Q&A: Should I give my baby a pacifier?

Question: My baby wants to go on sucking even after a feeding, and he screams if I don’t give him what he wants. I’ve thought about resorting to a pacifier, but I get conflicting opinions on this subject from family and friends. One breastfeeding mom I know says that pacifiers are an abomination. What do you think?

Answer:

As you’d expect, opinions on this subject are mixed. Some parents say they could not have survived their baby’s infancy without pacifiers, while others (including some breastfeeding advisers) have nothing good to say about them. In general, we think it’s wise to limit their use with a very young infant who has not yet established stable and efficient nursing patterns. The feel, texture, taste and smell of a pacifier are clearly different from those of mom’s nipples, and sucking a pacifier too soon may interfere with a baby’s ability to get used to the real thing.

Benefits and precautions

After two weeks or more of steady nursing, assuming everything is going well, a pacifier can be helpful. Among other things, it can be useful in calming a baby who is already fed but still wants to suck who doesn’t have anything else, such as a wet diaper, bothering him and will suck on it with apparent satisfaction. It goes without saying that inserting a pacifier in an infant’s mouth must not become a substitute for normal feeding, parental nurturing or checking to see if something is wrong.

That’s a lot to mention that a number of research studies suggest that pacifier use during sleep is associated with a significant reduction in the risk of Sudden Infant Death Syndrome (SIDS). There are a number of possible explanations for this finding, and the effect seems to be greater among infants who sleep in more hazardous environments, such as soft bedding.

How to choose and other pacifier tips

If you decide to use a pacifier, make sure you get a one-piece model with a soft nipple – either the straight bottle shape or the angled "orthodontic" type. Never use the nipple assembly from a feeding bottle as a pacifier because the nipple can come loose and choke your baby. Make sure the pacifier you get is the right size for babies younger than six months and that it is designed to survive boiling or trips through the dishwasher. For the first six months you will need to clean pacifiers frequently in this way to reduce the risk of infection.

If you find a pacifier that your baby likes, buy several. They have a knack for disappearing into the sofa, under the car seat or into the bottom of the diaper bag, so it’s a good idea to have lots of backups. Remember that babies are unable to replace pacifiers that fall out of their mouths and that you’ll have to do this for them. Because of the danger of strangulation, never tie a pacifier to a string or ribbon around a baby’s neck to keep it in place.

For some helpful additional tips on the use of pacifiers, see the Canadian Paediatric Society’s web page entitled "Pacifiers (soothers): A user’s guide for parents." For example, CPS suggests helping your child to give up their soother – ideally at around the age of 12 months – by encouraging him or her to leave it under a pillow in exchange for a gift from "the tooth fairy" (or from mom and dad).