The decision to use a pacifier — or not — is up to you. Consider the do's and don'ts of giving your baby a pacifier, and how to help him or her break the habit.

By Mayo Clinic Staff

Most babies have a strong sucking reflex. Some babies even suck their thumbs or fingers before they're born. Beyond nutrition, sucking often has a soothing, calming effect. That's why many parents rank pacifiers as must-haves, right up there with diaper wipes and baby swings.

Are pacifiers really OK for your baby, though? Understand the benefits and risks of pacifier use, important safety tips and steps to help wean your baby from the pacifier.

For some babies, pacifiers are the key to contentment between feedings. Consider the advantages:

  • A pacifier might soothe a fussy baby. Some babies are happiest when they're sucking on something.
  • A pacifier offers temporary distraction. A pacifier might come in handy during and after shots, blood tests or other procedures.
  • A pacifier might help your baby fall asleep. If your baby has trouble settling down, a pacifier might do the trick.
  • A pacifier might ease discomfort during flights. Babies can't intentionally "pop" their ears by swallowing or yawning to relieve ear pain caused by air pressure changes. Sucking on a pacifier might help.
  • A pacifier might help reduce the risk of sudden infant death syndrome (SIDS). Sucking on a pacifier at nap time and bedtime might reduce the risk of SIDS. If you're breast-feeding, wait to offer a pacifier until your baby is 3 to 4 weeks old and you've settled into an effective nursing routine.
  • Pacifiers are disposable. When it's time to stop using pacifiers, you can throw them away. If your child prefers to suck on his or her thumb or fingers, it might be more difficult to break the habit.

Of course, pacifiers have pitfalls as well. Consider the drawbacks:

  • Early pacifier use might interfere with breast-feeding. Sucking on a breast is different from sucking on a pacifier or bottle, and some babies are sensitive to those differences. Research suggests that early use of artificial nipples is associated with decreased exclusive breast-feeding and duration of breast-feeding — although it's not clear if artificial nipples cause breast-feeding problems or serve as a solution to an existing problem.
  • Your baby might become dependent on the pacifier. If your baby uses a pacifier to sleep, you might face frequent middle-of-the-night crying spells when the pacifier falls out of your baby's mouth.
  • Pacifier use might increase the risk of middle ear infections. However, rates of middle ear infections are generally lowest from birth to age 6 months — when the risk of SIDS is the highest and your baby might be most interested in a pacifier.
  • Prolonged pacifier use might lead to dental problems. Normal pacifier use during the first few years of life doesn't cause long-term dental problems. However, prolonged pacifier use might cause a child's teeth to be misaligned or not come in properly.

If you choose to offer your baby a pacifier, keep these tips in mind:

  • Wait until breast-feeding is well-established. If you're breast-feeding, the American Academy of Pediatrics recommends waiting to offer a pacifier until your baby is 3 to 4 weeks old, and you've settled into an effective nursing routine.
  • Don't use a pacifier as a first line of defense. Sometimes a change of position or a rocking session can calm a crying baby. Offer a pacifier to your baby only after or between feedings.
  • Choose the silicone one-piece, dishwasher-safe variety. Pacifiers made of two pieces pose a choking hazard if they break. Once you've settled on a favorite pacifier, keep a few identical backups on hand.
  • Let your baby set the pace. If your baby's not interested in the pacifier, don't force it. If the pacifier falls out of your baby's mouth while he or she is sleeping, don't pop it back in.
  • Keep it clean. Before you offer your baby a pacifier, clean it thoroughly. Until your baby is 6 months old and his or her immune system matures, frequently boil pacifiers or run them through the dishwasher. After age 6 months, simply wash pacifiers with soap and water. Resist the temptation to "rinse" the pacifier in your own mouth. You'll only spread more germs to your baby.
  • Don't sugarcoat it. Don't put sweet substances on the pacifier.
  • Keep it safe. Replace pacifiers often, use the appropriate size for your baby's age, and watch for loose parts or signs of deterioration. Also use caution with pacifier clips. Never use a string or strap long enough to get caught around your baby's neck.

The risks of pacifier use begin to outweigh the benefits as your baby gets older. While most kids stop using pacifiers on their own between ages 2 and 4, others need help breaking the habit.

Depending on your child's age, consider these techniques to wean your child from the pacifier:

  • Younger infants. Swaddling, rocking, singing, playing soft music and infant massage can be effective alternatives to pacifier use.
  • Older infants and toddlers. Activities, toys or other objects of affection, such as a blanket with satin edging, might help distract your child from his or her desire for the pacifier.
  • Toddlers and older children. Consider holding a special ceremony to bury or otherwise discard the pacifier — or allow your child to trade in his or her pacifier for a special book or toy. Your child's dentist also might be able to help your child stop using the pacifier by explaining the potential impact of prolonged pacifier use on his or her teeth.

If you need additional help weaning your child from the pacifier, consult your child's doctor.

Sep. 25, 2014