may take a while for you or your baby to get the hang of it. If you nurse your infant, hold off on the pacifier for the first few weeks -- that gives time for your milk to come in, and for both of you to get in a good nursing pattern. That way, your baby won't start to prefer pacifiers over the nipple. After that, studies show no link between pacifier use and breastfeeding troubles.
  • Ear problems. According to one study, children who use pacifiers are almost twice as likely to get multiple ear infections as children who don’t.
  • Tooth troubles. Some parents wonder if a pacifier will affect their kid’s pearly whites. Just make sure your baby doesn't use them long term, experts say. “Before age 2, any problems with growing teeth usually self-correct within 6 months of stopping pacifier use,” says Evelina Weidman Sterling, PhD, MPH, co-author of Your Child's Teeth: A Complete Guide for Parents.

After the 2-year mark, problems can start. Your baby's top or bottom front teeth may slant or tilt, 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 Tips

If pacifiers are part of your plan, follow some guidelines to keep your baby safe:

  • Use a brand that is free of bisphenol-A (BPA). 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.
  • Get the right size. Match it to your baby’s age to make sure it fits their mouth.
  • Don't let kids share a pacifier. You don’t want them to share germs. Also, wash pacifiers in soap and hot water to keep them clean between uses.
  • Pick a pacifier with ventilation holes in the shield to let air in.
  • Give the pacifier as is. If you sweeten it, it can damage your baby’s teeth.

When to Pull the Plug

Like all good things, your child’s time with the pacifier will come to an end. Family doctor Sumi Sexton, MD, offers these tips:

  • Honor the pacifier’s place. It may be tiny, but it has played a big role in your child’s life. Sexton says you can have your child quit cold turkey, but it doesn’t have to be cold-hearted. Approach the end gently.

“Don’t turn pacifier weaning into a power struggle,” Sexton says. “Use positive reinforcement instead of negative.” You can couple it with unique ideas like the "pacifier fairy" taking it away, she says.

  • Time it right. Wean your baby from a pacifier after 6 months old, when the risk of SIDS drops and ear infections become more likely. If you want to help them give it up slowly, try to limit it to nap time or sleep only, Sexton says. Also, try not to wean when other life changes occur.

“If there are major transitions going on at home or in the care setting -- a move, a new sibling, a change in caregiver, stress at home -- all of these may warrant continued use of the pacifier for soothing,” Sexton says.

  • Be consistent. Remember, you’re not the only person who will spend time with your child during the weaning process.

“Make sure that all other caregivers -- parents, grandparents, babysitters, etc. -- stick to the same plan so no one gets confused,” Sexton says.

WebMD Feature Reviewed by Dan Brennan, MD on May 27, 2015



Evelina Weidman Sterling, PhD, MPH, MCHES; co-author, Your Child's Teeth: A Complete Guide for Parents, Johns Hopkins University Press, 2013.

Hauck, F. Pediatrics, 2006.

Hoffman, H. BMJ, 2006. “Nonnutritive sucking.” "Will Using a Pacifier Affect My Breastfed Baby?" “Practical Pacifier Principles.”

Sumi Sexton, MD, family physician, Arlington, VA; associate professor of family medicine, Georgetown University School of Medicine; associate editor, American Family Physician; co-author, Pacifiers Anonymous: How to Kick the Pacifier or Thumb Sucking Habit, Mill City Press Inc., 2010.

Jaafar, S. ­­­Cochrane Database of Systematic Reviews, published online July 11, 2012.

Sexton, S. American Family Physician, published online April 2009.

Mitchell, E. Pediatrics, 2006.

Freney, J. Nursing and Health Sciences, 2006.

FDA: “Bisphenol A (BPA): Use in Food Contact Application.”

Schilder, A.Family Practice, 2008.

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