What Are The Risks Of Giving My Baby A Pacifier?

Are you pregnant and wondering if your baby will be safe while using a pacifier? Do the concerns of the older people in your life about pacifier safety have you sweating bullets?

We live in a day and age where the traditional ways of raising children are being questioned. We now know that some medicines our grandparents used are toxic, and that crib comforters are a pretty bad idea.

So, as modern parents, we naturally cast a suspicious eye over everything we are recommended. Is it safe? Or is it secretly dangerous?

Pacifiers, unfortunately, are not quite as clear cut. They have some serious upsides and some equally serious downsides to them. And in some cases there are studies directly contradicting each other.

I can’t tell you what to do in your situation, but I can make sure you have all the facts, so as a parent you can make an informed decision.

Will Pacifiers Hurt My Baby’s Teeth?

Pacifiers are not great for teeth. This much the experts agree on, and it’s actually many parents’ biggest concern about pacifiers.

Because of the shape of them, your baby’s teeth are gently nudged into a new position, a bit like braces do. This can cause the upper teeth to splay out and the lower teeth to fold in.

There are some tooth-friendly bottles out there, but pacifiers are different. Because a pacifier is in your baby’s mouth for much of the day, the pressure is constant.

Even a gently-shaped pacifier is going to have some effect. And buck teeth or a serious overbite are not just cosmetic problems — they can cause delays in proper speech, eating solids, and even affect jaw development.

Most of these problems do not seem to be an issue when your baby has no teeth, or only a few. But for these reasons you should wean your baby off a pacifier by the time they have their full set of baby teeth (source), (source).

I’ve Heard Babies Have Choked On Pacifiers

With anything that goes into a baby’s mouth, there is a real risk of choking that should not be underestimated. Just because a pacifier is made to be sucked does not mean we should automatically trust it to be safe.

Always buy pacifiers from established manufacturers. Some cheap novelty ones, or old designs, may have loose parts that are choking hazards.

Check your pacifier for size, moving parts, and air vents:

  • Size: Your baby’s mouth size will determine the right pacifier size. Always choose one for their age, or if they have dwarfism, intrauterine growth restriction (IUGR), or were premature, for the age that matches their size. A safe pacifier must be 1.5 inches across at least (source).
  • Moving parts: If there are any moving parts other than the handle, you need to throw it out. Check before each use, as sometimes parts can loosen with time (source).
  • Air vents: A pacifier must, by federal regulation, have air vents. Make sure the vents are about one-half inch somewhere on them. Those little dot air vents are actually not safe (source).

Finally, never use a pacifier tie or strap, as these can be a serious hazard for your baby. They can wrap around your baby’s neck and asphyxiate them.

Can Pacifiers Cause Nipple Confusion?

Pacifiers can make your child reject the breast and even the bottle. Because the size and shape is so different from a real nipple or bottle nipple, a baby might become confused and forget how to latch properly.

There are some pacifiers, like Hevea and NUK soothers, which imitate the shape and squishiness of the nipple. Likewise, your bottle manufacturer probably has their own range of pacifiers.

Always choose a pacifier that mimics your baby’s milk source to avoid confusion.

Pacifiers can also present other feeding challenges. They can also completely satisfy the sucking need of smaller babies, meaning they don’t notice when they are hungry until too late.

Pro Tip

Make sure you never use a pacifier before offering the breast or bottle to a baby under four months, and restrict pacifier use for premature, IUGR, or underweight babies (source).

The flip side, of course, is that some babies use the breast as a pacifier. If your baby is suckling but not swallowing, and leaving you sore, you might want to use a pacifier to prevent cracked nipples.

Will My Baby Get An Infection From Using Pacifiers?

Studies have shown that babies who use pacifiers are at greater risk of both oral thrush, and ear infections. This is because having something continually or frequently in your mouth means bacteria may get in.

Bacteria also breed on pacifiers, so unless you keep a steady supply and sterilize regularly, there will be some bacteria on your pacifiers (source).

But some other studies have found that more nipple-like pacifiers can help prevent ear infections. So, which is it?

It’s a bit complicated. Although bacteria can be introduced through pacifiers, the motion of sucking on something nipple-shaped seems to help babies’ ears naturally clean themselves.

The middle ground is to always use a clean pacifier. After your baby uses one, swap it for a clean one for the next use, even if they haven’t been put down anywhere dirty. This way you get the benefits with minimum risk.

Is It Safe To Put My Baby To Bed With A Pacifier?

Pacifiers can really be a lifesaver for parents with a restless baby. The act of sucking has been found to help babies get to sleep, but if you keep nursing your baby to sleep you can create a sleep association that will leave you exhausted.

Pacifiers have also been found to reduce the risk of SIDS. It is assumed this is because the motion of sucking keeps babies’ breathing regular.

A baby should never have a pacifier put in their mouth when they are already asleep, but if your baby falls asleep while sucking on one, feel free to leave it in (source).

The big downside to both of these is that pacifiers can create a sleep association. This means that you may end up with a baby who cannot sleep without their pacifier.

When they have their first sleep regression, you may have to get up through the night to keep replacing it. To prevent this, you may need to wean them off their pacifier between four and twelve months (source).

When Should I Start, And Stop, Using A Pacifier?

If you intend to use a pacifier, the starting age depends on you and your baby.

Small babies, premature babies, and IUGR babies should not be started until they are a healthy weight. This is because the pacifier may make them not want to nurse as often.

But a healthy baby can begin as soon as your milk comes in, or, if bottle fed, as soon as they are back at birth weight. This is anywhere from one- to six-weeks old (source).

Crucial to Know

Weaning off pacifiers can be done gradually, and should really be complete by age one.

Some parents like to break the association early, by around six months, before their baby can remember the pacifier.

Others leave it until about a year, but no longer, because by then their teeth are growing in. Besides, when they can walk it is harder to keep them away from finding their pacifier!

That said, some babies will even wean themselves off their pacifier, or start chewing it instead when they begin teething. This could make the transition very easy, so seize the moment.

Make sure to get rid of all your pacifiers if this happens, and you won’t have to go back.


The Bottom Line

As I said at the start of the article, pacifiers are not a black or white thing. They have their upsides and downsides, and nobody but you, the parent, can make the choice for your baby.

But with this guide, now you can make an informed decision about whether they are right for you and your child.

What do you think about pacifier use? Did your babies love them or hate them? What difficulties did you face when using a pacifier?

We’d love to hear all about your experiences in the comments. If you know of any moms who are wrestling with this decision, send this article their way.

7 Easy Steps to Weaning Your Child Off the Pacifier
7 Simple Steps to a Pacifier-Free Child
How Does a Pacifier Affect Breastfeeding?
Boob Versus Binky -- How Pacifiers Affect Breastfeeding
How to Clean and Sterilize Pacifiers (5 Simple Steps)
Sterilizing Pacifiers In 5 Simple Steps
Can Bottles and Pacifiers Harm Your Baby’s Teeth?
Pacifiers & Baby's Teeth: What You Need to Know
11 Best Baby Pacifiers on the Market (2019 Reviews)
The 11 Best Pacifiers You Can Buy In 2019

2 Reader Comments

  1. Alexandra

    Pacifiers are good and bad 🙂 I found them to be a blessing in the beginning. But I kept wondering when to wean my baby off the pacifier. I even started sleep training because I heard that it could help with kicking the pacifier habit. Then, I found some compilation guide by Susan Urban, I think, with plenty of methods on how completely get rid of the pacifier. Most of the methods are for children over the 18th month, but there is one called the three-step method, that you can use at any age and basically is just slowly weaning off from the binky — so now at 9th months, we are paci-free 🙂

    • Team Mom Loves Best

      Hi Alexandra! Thanks so much for reading and sharing your experience. We’re so glad you found a way out of the pacifier habit. It can be a difficult one for mamas to crack 🙂

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