Pacifier Safety - Can Newborns Sleep with Pacifiers?

By ryan

Baby With Pacifier

As a new parent, you are faced with an avalanche of questions and decisions that you probably have never thought of before. All of these decisions feel far weightier because they directly affect your newborn baby.

Adding to the confusion is the myriad of parenting methods, theories, books, and well-meaning Facebook friends who always seem to have all of the answers.

One of the areas of intense confusion is the pacifier, which is also known as a “dummy.” Infants are born with a powerful need to suck. Even in the womb, babies have been observed sucking on their fingers and toes. As such, pacifiers, in one form or another, have been around for thousands of years. The modern form of the pacifier was first introduced, however, by a druggist in New York City in 1909 (source).

In fact, the use of a pacifier is actually a very hotly-debated topic. This can leave exhausted new parents wondering what’s best for their newborn. Some of the questions you might be asking are:

  • When can I give my baby a pacifier?
  • What are the pros and cons of pacifiers?
  • Can babies sleep with a pacifier?

In this post, we will take a detailed look at the above questions and answer them using evidence from scientific studies.

When is it ok to introduce a pacifier?

If you are wondering when to introduce a pacifier to your baby, you are probably worried about your child having trouble breastfeeding. The shape of a pacifier is different than the shape of a real nipple and can certainly create confusion for an infant who is trying to learn how to latch onto the breast for milk. It’s simply an issue of muscle memory.

According to this article the physical action babies use to suck on a pacifier is different than the physical action to extract milk from the breast. The same can be said for using a bottle. If a mother wants to breastfeed, it’s best if the pacifier stays on the shelf while the baby is learning how to get milk from the breast.

  • For babies who drink from a bottle: You can introduce a pacifier at any age.
  • For babies who are breastfeeding and don’t have any trouble latching: 3-4 weeks.
  • For babies who are breastfeeding and DO have trouble latching: 4+ weeks or whenever the baby has mastered breastfeeding.

The key is this: establish a pattern of high-quality breast feeding before you introduce a pacifier.

As a new mother, it’s also important that your baby gets lots of milk. However, it is also easy to assume at times that your hungry baby is actually just crying to be soothed - it can be tempting to pop in the pacifier so you can get a much-deserved break! The problem with this is that your baby might be soothing because of the pacifier, but his real need - hunger - isn’t being properly met. Be careful, if a pacifier is introduced too early, it may cause you to accidentally cut back on the much-needed milk a baby is asking for.

Remember: Only use a pacifier to soothe - never use it as a means to push off or ignore feeding.

When to start using a pacifier if baby is premature?

It’s critical that premature babies begin oral feeding as soon as possible. In 2009, this study found that premature babies who were given a pacifier were the quickest to begin oral feeding. Another interesting observation from this study also discovered that having premature babies listen to lullaby music aided in earlier oral feeding patterns.

Regardless of what was found in the above study, you should always consult your doctor regarding the issue of pacifier introduction with a premature baby.

What are the Pros and Cons of pacifiers?

There are certainly clear advantages and disadvantages to to using a pacifier. Ultimately, it’s up to you to decide if you will use a pacifier. The following list can help you make a more informed decision.

What are the pros for using a pacifier?

  • It’s better than sucking a thumb.  Babies will find a way to suck on something. Introducing a pacifier is actually preferable to the habit of sucking on a thumb or finger. Thumb sucking can lead to dental problems if the sucking doesn’t stop before the age of two. It’s much easier to remove a pacifier than it is to remove a thumb!
  • It can teach a baby to self-soothe. For parents, one of the most rewarding moments within the first year is when the baby falls asleep on her own. A pacifier can help train your child to soothe without your physical presence. 
  • Pacifiers can help with traveling by plane. Have you ever forcefully yawned when taking off or landing in an airplane to “pop” your ears? Pacifiers can help achieve the same effect and will protect your infant’s delicate ears during takeoff and landing. 
  • It can be used as a tool to help soothe your baby. Sometimes babies are just fussy. You’ve gone through your checklist: clean diaper, full belly, plenty of sleep, and your baby is still crying. A pacifier can help simply calm your baby down, which can calm your nerves as well! 
  • Pacifiers can help reduce the risk of SIDS. Multiple studies have shown a correlation between pacifier use and a lower risk of SIDS (sudden infant death syndrome) (source). The reasons why pacifiers help reduce the risk of SIDS is still unclear, but research is pretty clear that giving your baby a pacifier at night can help. In fact, there are a number of steps you can take as a parent to help reduce the risk of SIDS. Here is another resource if you would like to learn more about reducing the risk of SIDS - download this ebook for free!

What are the disadvantages of using a pacifier?

  • A pacifier can interfere with breastfeeding: As we mentioned earlier, one of the biggest objections to the pacifier is what’s known as “nipple confusion.” For babies who are still learning how to breastfeed, a pacifier can prove to be a significant barrier to learning. 
  • A pacifier can create tooth issues: If your baby is still sucking a pacifier after 24 months, then the continued use can cause teeth to grow in crooked. 
  • A pacifier can lead to an increased risk of oral candida: Candida is a naturally occurring organism in the human mouth but can sometimes grow more than normal. When a pacifier isn’t cleaned, it can become infected with microorganisms that can lead to an increase in this condition. If you decide to use a pacifier, make sure to keep it clean!
  • It can be difficult to separate the child from a pacifier: If a child has been using a pacifier to self-soothe for years, it can be difficult for them to separate. 
  • A pacifier can increase the risk of ear infections: According to this study, there is a strong correlation between a higher rate of ear infections and the use of a pacifier. The study concludes that due to other non-measurable contributing factors, a parent doesn’t need to limit pacifier use unless their baby begins having ear infections.

Key Takeaway: It’s up to you as a parent whether or not to give your child a pacifier. There is no clear right or wrong answer. Follow your instincts, watch and listen to the needs of your baby...and yourself.

Can Babies Sleep with a Pacifier?

Yes, you can safely give your baby a pacifier at bedtime. To make it as safe as possible, though, make sure to follow these guidelines:

  • DON’T attach a string to the pacifier as this can present a strangling risk.
  • DON’T give your baby a pacifier at night while he or she is learning how to breastfeed.
  • Make sure to keep the pacifier clean using hot water to disinfect. 
  • Use the right size of pacifier for your child’s age.
  • DON’T coat the pacifier with anything.
  • Only use 1-piece pacifiers.
  • Ensure the pacifier has breathing holes in the guard.

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