Pacifiers: Are they good for your baby?

Most babies have a strong sucking reflex. Some babies even suck their thumbs or fingers before they're born. Beyond helping with nutrition, sucking often has a soothing effect. Are pacifiers really OK for your baby, though? Understand the benefits and risks of pacifier use, safety tips, and steps to wean your baby from the pacifier.

The pros

For some babies, pacifiers are the key to contentment between feedings. Consider the advantages:

• A pacifier might soothe a fussy baby. Some babies are happiest when they're sucking on something.
• A pacifier offers temporary distraction. A pacifier might come in handy during and after shots, blood tests or other procedures.
• A pacifier might help your baby fall asleep. If your baby has trouble settling down, a pacifier might do the trick.
• A pacifier might ease discomfort during flights. Babies can't intentionally "pop" their ears by swallowing or yawning to relieve ear pain caused by air pressure changes. Sucking on a pacifier might help.
• A pacifier might help reduce the risk of sudden infant death syndrome (SIDS). Sucking on a pacifier at nap time and bedtime might reduce the risk of SIDS.
• Pacifiers are disposable. When it's time to stop using pacifiers, you can throw them away. If your child prefers to suck on his or her thumb or fingers, it might be more difficult to break the habit.

The cons

Of course, pacifiers have pitfalls as well. Consider the drawbacks:

• Your baby might become dependent on the pacifier. If your baby uses a pacifier to sleep, you might face middle-of-the-night crying spells when the pacifier falls out of your baby's mouth.
• Pacifier use might increase the risk of middle ear infections. However, rates of middle ear infections are generally lowest from birth to age 6 months — when the risk of SIDS is the highest and your baby might be most interested in a pacifier.
• Prolonged pacifier use might lead to dental problems. Normal pacifier use during the first few years of life generally doesn't cause long-term dental problems. However, prolonged pacifier use might cause a child's teeth to be misaligned.
• Pacifier use might disrupt breast-feeding. If you're breast-feeding, you might wait to offer a pacifier until your baby is 3 to 4 weeks old and you've settled into a nursing routine. However, a review of unrestricted pacifier use in healthy, full-term infants found that it had no impact on the continuation of breast-feeding.

Pacifier do's and don'ts

If you choose to offer your baby a pacifier, keep these tips in mind:

• Don't use a pacifier as a first line of defense. Sometimes a change of position or a rocking session can calm a crying baby. Offer a pacifier to your baby only after or between feedings.
• Choose a one-piece, dishwasher-safe variety. Pacifiers made of two pieces pose a choking hazard if they break.
• Let your baby set the pace. If your baby's not interested in the pacifier, don't force it.
• Keep it clean. Until your baby is 6 months old and his or her immune system matures, frequently boil pacifiers or run them through the dishwasher. After age 6 months, simply wash pacifiers with soap and water. Resist the temptation to "rinse" the pacifier in your own mouth. You'll only spread more germs to your baby.
• Don't sugarcoat it. Don't put sweet substances on the pacifier.
• Keep it safe. Replace pacifiers often and use the appropriate size for your baby's age. Watch for signs of deterioration. Also use caution with pacifier clips. Never attach a pacifier to a string or strap long enough to get caught around your baby's neck.

Pulling the plug

The risks of pacifier use begin to outweigh the benefits as your baby gets older. While most kids stop using pacifiers on their own between ages 2 and 4, others need help breaking the habit. Use praise when your child chooses not to use the pacifier. If your child has difficulty giving up the pacifier, consider asking your child's doctor or dentist for help.