The Ultimate Pacifier Use Guide for New Parents

How to Use Pacifiers Responsibly

As a new parent, you want nothing more than to nurture your bond with your little one, grow together in love, and enjoy each moment learning about one another and becoming closer every day. We all want our children to develop into happy, healthy little people, enabled positively by the choices we made during their earliest and development periods.

There are differing opinions when it comes to how and when to use a pacifier – and having questions is totally normal. Every baby is unique and we believe that parents know and do what’s best for their little ones. This guide shares what we know are evidence-based facts around pacifiers, so you can make the most educated, informed decisions when it comes to introducing pacifiers responsibly and using one with your baby.

We all know that suckling is an innate, natural reflect of most babies. When babies suckle to calm themselves or self-soothe to sleep without nursing, that’s what experts call non-nutritive sucking (NNS). Non-nutritive sucking has already been observed in the womb when your baby practices suckling on their hands and/or fingers. Introducing a pacifier can help satisfy your little one’s natural desire to suckle.

Parents have given their babies objects to suckle on for centuries. When choosing a pacifier today, knowing what criteria is most important for your baby’s unique needs – such as weight, material, flexibility, softness, or the shape of the shield and teat – can make a world of difference when it comes to your little one’s overall pacifier experience.

What Can a Pacifier Do For My Baby?

…A lot! In fact, the pacifier can:

• Satisfy your baby’s natural suckling desires, especially after he or she has been fed but still wants to suckle.
• Help to calm and relax babies when other comfort attempts have not been effective. Suckling on a pacifier helps them to regulate their emotions.
• Help reduce babies’ feelings of pain, such as during a vaccination or when a blood sample is taken.
• Provide additional practice to exercise the mouth muscles, which then supports oral development.

True or False? Test Your Pacifier Knowledge!

• Using a pacifier shortens the length of time that you may breastfeed.
  False! The opinions of healthcare professionals are sometimes divided on when the right time is to start using a pacifier. Scientific evidence shows that using a pacifier from birth will not harm initiation and duration of breastfeeding in healthy term babies, especially when mothers are motivated to breastfeed. Many parents choose to offer a pacifier once lactation is established and breastfeeding is going well for both you and your baby.
• Pacifiers cause eventual crooked teeth.
  False. However, pacifier use should be limited to less than 6 hours per day. With that in mind, it’s important to remember that each child’s mouth and teeth develop differently. Using pacifiers with children older than 24 months should be a decision made individually by each parent, based on discussion with their little one’s pediatrician and pediatric dentist.
  
  The American Academy of Pediatric Dentistry recommends that weaning from the pacifier should start by 3 years of age at the latest. Following these guidelines and ensuring the limited and responsible use of a pacifier shouldn’t cause problems later on with crooked teeth. Be sure to choose a pacifier that supports oral development, which is usually designated by the word “orthodontic” on the package and/or in the product description.

What Does the Ideal Pacifier Look Like?

Speech-language pathologists recommend the following features in pacifiers to help support the natural movement of your baby’s mouth muscles:

• Thin shaft, which minimizes the space between the upper and lower jaw.
• Flat teat, which takes up less space in the mouth and allows for more tongue movement.
• Flexible and elastic teat, which allows for additional tongue movement.
• Lightweight structure to minimize the work of the facial muscles.
• Ergonomic shield, which helps the pacifier fit the contour of your baby’s face and prevent aggravating pressure points.

How Can I Keep Pacifiers Clean and Safe For My Baby?

Want to keep your little one’s pacifiers in clean, quality condition? Follow these guidelines:

• Boil the pacifier for 5 minutes before first use. Allow it to thoroughly and completely cool before use. If needed, squeeze any remaining water out of the teat that may have collected while boiling.
• Sterilize your baby’s pacifier regularly, especially if you live in an area where water is not safe. You can sterilize the pacifier in boiling water; using an electric home sterilizer for bottles, nipples, and other baby products; or with steam sterilization using your microwave and the sterilization box included with your pacifier.
• Wash your little one’s pacifier with warm water between uses.
• If the pacifier falls onto the floor, avoid putting it into your own mouth to quickly clean it as this could transfer bacteria and viruses to your baby.
• Firmly pull the teat and carefully inspect it for tears or holes before each use. Always replace pacifiers right away at the first sign of wear or damage.
• Replace pacifiers that are used daily about every 1 – 2 months.
• Replace pacifiers immediately after your little one has had any infectious illness, such as a cold or stomach flu.
• Use a protective cap or box to help keep pacifiers clean while out and about or away from home.
• When weaning your little one from their pacifier, we strongly recommend against shortening the teat by cutting it off or damaging it in any way. Doing so could potentially lead to choking as a result of your baby accidentally swallowing tiny and/or loose parts. For helpful weaning tips, read on to the “Goodbye Pacifier!” section of this guide.

Goodbye, Pacifier! How and When to Wean Your Baby From the Pacifier

Eventually, the time will come when you decide to stop using the pacifier. Some children have no problem giving up their pacifiers, are ready to do so, and may have even begun self-weaning. Others may need more time to adjust. Patience and understanding are key when helping your little one say goodbye to their pacifier, but these tips can ease their journey going forward:

• Don’t rush – Take time preparing your little one for this big step.
  Prepare your child slowly and gently as it comes time to say goodbye to their pacifier. Goodbyes are never easy and neither are changes – Depending on your child’s age, you may wish to talk with them and decide on a farewell plan together. Allow him or her to have a say in the decision, feel that you’re supportive of them, and that you are acknowledging their effort and feelings. A child should never be forced to give up their pacifier by punishment or through humiliation.
• Plant the seed.
  When you think your little one may be ready to discontinue using their pacifier, make a plan and stick with it. Start talking about weaning from the pacifier in advance, so your child has ample time to get used to the idea. From there, you can gradually begin reducing pacifier use.
• Read together.
  Reading with your little one is a great bonding activity. It’s an opportunity to talk about a lot of things and spend quality time together. There are many children’s picture books that encourage kids – in an age-appropriate way – to stop using their pacifier. This can help prepare them and help them to understand when it’s time to say good-bye.
• Out of sight, out of mind.
  It can be helpful if your little one doesn’t always see or have access to their pacifier. This prevents them from constantly being reminded that it’s there and then wanting to use it. Put the pacifier away when it’s not in use and offer it only in situations, such as if your baby is sick, if they’re receiving a shot, or if you’re traveling together on a plane.
• Take things day by day and step by step.
  It’s okay to start with small steps! Encourage less pacifier use gradually, day by day. For example, allow your little one to use their pacifier only at naptimes or in the evenings to help them fall asleep – and then progressively decrease the daily amount of time that he or she is using their pacifier.
• Be conscious of timing.
  Don’t start weaning your child from their pacifier if there is currently a stressful situation or major life event happening, such as welcoming a new sibling, moving to a new home or bedroom, being sick, traveling, or experiencing a major change within the family like separation or divorce. It’s always best to choose a calm, non-stressful period to begin weaning your little one from their pacifier!
• Consider a farewell ritual to say goodbye to the pacifier together.
  There are many creative ways to help your little one let go of their pacifier. For example, a pacifier tree involves asking a friend or relative whether you may hang the last pacifiers on a tree in their garden. Visit the friend or relative together and hang the pacifiers on a tree branch. This symbolic act can help your little one better understand the finality of saying goodbye. Planning a fun activity afterwards can be a great way to bond and celebrate this milestone together!
  
  Another idea is the pacifier fairy, who comes and takes the pacifier away when no one is looking. Talk to your child and plan a time when they are ready to invite the fairy into your home. Let your child choose a spot to leave their pacifiers for the fairy to take them away. Tell your little one that the fairy – much like the tooth fairy! – comes overnight and leaves a surprise in place of the pacifiers. Just be sure that there are no additional pacifiers anywhere in your home that could be found later.
• Help your little one through the journey.
  Stay firm and supportive. After agreeing to take the pacifier away, he or she may still have a difficult time getting used to the situation. They may ask for the pacifier (and probably will) and might even cry for it. Do your best to remain firm and don’t give in, while remaining supportive, comforting, and reminding them of your agreed-upon decision. It’s never easy to say goodbye, so remember to have patience with your little one as they express their feelings. Snuggle with him or her, give them a relaxing massage, or play some comforting music to ensure a soothing environment.
  
  When preparing to help your little one through this phase, consider how you’ll react and respond to him or her when they complain or cry for their pacifier. For some children, the weaning process is difficult and they may protest. Allow them to express their feelings and stay supportive at all times. You can help him or her cope by giving them a lot of extra hugs, attention, and playtime. Eventually, the complaining will decrease as your little one becomes more accustomed to the transition!
• Distract your baby.
  If he or she asks or motions to use their pacifier, you can try distracting them with games, cuddling, playtime, or even reading books together.

Remember, what works for one child may not work for another. Children are their own little people and developing their own little personalities, likes, and dislikes every day! You may even have completely different pacifier experiences from one of your children to another.

What remains true, however, is that you know your little one best and you’ve been doing a great job building a loving bond together – which includes joyful moments and difficult ones too! Like your little one’s other milestones, you’ll go through this together as part of the journey.

Be sure to praise your little one when they fully give up their pacifier, and even as they take small steps towards weaning from it. Tell him or her how proud you are of what they did and acknowledge that it’s a big step. And, of course, be sure to lavish a lot of hugs and cuddles on your child throughout the process! Remember, in love we grow.

References

1. Lubbe W, Ham-Baloyi W. When is the use of pacifiers justifiable in the baby-friendly hospital initiative context? A clinician's guide. BMC. Pregnancy. Childbirth. 2017; 17(1):130.
2. Jenik AG, Vain N. The pacifier debate. Early Hum Dev. 2009; 85(10 Suppl):S89-S91.
3. Pillai Riddell RR et al. Non-pharmacological management of infant and young child procedural pain. Cochrane Database Syst Rev. 2015; (12):CD006275.
4. Sampallo-Pedroza RM et al. Description of oral-motor development from birth to six years of age. Rev Fac Med. 2014; 62(4):593–604.
5. Alm B et al. Breastfeeding and dummy use have a protective effect on sudden infant death syndrome. Acta Paediatr. 2016; 105(1):31–38.
6. Moon RY, AAP Task Force on SIDS. SIDS and other sleep-related infant deaths: Evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics. 2016; 138(5):e20162940.
7. Jaafar SH et al. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2016; (8):CD007202.
8. Proffit WR. On the aetiology of malocclusion. The Northcroft lecture, 1985 presented to the British Society for the Study of Orthodontics, Oxford, April 18, 1985. Br J Orthod. 1986; 13(1):1–11.
9. AAPD. Guideline on periodicity of examination, preventive dental services, anticipatory guidance/counseling, and oral treatment for infants, children, and adolescents. Latest revision 2018. In: American Academy of Pediatric Dentistry, editor. The reference manual of pediatric dentistry. 2019-2020. Chicago IL: AAPD; 2020. p. 209–19.
10. Furtenbach M et al. Myofunktionelle Therapie KOMPAKT I - Prävention: Ein Denk- und Arbeitsbuch. Vienna: Praesens; 2013. ( vol 2). 235 p.
11. WIC Breastfeeding Support. Baby's hunger cues: USDA. Available from: https://wicbreastfeeding.fns.usda.gov/babys-hunger-cues.
12. Lieberthal AS et al. Clinical practice guideline: The diagnosis and management of acute otitis media. Pediatrics. 2013; 131(3):e964-99.