Should you give your baby a pacifier?

“Babies love to suck,” says Natasha Saunders, a paediatrician at Toronto’s Hospital for Sick Children and co-author of Baby Care Basics. Sucking is a natural, calming reflex that helps babies soothe themselves. “Every child is different and some babies are able to self-soothe without using a pacifier, but for others a soother can be a huge help,” says Saunders. 

Amanda Robertson, a mother of two in Mississauga, Ont., didn’t hesitate about giving pacifiers to her two sons. “They both liked sucking and I didn’t want them sucking their thumbs,” she says. (She worried that thumb-sucking would be harder to stop later on.) “A soother you can just take away once it’s run its course,” she says. Her eight-month-old son Oliver has had a pacifier since he was a month old. “Once I had firmly established breastfeeding, and he’d taken a bottle for the first time, I offered him a soother.”

When should you introduce a pacifier? Most experts recommend waiting until about the four-week mark before offering your baby a soother. “Ideally, babies born at term should have established breastfeeding before you offer them a pacifier,” says Saunders. There is some concern that introducing a pacifier too soon could interfere with an infant’s breastfeeding latch, cause nipple confusion, or even cause a mother's milk supply to drop because the baby is sucking at the breast less. Though some research has found that pacifier use is associated with quitting breastfeeding earlier, experts have concluded that pacifiers likely aren't the cause—rather, soothers are more likely to be used if moms are having difficulty breastfeeding. Organizations like the Canadian Paediatric Society (CPS) recommend parents wait to begin using a pacifier until breastfeeding is going well. The exception to this rule is preemies. 

According to the CPS, non-nutritive sucking via pacifiers is now considered part of routine developmental care for preterm infants because it provides the comfort they need, especially when they’re in an incubator away from their mother’s constant attention. Studies show that preterm infants who use a pacifier develop weight more rapidly, have a lower incidence of necrotizing enterocolitis (a serious intestinal disease common in preemies), and are discharged from the hospital sooner.

And what if your baby is able to self-soothe with her thumb? Should you try to switch her to a pacifier? Saunders says ideally yes, because thumb-sucking is a harder habit to break, but don’t push it if your child isn’t into it. The benefits of using a soother Research by the American Academy of Pediatrics shows giving infants a pacifier at night helps reduce the risk of Sudden Infant Death Syndrome (SIDS). “While it’s not as significant as sleeping position or avoiding blankets, some studies show that sucking on a soother does help prevent SIDS,” says Saunders. It even helps if your baby spits it out as soon as she falls asleep. The only time pacifiers should be restricted is if a child is prone to ear infections. “Sucking on a soother may make it difficult for the ear tubes to drain properly,” says Saunders. 

Giving up the pacifier Once your child is two or three years old, though, it’s time to phase out the soother to avoid adverse dental effects. When a child sucks on a soother, it pulls the jawbone forward—and the teeth follow. If the baby’s palette is still soft, the bone will return to its original position once the child stops sucking. But once the palette starts to fuse, it becomes more complicated to fix any positional problems with teeth, says Tarra Elliott, owner of Eglinton Way Dentistry in Toronto. “If your child hasn’t dropped it already, you’ll want to get rid of the soother around age three or four,” Elliott says.

Children usually forget quickly at this age, so it’s best to just take the soother away and deal with a couple of rough days. Or you could phase the soother out and let your child use it just for sleeping for a while. “Reducing the amount of time spent on the soother will reduce the risk of dental damage,” says Elliott. Underlying changes to the jawbone usually don’t start until around age four, and the hard palette isn’t fused until about ages six to eight. Every child is different, so if you’re worried, talk to your dentist and she’ll be able to tell if your child’s palette has already started to fuse.

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