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. Here are 5 true-or-false statements about pacifiers that can guide you to deciding if a pacifier is right for your family.

1. Pacifiers May Reduce the Risk of SIDS

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 they will stop breathing," says Jennifer Shu, M.D., a Parents advisor and coauthor of Heading Home With Your Newborn. "Plus, having a pacifier in your baby's mouth helps to keep their airway open," she adds, which could also help decrease the 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 they don'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.

• RELATED: The 10 Best Pacifiers, According to Parents and Babies

2. Breastfeeding Newborns Should Never Use a Pacifier

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, every baby is different and as long as breastfeeding has been established and there are no other complications (such as a low milk supply), you can talk to your doctor about introducing a pacifier.

"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 they are gaining weight well and have recently been fed. Just take care to not offer a pacifier to your baby instead of your breast when they might be hungry.

• RELATED: 8 Common Breastfeeding Problems and Solutions

3. Pacifiers Typically Cause Dental Problems

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 pacifier that's important, but how vigorously they suck, cautions Dr. Shu. Gentle suckers put less pressure on their front teeth and may be able to hold on to the pacifier 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.

4. Using a Pacifier May Increase the Risk of Ear Infections

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 2000 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.

• RELATED: How to Prevent Ear Infections

5. You Need to Wash Your Child's Pacifiers Frequently

TRUE: It's not news that pacifiers can 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 2012 research done 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 pacifiers through the dishwater, sterilizer, 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, you should inspect your baby's pacifiers regularly and replace them anytime they are worn or broken. As a general rule, replace pacifiers every 4 weeks.

And fun fact: a 2013 study also suggested that parents popping their baby's dropped pacifier in their own mouth could have some potential benefit for the baby by helping pass on some of their own immune system's antibodies to their baby. Doesn't make you feel so guilty now for dropping that pacifier, does it?

Originally published in the February 2014 issue of Parents magazine.

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