5 Truths About Pacifiers Every Parent Should Know

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 and risks of pacifiers are more fuzzy.

That's why we went to our experts to set the record straight once and for all. Here are five truths about pacifiers every new parent should know.

1. Pacifiers May Reduce the Risk of SIDS

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., co-author 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.

2. Breastfeeding Newborns Can Use a Pacifier

The threat of "nipple confusion" often makes breast- and chestfeeding parents shy away from pacifiers, and it's in part why the AAP recommends that parents wait to offer pacifiers to nursing babies until breastfeeding is well established, which takes about three or four weeks. 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.

That said, the AAP published a June 2022 report in Pediatrics that says the following: "A Cochrane review found that pacifier use in healthy term infants before and after lactation is established does not reduce the duration of breastfeeding up to 4 months of age, but there was insufficient evidence on the potential harms of pacifiers on infants and mothers. The recommendation was that mothers who are well-motivated to breastfeed should be encouraged to decide on pacifier use based on personal preference."

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 breastfed 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.

3. Pacifiers Don't Usually Cause Dental Problems in Babies

For most babies, there's no harm done from pacifier use in the first two years. Your child's mouth is so malleable that whatever changes a pacifier may cause in the palate and teeth during those years can often correct themselves. If your child continues to use a pacifier well into toddlerhood, however, it can lead to malocclusions (when the teeth don't align properly), such as an open bite in the front or a crossbite in the back.

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

Older babies who regularly use pacifiers had more ear infections than those who stopped using them at 6 months, according to a 2000 study published in Pediatrics. Some doctors speculate that the correlation is a result of how 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.

5. Pacifiers Should Be Washed Frequently

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. Dirty pacifiers also raise the risk of thrush.

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.