Pacifiers do not harm an infant but there are some risks to pacifier use. Never loop a pacifier around an infant’s neck. This can lead to strangulation. Self-made pacifiers may be dangerous due to the risk of choking if part of the pacifier breaks off. There should be small ventilation holes at the base of a pacifier and make sure the pacifier is the right size for your infant. A BPA (Bisphenol A) free pacifier is also a good idea. The pacifier should be dishwasher safe and buy several so they can be washed in the dishwasher or washed frequently with hot soapy water and allowed to air dry.
Pacifiers can help soothe an infant. Many infants benefit from sucking and infants who use a pacifier have a decreased risk of SIDS. Pacifiers are also helpful on airplane flights where middle ear pressure can cause pain for many infants. They also help many infants fall asleep easier.
Pacifiers should not be used on a hungry infant to delay feeding and it is best to avoid having the pacifier become a “lovey” or a transitional object. By fading the use of a pacifier at about 12 months the transition off a pacifier is often easier. Delaying elimination of the pacifier beyond 18 months of age often makes the transition off a pacifier much more difficult.
Children who continue to use a pacifier beyond age two may change the alignment of their teeth. This can lead to future dental problems. The older your child is the more difficult it is to transition away from the pacifier. Many children use the pacifier as a sleep cue or as a transitional support. This dependence often causes sleep consequences such as frequent interval waking that are difficult to manage. Never pressure your child to stop using a pacifier. Pressure and punishment are not helpful. By relying on praise and distraction most parents are able to substitute an acceptable and less risky transitional support.
Deciding whether to use a pacifier is a great opportunity for you to learn how to recognize, understand and respond to your infant or child’s cues. Infants who soothe and self settle easily without using a pacifier often do not need a pacifier. Infants who suck on their own hands and fingers are able to rely on these natural pacifiers in the same way as infants who suck on the little finger of a parent.
Infants who are breastfed should not be given a pacifier for at least several weeks after delivery. This allows maternal milk production to increase and supports the development of a strong physical attachment between mother and child.