Pacifiers can be a helpful tool to use, especially for young babies as they can provide comfort when a little one is fussy and tired. However, they can become a challenge when older babies won’t settle to sleep without one, or when they need help finding it many times during the night. It can also cause dental issues if used for too long, as well as speech delays if a toddler has it in their mouth for long periods of time during waking hours.
So, paci’s can be helpful for little ones as long as they are not used too much or for too long. Given how effective pacifiers can be in calming a little one, the line between use and overuse can be tough to find. I know how tempting it is to keep giving a child a paci especially when it means they stop fussing or crying, but it’s important to weigh the benefits with the concerns for long term use.
The AAP (American Academy of Pediatrics) recommends the use of a pacifier once breastfeeding is established when settling an infant for sleep as there is some research which indicates that sucking can help to reduce the risk of SIDS (Sudden Infant Death Syndrome), along with being soothing since the sucking reflex is very strong in the first few months of a baby’s life.
However, prolonged use of a pacifier past 2 years is not recommended, as it can cause dental problems as well as increase the possibility of ear infections. I usually tell parents to wean their little one off of a paci by 12 months as most little ones that age can find other ways to settle, and the longer a little one uses a paci the harder it can be to let it go.
Not all babies like pacifiers, so if you’ve tried a few different kinds and your little one just won’t take it, that’s fine. It can be a bit confusing and worrying if you know that the use of a pacifier is recommended to help reduce the risk of SIDS, but it’s best not to force the issue. It’s something to try, but know that some babies just refuse to suck on a pacifier and you don’t want to push to make that happen. You want to offer it, but not if it causes stress for you or your little one. You’ll find other ways to comfort your baby and it will be one less thing you need to wean them off of down the road.
Here are some suggestions for when to use a pacifier and how and when to phase it out.
Some babies take to a paci right away, while others have a harder time keeping it in their mouths until they figure out how to use their tongue to hold it in. You never want to force a baby to take a pacifier, and you don’t want to hold it in their mouth if they are trying to spit it out. It’s better to offer it, and then try again later if they don’t seem to want it.
Tip: Try a few different kinds to see which one works best for your baby. Have your little one suck on your finger first and then switch to the paci.
If you are in the early stages of breastfeeding it’s best to wait 2-4 weeks before offering a pacifier until breastfeeding is established. It’s important to build your milk supply by nursing 8-12 times in 24 hours.
Tip: Be sure you are feeding your baby frequently in the early weeks after birth and not using the paci if your little one is hungry. If your baby is sucking intensely on the pacifier and seems restless, try offering a feed to see if they need to eat instead.
Once your milk supply has been established non-nutrative sucking can be helpful for a young baby, especially if they are tired and fussy. Sucking can be a great comfort for a little one and can help them calm down enough to settle to sleep. That said, it’s important to pull back on the use of the paci once your baby is a bit older so they can learn other ways to settle.
Tip: If your baby tends to cry when they are overstimulated or tired you can offer the paci to help them calm down. Holding your baby close while walking or rocking along with offering the pacifier can help them to settle.Think of it as a helpful transitional tool.
The pacifier can help when you are laying your little one down in their bassinet or crib for sleep. Once your little one is fully asleep the pacifier usually falls out as the jaw relaxes. This can sometimes wake a baby up and they cry out wanting the paci back in their mouth.
Tip: Once you have rocked your baby to sleep with the paci in their mouth, lay them down (always on their back). Keep your hand on them for a minute until they settle. Once they are more relaxed you can gently remove the paci before it falls out of their mouth. This gives your baby the opportunity to get used to sleeping without it in their mouth which makes it easier to wean them off the paci when they are older.
Pacifier Weaning:
Start by putting your baby down without the paci so they get a chance to figure out other ways to settle. If they become upset, you can then offer the paci to help them settle in the way that is familiar to them. Once they are asleep try to remove the paci. Each night wait a little longer before you offer the paci until your little one no longer needs it to fall asleep.
Reduce the number of pacifiers you have in the house and keep them out of sight. Use only in the crib or in the car (if needed). The less your little one sees them around the less likely they are to ask for one.
If your little one is 12 months or older, you can offer a safe lovey for them to have in the crib as an alternative source of comfort. Offer the lovely first before you wean the pacifier. Use a lovey that does not have a pacifier attached to it.
Try to avoid putting 10 paci’s in the crib with your little one. It might be tempting as it may mean they will find one in the middle of the night saving you from having to go into their room, but it doesn’t always work. Your little one might wake up from rolling on top of one (or more) of them. If you want to put more than one paci in the crib try to tuck them into the corners of the crib and show your baby where they are.
Some parents tell their toddler a story once it’s time to wean the pacifier completely. I’ve heard some say they tell their toddler that the paci fairy came to take them to a baby who needs them. Or they box all the paci’s up and say it’s time to give them to a new baby. Or they tell their child they are a big boy/girl now and don’t need a paci because they aren’t a baby anymore. I don’t recommend this approach as it can cause a child to feel sad about no longer being a baby. I also don’t like being sneaky with kids and telling them something that isn’t true. I think it’s better to be honest about what you are doing and hold space for your child’s feelings if needed.
Safety notes:
Never attach a paci to your baby’s sleep wear with a clip or on a string or cord of any kind.
Never hold a paci in your baby’s mouth if they are trying to spit it out. And never adhere a paci to your baby’s face to keep it from falling out.
Never put any kind of sweetener on the paci to get your baby to take it (in particular, never use honey) and never put something sour or bitter on the paci as a way to wean your baby off the paci.
Never cut your baby’s pacifier as a way to make it less appealing. This damages the paci and can pose a choking hazard.
Using a pacifier to soothe a baby may end up being something that works for your little one, but don’t worry if not. They will find other ways to settle and soothe themselves.
A note on thumb and finger sucking:
Though this blog focuses on pacifiers I did want to mention thumb and finger sucking as well. We know how important sucking is for soothing a tired child and since thumbs and fingers are readily accessible, little ones often turn to their own hands to find comfort. The good news is thumbs and fingers are right there and babies can easily find them once they are old enough. The challenge is that it can be harder to wean off of the thumb/finger sucking habit. As with pacifiers there is also concern about how thumb/finger sucking can cause dental issues as a child gets older.
Despite the concerns it’s important to recognize that thumb/finger sucking can be helpful for your child especially as they get used to settling themselves to sleep. When your little one is young it’s best not to try to change this form of comfort and wait until your child can understand the importance of finding other ways to settle.
The main focus is to keep your little one’s hands clean and their nails short. You don’t want to draw too much attention to this form of comfort or your child may do it more. You don’t want to shame your child for sucking their thumb or fingers. You can offer other forms of comfort like a lovey (when your little one is 12 months or older).
If your little one reaches their 3rd birthday and has not let the habit go, it may be time to encourage your child to stop sucking their thumb/fingers Talk with your child about what else they can do when they are tired and help them become aware without making them feel bad for wanting to comfort themselves this way. Sometimes sticker charts can help, but I have found that it’s most effective to offer alternative ways to find comfort. You can suggest they hum or sing a song, or hold something soft, or rub their hands on something soft.
I do not recommend putting something bitter or awful tasting on your child’s thumb or fingers. If you decide to try painting nail polish on their fingers, be sure it’s non-toxic. I don’t recommend covers for a child’s hands as a way to get them to stop. Your dentist might recommend a mouth guard for an older child. Your child’s dentist can be a helpful ally in supporting your child in finding other ways to find comfort.
If you need help in weaning your child off of a pacifier or in dealing with any challenging sleep issues with your infant or toddler let me know. I know it can be tough to find solutions to sleep struggles when you are tired yourself, so let’s work together to come up with a plan that you can feel good about.
Disclaimer: Elizabeth Green's Early Parenting Sleep Consultations and written materials are for educational purposes only and are not meant as medical advice. All spoken and written information is to be used at each parents' discretion.
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