5 Binky Basics: What You Need to Know About Pacifiers

Fact: Babies can get fussy. Fact: Pacifiers can, well, pacify them. These two pieces of information are unanimously agreed upon, but the rest of the "facts" circulating around the benefits or harm of pacifiers are more fuzzy. That's why we went to our experts to set the record straight once and for all.

TRUE: Several studies have found a decrease in the risk of sudden infant death syndrome (SIDS) in infants who use a pacifier. "The periodic movement of your baby's mouth while sucking keeps him in a lighter state of sleep, so there is less of a chance that he will stop breathing," says Jennifer Shu, M.D., a Parents advisor and coauthor of Heading Home With Your Newborn. "Plus, having a paci in your baby's mouth helps to keep his airway open," she adds, which could also help decrease his risk of SIDS. The American Academy of Pediatrics (AAP) suggests offering a pacifier when you put your baby down to sleep for the night. However, this doesn't mean that you need to offer your baby one if he doesn't take well to using a pacifier at bedtime. And if your baby does use one to fall asleep, you shouldn't feel obligated to keep popping the plug back in when it falls out during the night either.

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FALSE: The threat of "nipple confusion" often makes new moms shy away from pacifiers, and it's in part why the AAP has recommended that nursing babies wait to use pacifiers until about one month of age, when breastfeeding is well established. However, more and more experts are questioning this prevailing wisdom, especially now that pacifiers are thought to reduce the risk of SIDS. In fact, a recent study conducted by researchers at Oregon Health & Science University Doernbecher Children's Hospital, in Portland, found that the percentage of babies who exclusively breastfed actually dropped after pacifiers were banned from the Mother-Baby Unit, and more moms ended up supplementing with formula. "Some babies can't meet their sucking needs by feeding alone," explains Freda Rosenfeld, a lactation consultant in Brooklyn, New York. So there's nothing necessarily wrong with a newborn using a pacifier, if she is gaining weight well and has recently been fed. Just take care to not offer a paci to your baby instead of your breast when she might be hungry.

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FALSE: For most babies, there's no harm done in the first two years. Your child's mouth is so malleable that whatever change a pacifier may cause in the palate and teeth could correct itself. If your child continues to use the paci into toddlerhood, it can lead to malocclusion (when the teeth don't align properly), such as an open bite in the front or a cross bite in the back. However, it's not just the age at which your child gives up the paci that's important, but how vigorously he sucks, cautions Dr. Shu. Gentle suckers put less pressure on their front teeth and may be able to hold on to the paci longer, even until age 3. On the other hand, babies who have a more energetic suck can develop visible problems with their bite around 18 months.

TRUE: Older babies who regularly use pacifiers have a third more ear infections than those who stopped using them at 6 months, according to a study published in Pediatrics. Some doctors speculate that it's because sucking changes the pressure in the ears. This pressure difference may prevent fluid from draining through the tube that connects the middle ear to the back of the nose and throat. When fluid collects there, it can lead to infections. Still, the research isn't persuasive enough to make a case against pacifiers in general. And they're only a concern if a baby already suffers from frequent and recurrent ear infections, says Dr. Shu.

TRUE: It's not news that they get germy--but just how dirty may come as a surprise. When examined under a microscope, used pacifiers were found to have fungi plus bacteria similar to E. coli on and within the nipple, according to recent studies by Richard Thomas Glass, D.D.S., Ph.D., professor of forensic sciences, pathology, and dental medicine at Oklahoma State University Center for Health Sciences. To eliminate some of the bacteria, experts recommend running your baby's pacis through the dishwater or hand-washing with hot, soapy water daily or whenever they're dropped. Store the clean, dry pacifiers in plastic zip-top bags for extra germ protection and during transport, suggests Dr. Glass. Plus, it's also a good idea to replace your pacifiers regularly.

Originally published in the February 2014 issue of Parents magazine.

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