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Pacifiers: Are they good for your baby?

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.

The pros

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 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.
  • Pacifiers might help reduce the risk of sudden infant death syndrome (SIDS). Researchers have found an association between pacifier use during sleep and a reduced risk of SIDS.
  • 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.

The cons

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 top front teeth to slant outward or not come in properly.
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References
  1. Sexton S, et al. Risks and benefits of pacifiers. American Family Physician. 2009;79:681.
  2. O'Connor NR, et al. Pacifiers and breastfeeding. Archives of Pediatrics & Adolescent Medicine. 2009;163:378.
  3. Hanzer M, et al. Pacifier use does not alter the frequency or duration of spontaneous arousals in sleeping infants. Sleep Medicine. 2009;10:464.
  4. Rovers MM, et al. Is pacifier use a risk factor for acute otitis media? A dynamic cohort study. Family Practice. 2008;25:233.
  5. The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics. 2005;116:1245.
  6. Thumb, finger and pacifier habits. American Academy of Pediatric Dentistry. http://www.aapd.org/publications/brochures/tfphabits.asp. Accessed May 4, 2011.
  7. Hebling SR, et al. Relationship between malocclusion and behavioral, demographic and socioeconomic variables: A cross-sectional study of 5-year-olds. The Journal of Clinical Pediatric Dentistry. 2008;33:75.
  8. Berkowitz CD. Thumb sucking and other habits. In: Berkowitz CD. Berkowitz's Pediatrics: A Primary Care Approach. 3rd ed. Washington, D.C.: American Academy of Pediatrics; 2008:1.
  9. Shelov SP, et al. Caring for Your Baby and Young Child: Birth to Age 5. 5th ed. New York, N.Y.: Bantam Books; 2009:58.
  10. Schwartz RH, et al. Infant pacifiers: An overview. Clinical Pediatrics. 2008;47:327.
  11. For the dental patient: Thumb sucking and pacifier use. Journal of the American Dental Association. 2007;138:1176.
  12. Nowak AJ, et al. Oral habits and orofacial development. http://www.uptodate.com/home/index.html. Accessed May 4, 2011.
  13. Holt K, et al. Bright Futures Nutrition. 3rd ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2011:32.
PR00067 Aug. 27, 2011

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