The pacifier Debate
When it comes to healthy sleep foundations, many parents wonder if offering a pacifier to their infant is a good choice. There are pros and cons to using a pacifier with babies. In this blog post, I will go through the benefits and disadvantages of pacifying, how long I recommend using a pacifier, how pacifiers impact sleep training, and ways to eliminate pacifier use if that is your wish.
Pacifier Pros and Cons
Pacifiers come with pros and cons. The way I see it, most of the benefits of using a pacifier are for babies aged 0-3 months. After three months the benefits become reduced, while some of the disadvantages become clear.
Pros
According to the American SIDS institute, “Several studies have found a lower risk of sleep-related death when babies use a pacifier.” (sids.org) They also note that breastfeeding mothers should wait to introduce the pacifier after breastfeeding has been well established.
The pacifier is a powerful soothing tool, as sucking is a natural pain reliever for infants. My son experienced a lot of bad gas due to to some feeding issues related to tongue tie early in life. The pacifier was a huge tool for us in soothing him. Dr. Harvey Karp includes “suck” as one of his 5 S’s for soothing newborns.
Pacifiers are a natural pain reliever, and a good alternative to using medications to relieve symptoms like gas and colic.
Pacifiers are relatively inexpensive to buy and come in many varieties, our favorite has always been the MAM, but I recommended trying a few different brands to see which your baby prefers.
Cons
Pacifying before breastfeeding is well-established can have a negative impact on your milk supply. (Anecdotally I have NOT found this to be true for either of my two children, who were both given pacifier night one in the hospital! My supply was just fine.)
The pacifier can quickly become a sleep-crutch if your baby requires you to “replug” their pacifier every time it falls out of their mouth
Long-term use of pacifiers can lead to dental issues in the future
Pacifiers with any sort of attachment, such as a lovey or clip that is put on the child’s garment, are unsafe to use for sleep
Babies that have not yet developed the pincer grasp (typically developed around 8-10 months of age) are unable to “replug” their own pacifiers, and even those with the grasp may not be able to find their pacifier in the night, or may simply be too agitated to “replug” it without assistance
To summarize, a pacifier can reduce the risk of SIDS and is a great soothing tool, especially for infants from months 0-3. After 3 months a pacifier runs the risk of becoming a sleep crutch, leading to multiple night wakings when it falls out of your baby’s mouth.
Sleep Training: Can it Be Done with a Pacifier?
My general recommendation is to eliminate the pacifier when sleep-training, because I find it really does lead to better results. However, you are the parent, and as always, you get to decide! For babies that are too young to learn to replug their own pacifier, we can put them down with their pacifier, and we can either a) not replug it at all when it falls out b) replug it once c) only replug it after an established night-feeding session. Not replugging it at all will usually lead to weaning the pacifier altogether, and is my best suggestion if you do choose to keep the pacifier. However, if you have a little one that uses the pacifier to help cope with gas pains, or the like, you may prefer a gentler approach and offer to “replug” the pacifier within the sleep-training plan.
For children with the pincer grasp, we can teach them how to replug their own pacifiers during the day. We can practice by placing pacifiers in their palm and teaching them to bring their hand to their face to replace it. This is a skill that should be practiced a lot during the day, so that it doesn’t become a sleep disturbance at night. Many parents also find it helpful to place many pacifiers in the crib, so that when the child wakes up, it’s easy for them to locate one and replug it. They even make glow in the dark pacifiers that are easier for you babe to spot in the night!
While it is possible to teach older babies to replug their pacifiers, it is still my best recommendation to sleep train without it. As your child ages they will become more and more attached to it, and it will be a lot harder to break them of it. Long-term pacifier use can lead to dental problems later down the line.
The good news is that every child has built in pacifiers; all of their lovely little fingers. When my daughter picked up thumb-sucking at 4 months of age, she quickly abandoned the pacifier and became a much better sleeper. After all, you can’t lose your thumb! Thumb-sucking of course has its own set of problems, and can also lead to dental issues, but oftentimes children naturally wean from thumb-sucking by the time they are ready to start school.
Eliminating the Pacifier
As Kim West “The Sleep Lady” puts it, there is no gentle way to wean the pacifier; it’s either in their mouth or it’s not. One suggestion is to cut the pacifier cold turkey. Throw it away and put a hard-stop on pacifier use during the day, and at night. For older toddlers, you can even explain why you are throwing it away, and you can make it very clear that the pacifier is not coming back. While this may seem cruel, the more clear you can be with your child, the quicker they will move on. If you let them have the pacifier sometimes, but not other times it will just be confusing and lead to more protesting. Some people like to enlist a “pacifier fairy”; they have a guest visit the house and collect all the pacifiers to give to other little babies out there who don’t have any. If you prefer this more whimsical approach to cutting the Paci, go for it! I’ve always preferred a more no-nonsense style when it comes to these things, but you should pick the approach that feels right to you.
Some parents opt to remove the pacifier for nighttime sleep, when the child has more time to practice self-soothing and get to sleep, while keeping it for daytime sleep, since there is less time in a nap to get to sleep, and the help with soothing might be worth it. You can try this, but you may find it’s too confusing for your little one.
My take, if you decide it’s time to eliminate the pacifier for the good of your little one, then just eliminate it! The more quick and clear you can be with this process the easier time your child will have moving on.
Summary
Pacifiers can be a good option for babies under 3 months. If you can, eliminate pacifier use around 4 months of age. If your child is 8-10 months old and you have not eliminated the pacifier, you can train them to replug their own Paci! However, the older your child gets the more difficult it will be to break this habit in the long-run. For best sleep-training results, ditching the Paci is my personal recommendation, and I usually opt to go cold-turkey! Like I always say, you are the parent, and you get to decide! My sleep-plans are always customized to you, so it’s something we can discuss more as we build out your plan!
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