Breastfeeding and Pacifiers

Breastfeeding and Pacifiers

A pacifier is one of the easiest ways to calm a fussy baby. But, are pacifiers really a wise choice? When is it safe to start a baby on a pacifier, and how do you introduce a pacifier to a baby that is exclusively breastfed? Parents wrestle with questions like these as they try to decide whether a pacifier is the right choice for their little one. 

Pacifier use is actually recommended by the American Academy of Pediatrics (AAP) but with certain precautions attached. You can read a brief note of the AAP’s stance on pacifiers, but we will delve much deeper into pacifier use in this article. Along with answering the above questions, we will look at how to choose the right pacifier and some of the pros and cons of pacifier use.

Can I Give My Newborn a Pacifier?

Sucking on a pacifier is a different action from the sucking babies do as they breastfeed. For some babies, alternating between breast and pacifier can lead to nipple confusion. 

This is why the AAP recommends that for healthy babies, the introduction of the pacifier should wait until breastfeeding has been well-established. This usually occurs at around 4 weeks. By this time, baby has perfected both latching on and the sucking technique, and mommy is producing a good supply of milk. 

There are instances in which a baby younger than 4 weeks old could benefit from being given a pacifier. American Family Physician, a journal published by the American Academy of Family Physicians, cites the following occasions.

  • The pacifier is used as a means of pain relief for a newborn undergoing medical treatment.
  • Non-nutritive sucking of the pacifier is used to help preterm babies transition from being fed by a tube to bottle feeding.
  • The pacifier is used to help the preterm baby bottle feed better. 

Other sources also suggest that the pacifier helps preterm babies transition faster to breastfeeding by improving their sucking ability.

Pacifier Use for Oversupply Breastfeeding

Over the first six weeks, a mother’s body will usually adjust milk production to match the demands of her baby. Some mothers, however, experience a condition known as oversupply. This is when the breasts continually produce much more milk than the baby needs. 

Oversupply can negatively affect both mom and baby, as pointed out by La Leche League International. Issues include blocked milk ducts, which can further lead to mastitis (inflammation of the breast due to infection). Your baby may develop digestive problems such as excessive gassiness, explosive loose, green stools, and spitting up often.

Coping with oversupply usually involves reducing milk production. One strategy is to not offer the breast to your baby as a means of comfort. If your baby has been fed and no longer needs to suck for food but is still fussy, then offering a pacifier instead of the breast so baby can suck for comfort is a good idea. The reduction in stimulation may help the breasts to produce less milk.

Pros and Cons

Parents need to weigh both the advantages and disadvantages as they consider whether or not to use a pacifier with their breastfeeding baby.

Pacifier Use – Pros

1. Pacifiers have been shown to significantly reduce the risk of Sudden Infant Death Syndrome (SIDS). The Centers for Disease Control and Prevention (CDC) is one of many agencies that recommends pacifier use at bedtime and naptime, preferably after breastfeeding has been well-established.

2. A pacifier satisfies the baby’s natural reflex for non-nutritive sucking. This is when the baby sucks for reasons other than wanting food (most commonly, for comfort).

3. Using a pacifier during air travel can help relieve the painful buildup of pressure in your baby’s middle ear.

4. A pacifier can help to comfort a baby going through painful or stressful situations.

5. Preterm babies gain weight quicker and leave the hospital sooner when a pacifier is used during their Neonatal Intensive Care Unit (NICU) stay.

6. Without a pacifier, a baby might turn to the less desirable habit of thumb-sucking/finger-sucking. Plus, it’s easier to break a child out of using a pacifier than it is to break them out of the habit of thumb-sucking.

Pacifier Use – Cons

1. Early use of a pacifier might interfere with your baby learning to latch on and breastfeed properly. This, in turn, can lead to low weight gain and even weight loss for baby. For the breastfeeding mother, it can cause conditions such as engorgement, sore nipples, and mastitis. 

2. The American Dental Association (ADA) advises that “Pacifiers can affect the teeth in essentially the same way as does sucking on fingers and thumbs.” Children who use pacifiers past the age of two may develop pacifier teeth, similar to the misalignment of teeth caused by thumb-sucking. 

3. Pacifier use has been indicated in the increased risk of ear infections in older children. For this reason, it is recommended that babies be weaned from a pacifier when they are between 6 and 12 months old.

4. A baby may become a restless sleeper because he wakes and cries each time the pacifier falls out of his mouth.

5. Some studies have shown that pacifier use can lead to early weaning. This can affect both mother and baby as they will be missing out on the important benefits breastfeeding provides

What Pacifier Is Best for Breastfed Babies?

Trying to decide which of the many different types of pacifiers is best suited for your breastfed baby is daunting, to say the least. Here are a few guidelines to help make the process easier.


  • The base of the pacifier nipple should be wide so that sucking on it better mimics the sucking needed for breastfeeding. Ones like the Philips AVENT Soothie Pacifier are designed to reduce the chances of nipple confusion. 
  • Some pacifiers are rounded while others are more square-shaped. Some babies prefer one to the other, and some babies really don’t care either way. If your baby refuses a pacifier, it could be because of the shape. Try a different one next time.


Pacifiers are usually sold in three sizes. Be sure to check the packaging to see what age the pacifier is meant for instead of trying to guess whether it is the right size for your baby.

  • Small: Up to 6 months
  • Medium: 6 to 18 months
  • Large: 18 months or older


  • Select pacifiers that are made as one piece. Two-piece pacifiers may come apart and put the baby at risk of choking on one of the pieces.
  • Ensure that the shield of the pacifier is at least one-and-a-half inches wide. That way, the entire pacifier will not fit in your baby’s mouth. 
  • The pacifier’s nipple should be soft, but the shield should be firm. There should also be ventilation holes in the shield. 


  • Common materials for making pacifiers are plastic, latex, and silicone. Each has its good points, but the silicone pacifier is the most popular of the three. 
  • Plastic pacifiers are durable and easy to clean but can develop dangerous jagged cracks.
  • Latex pacifiers are soft and flexible, but they wear easily and are not typically dishwasher safe. Plus, you will have to worry about your child and latex allergy.
  • Silicone pacifiers are soft, clean easily, and do not retain odors. Most of them are dishwasher-safe.

How to Get a Breastfed Baby to Take a Pacifier

It is easy for a breastfed baby to get used to the idea of using mommy as a pacifier. Here are a few tricks you can try to convince your breastfed baby to get his comfort by sucking a pacifier instead.

Offer it as you would the breast.

Use the pacifier to activate your baby’s rooting instinct, just as you do with your nipple at the beginning of a feed. Hold baby close and gently stroke her cheek with the pacifier. Once she turns her head, you can slide the pacifier into her mouth.

Tease baby a bit by pretending to take the pacifier away.

As your baby takes in the pacifier, gently pull it away very slightly. He will naturally try to hang on to it. Continue doing this for a while until your baby begins to suck with greater strength and determination to hang on to his pacifier. Repeat the exercise a few times a day.

Make the pacifier more attractive. 

Your baby may be more willing to take the pacifier if it actually tastes like something she likes instead of just rubber. Place a few drops of breastmilk on the pacifier and see if that is sufficient to entice your baby to take it into her mouth and not push it out.

Pop the pacifier in right at the end of a feed.

Most babies continue the sucking action when they are removed from the breast. At the end of a feed, when you know your baby is full, take him off the breast and slip in the pacifier while his little mouth is still working.

Be Patient.

Some breastfed babies take to a pacifier straight away, some never take a pacifier at all, and most others just need gentle coaxing. If baby refuses your first attempts at offering the pacifier, then don’t force the issue. Simply try again in a week or two.

One thing you should never do is dip the pacifier in sugar or any other sweet substance. These can get baby hooked on sweets and lead to dental issues as your baby grows. It is important to know, too, that dipping the pacifier in honey could prove deadly for a baby.

Whichever pacifier you decide to buy, be sure to bookmark the following web address for the U.S. Consumer Product Safety Commission. You can simply enter “pacifier” in the site’s search bar to get a list of recent pacifier recalls.

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