Should You Give Baby A Pacifier? Are Pacifiers Safe?

Should you give baby a pacifier? Are they safe? The answer is not as clear cut as parents and parents-to-be might wish. On the one hand, the pacifier, also known as “dummy” or “binky,” may prevent Sudden Infant Death Syndrome (SIDS). On the other hand, pacifiers may cause dental problems, cause middle ear infections, or even pose a choking hazard. And that’s just the beginning of a long list of pacifier pros and cons to consider.

Faced with conflicting facts, a parent may find it difficult to decide whether or not it is a good idea to give the baby a pacifier. It would be so much easier if experts would just come out with a statement either for or against the pacifier. That, unfortunately, is not going to happen.

This being the case, parents should examine all available information on pacifiers. Parents should also take into account a baby’s needs and nature as well as those of the parents, too.  The last consideration may surprise you. Your needs and nature are, however, as relevant as any other piece of the puzzle in making your decision about whether or not to let your baby use a pacifier.

Active Attention Versus The Pacifier

Think about it: are you likely to be patient with a baby who needs lots of rocking and active attention in the middle of the night? Or could sucking on a pacifier calm the baby enough, so you can stay in bed and sleep between feedings? Now this may not be something you can know in advance. If you are expecting a first baby, it can be difficult to predict how you will respond to the need to care for a crying baby when you are very tired.

Then too, healthy babies have a strong desire to suck. In fact, some babies will suck their thumbs before they are born, as delighted parents may note during an ultrasound examination. This urge to suck is nature’s way of ensuring that babies get enough milk to survive.

A mother’s milk production is stimulated through the baby’s sucking. How much milk is produced depends on how much, how often, and how strongly the baby suckles. Sucking and the mother’s milk supply may be the earliest known example of supply and demand.

Nursing: Should You Give Baby A Pacifier?

But what if you don’t plan to nurse your baby? And what if your baby still wants to suck when she’s finished nursing or a bottle feeding? A baby’s nervous system is underdeveloped. The baby may need to suck past the point of what is needed to produce milk. Here, a pacifier can be a darned good thing to have. The baby has something to suck, and is calm and happy which means you are calm and happy, too.

On the other hand, also due to the developing nervous system, a baby can develop what is known as    “nipple confusion.”  In nipple confusion, the baby becomes used to one sort of nipple, be it mother’s, a baby bottle nipple, or the nipple of a pacifier.  The baby can become agitated and refuse to suck more than one type of nipple. That can be a big problem if you want to nurse, but your baby only wants the pacifier, for instance.

Another common scenario is the baby who sucks a pacifier while sleeping and then doesn’t have enough of a sucking urge left to strongly suckle during nursing sessions. Since milk production is dependent upon sucking, the mother’s milk supply may dwindle as the result of using the pacifier, and the baby won’t get enough milk to satisfy his hunger. The solution here is to stop the pacifier immediately, and let the baby suckle as much as possible at the breast. The baby may be crying from hunger and from a need to suck and that’s okay. You want her hungry and willing to suck long enough to bring your milk supply back up to levels high enough to sustain your baby’s nutritional needs.

Sleeping Baby Pacifier
A pacifier can help babies sleep

One way to ensure your baby won’t refuse the pacifier is to bring it with you to the hospital when you arrive to deliver your baby. You can purchase and sterilize a few pacifiers, bag them up, and stow them in your hospital bag, to use whenever the baby is next to you and between feedings. Sterilize the pacifiers by boiling them for 5 minutes in a small pot of water.

Finally, it is important to consider the mother’s skin type. If she is fair-skinned, she may be more vulnerable to cracks in the skin and pain from nursing. In such a case, if milk is ample, the pacifier can give the baby the extra sucking he needs while giving mom’s skin a break.

Pacifier Pros

Here are some reasons to use a pacifier:

  • Sucking makes babies happy. When babies are fussy, pacifiers can often soothe them.
  • Pacifiers can offer a distraction and stop a baby’s crying during vaccinations, lab tests, or other medical procedures.
  • Sucking on a pacifier can help a tired baby fall asleep.
  • The use of a pacifier can prevent ear pain from air pressure changes during air travel. The sucking helps “pop” the ears.
  • Statistics show that sucking on a pacifier during naps and periods of sleep may cut the risk of SIDS.
  • It is easier to give up a pacifier than sucking the thumb, because thumb sucking is multisensory, providing stimulation to both thumb and mouth, while the pacifier provides only oral stimulation.

    Older Child with Pacifier
    It can be difficult to wean the older baby from a pacifier.

Pacifier Cons

Here are some of the drawbacks to using a pacifier:

  • Using the pacifier can cause nipple confusion and may lower the chances of a successful breastfeeding experience. The American Academy of Pediatrics suggests waiting to offer the pacifier until the baby is 3 to 4 weeks old, and is nursing well. The baby, however, is likely to reject the pacifier if offered it so late (that is this author’s humble opinion, having raised 12 children).
  • Babies can develop a dependence on the pacifier. That could mean that every time your baby loses his pacifier during sleep, he cries until you go to him and put the pacifier back into his mouth. In other words, the pacifier may help your baby sleep and may also cause him to lose sleep.
  • Pacifiers are thought to increase the risk of middle ear infections. It’s important to note that very young babies rarely get middle ear infections in the first 6 months, while their risk for SIDS is at its highest during this time.
  • If your baby continues to use the pacifier after the age of three years, he could develop problems with crooked teeth or teeth that don’t come in as they should.

Are Pacifiers Safe?

Some Pacifier Guidelines:

  • Buy one-piece silicone pacifiers, which are less likely to pose a choking hazard.
  • Always have spare pacifiers on hand.
  • Buy pacifiers that are free of bisphenol-A (BPA), which may be toxic.
  • Boil pacifiers or run them through the dishwasher from time to time (and certainly after they fall on the floor) until your baby is 6 months old. After that point, soap and hot water is good enough.
  • Watch pacifiers for signs of wear and replace them when they begin to age and deteriorate.
  • If you use a pacifier clip, make sure the string or chain is not long enough to get tangled around a baby’s neck

Your baby may not want to suck as much by the time he or she is 9 months. This can be a good time to wean from the pacifier. Try cutting back on the pacifier by not offering it automatically for sleep and comfort. Let the weaning be a gradual thing.

For older children, it may be helpful to discuss the fact that big children don’t use pacifiers. You could make a ceremony of putting away the pacifier in a special box of honor, which the two of you decorate together. Praise your child often for being big enough to stop using the pacifier.

Did your child use a pacifier? How did you wean your child from using the pacifier?


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