While American Academy of Pediatrics (AAP) are recommending pacifier use to prevent SIDS, babies also use pacifiers for non-nutritive sucking (NNS) and soothing. Another form of NNS is thumb sucking. Many babies begin to suck their fingers or thumbs before they are born. It is generally easier to wean a child from a pacifier than it is to wean a child from sucking their fingers or thumbs. Most babies have a natural need to suck, and most find it calming.
Tips for Parents About Safe Pacifier Use
- Wait until breastfeeding is going well (usually after about three to four weeks). If a pacifier is given to a baby before then, nipple confusion may occur and make breastfeeding hard to establish. After a pacifier is introduced, it should never be used to delay or replace regular feedings.
- The best times to use a pacifier are at naptime and bedtime to help lower a baby’s risk for sudden infant death syndrome (SIDS)
- Let a baby decide whether to use a pacifier. If a baby shows no interest in using a pacifier, do not force it.
- Attach pacifiers with clips that have short ribbons to keep from falling. Never tie a pacifier to a baby’s wrist or neck or to a baby’s crib. The string can get tangled around the baby’s neck and make the baby choke.
- Clean pacifiers and replace them regularly.
- Wash a pacifier that has fallen on the ground or floor with soap and warm water before giving it back to a baby. Parents who clean pacifiers with their mouths pass bacteria that cause tooth decay to the baby. Carrying extra pacifiers is a good idea.
- A baby’s risk for tooth decay increases if pacifiers are coated with sugar, honey, or jam.
- Do not share pacifiers. Each baby should have their own pacifier(s). Letting babies share a pacifier can pass bacteria that cause tooth decay and increases a baby’s risk for tooth decay.
- Check pacifiers for wear and tear. Look at the rubber every now and then to see if it is discolored, cracked, or torn. If it is, it needs to be replaced.
- Non-orthodontic pacifiers may have detrimental effects such as malposition of erupting teeth, malocclusions such as anterior open bite, delay in oro-myofacial development, and/or palatal collapse. Thumb sucking is even worse because the child is putting forces on the teeth and palate and a negative pressure.
- Between ages 2 and 4, most children stop using a pacifier on their own. If a child continues to use a pacifier after age 3, parents need to help take it away gradually
- Limit pacifier use to certain times (such as naptime or bedtime) or to certain places (bed).
- In most cases, when a child uses a pacifier in bed, it falls out of the child’s mouth during sleep.
- Throw it away. Encourage the child to throw their pacifier away. If the child asks for a pacifier, parents can remind them that the child threw it away, that the child is a big kid, and that big kids don’t use pacifiers.
- Trade it. Encourage the child to put pacifiers under the pillow for the “pacifier fairy” (or another positive cultural character) who will trade them for a gift, like a toy. If the child keeps asking for a pacifier, remind the child that all the pacifiers were given to the pacifier fairy (or other character), who gave the child a gift.
- Poke holes in it. This alters the pacifier so it is no longer satisfying to suck on. It’s best to use a clean pin to poke two to three holes in the tip
- Kids that suck their thumb also need constant reminders, such as colorful bandaids on both thumbs, or a bad tasting nail polish (Mavala Stop) to discourage this habit