Tips for Choosing a Safe Pacifier for Your Baby

March 14, 2023

Baby holding a pacifier — Image by Daria Nipot via Shutterstock

With so many pacifiers on the market today, trying to decide which one to choose for your baby can be daunting. This article will discuss the pros and cons of pacifier use, how to choose a pacifier for your baby, and general pacifier safety tips.

Pacifiers are safe to use and have many benefits, including helping your baby fall asleep, soothing them during times of stress, and decreasing the risk of sudden infant death syndrome (SIDS).
Prolonged pacifier use can have some drawbacks, including dependency, increased risk of ear infections and dental issues, and possible interference with breastfeeding.
The safest pacifiers are the appropriate size for your baby’s age, are made of rubber latex or silicone, have a one-piece construction, and have a shield that is at least 1.5 inches across.
Parents should inspect their baby’s pacifier frequently for defects, wash pacifiers often, check for recalls, and avoid using supplemental pacifier items (such as pacifier cords or stuffed animal attachments).

Are pacifiers safe?

Pacifier use is perfectly safe. Babies are born with a natural desire to suck. This sucking reflex is important for feeding, but it can also provide a soothing effect. A pacifier can provide an outlet for satisfying the sucking reflex beyond what a bottle or breast provides during feeding times.

Pros

May help your baby fall asleep faster or stay asleep longer. Most babies find comfort in sucking on something. A pacifier often helps them relax and drift off to sleep easier.
Provides a soothing distraction for fussy babies. Pacifiers can be particularly calming during times of stress, such as after shots or during air travel.
May reduce the risk of sudden infant death syndrome (SIDS). Multiple studies have shown pacifier use reduces the risk of SIDS.

Cons

Your baby may become dependent on the pacifier. Experts agree that the longer a baby uses a pacifier, the more likely they are to become dependent on it for sleep. You may find yourself waking up multiple times in the night to put the pacifier back in your baby’s mouth because they feel they cannot sleep without it.
May increase the risk of ear infections after 6 months of age. Generally, the risk of ear infections is lower in babies that use pacifiers from birth until 6 months of age. However, from 6 months of age and older, the risk of developing an ear infection increases.
May increase the risk of dental problems with prolonged use. As their teeth grow in, babies and toddlers are at a risk for malalignment the longer they use a pacifier.
May interfere with breastfeeding. It is best to wait until breastfeeding is well established (usually by 3–4 weeks) prior to offering a pacifier. This is because the sucking technique for a breast is different than that of a pacifier, so it is best to give the baby some time to master their breastfeeding technique prior to pacifier introduction.

When to introduce a pacifier to your baby

Formula-fed babies can be offered a pacifier from birth. However, if your baby is breastfed, it is generally recommended to wait until breastfeeding is well established before offering a pacifier in order to avoid possible feeding difficulties.

How to choose a safe pacifier

When choosing a safe pacifier for your baby, consider the following:

Size and shape of the nipple. Pacifier nipples come in many different shapes, including cylindrical, bulbous, flat, and orthodontic. Many babies tend to have a preference for certain pacifier shapes, so you may have to try several different ones before finding your baby’s favorite. Pacifiers also come in multiple sizes, such as 0–6 months or 6 months and over. Generally, pacifier size is a matter of preference, but there is a safety component to using the appropriate pacifier size for your baby’s age. A pacifier that is too small can be a choking risk if the baby puts the entire thing in their mouth.
Material. Natural rubber latex and silicone are the two most common materials used for pacifiers. Latex pacifiers tend to be softer and more flexible than silicone pacifiers, making them a bit more "breast-like." However, latex pacifiers also deteriorate quicker and are not dishwasher safe. Parents should consider the pros and cons of each pacifier material before deciding which type to give their baby.
Construction. The safest pacifiers are made of one solid piece and cannot come apart. Pacifiers made of two or more pieces pose a choking hazard if they break and can grow mold or harmful bacteria inside the nipple if not thoroughly cleaned.
Shield design. The pacifier’s shield should be at least 1 ½ inches across in order to prevent your baby from being able to put the entire pacifier in their mouth. The shield should also have ventilation holes to allow your baby to breathe easier if their nose touches the shield.

General pacifier safety tips:

Inspect pacifiers often for defects. Pacifiers deteriorate over time, so inspect them periodically for tears, discoloration, or loose parts. Damaged or discolored pacifiers should be thrown away.
Replace pacifiers frequently. Pacifiers should be replaced if they are damaged, discolored, or no longer the appropriate size for your baby. For example, older babies should not continue to use a newborn-sized pacifier because they could easily fit the entire thing in their mouth and choke.
Check for recalls. Continuing to use a pacifier that has been recalled puts your baby at risk for injury or even death. It is important to stay up-to-date on the latest safety recalls to ensure your child’s pacifier is still safe to use.
Wash pacifiers frequently to remove germs. It is recommended that you boil pacifiers, wash them with soap and hot water, or run them through the dishwasher often, especially for babies under six months old or those with weakened immune systems.
Avoid using supplemental pacifier items during sleep, such as pacifier cords or stuffed animal attachments (“Wubbanubs”). These items can cause injury to your baby during unsupervised sleep.