Let’s Talk About Pacifiers: Benefits, Risks, & When to Wean
“My baby won’t take a pacifier, is that bad?”
“My baby will only fall asleep if she has a pacifier, is that bad?”
“I have no idea which pacifier is best so I just bought them all!”
“When should I wean my baby from the pacifier?”
“How the h*** do I wean my toddler from the pacifier??”
Hi, I’m Cecelia. I’m a pediatric feeding therapist, licensed speech-language pathologist, board certified lactation consultant, and certified perinatal mental health specialist. Put simply: I help parents feed their babies and feed good doing it.
Pacifiers are an amazing soothing tool, but many parents are confused about how to use them—and when to stop using them.
Here, I’ll do a deep dive into the benefits and risks of pacifiers, how to choose a pacifier (with links to a few of my favorites), and guidance on when & how to wean.
Benefits of pacifier use for babies
Soothing: Pacifiers can be a helpful soothing tool. Sucking has a calming effect on babies’ physiology, and pacifiers can help your baby stay calm during difficult experiences like medical procedures and separation from you.
SIDS: Pacifier use may reduce SIDS risk for babies sleeping separately from their parent.
Risks of prolonged pacifier use
Dental issues: Prolonged pacifier use increases risk of dental issues from atypical application of pressure to the gums, teeth, & palate. This may impact airway development, oral motor skills, oral hygiene, and more.
Speech development: There is no evidence that pacifier use causes speech delays or speech sound disorders. However, it may limit opportunities for babies & toddlers to babble, try new sounds, imitate speech & environmental sounds, and experiment with their voice.
Breastfeeding issues: Pacifiers should not be introduced until breastfeeding is well established, usually at least 2-3 weeks. Pacifier use can prevent babies from expressing early nursing cues, which may slow weight gain, lower milk supply, and harm the breastfeeding relationship.
What’s the best pacifier?
There is no one “best” shape or brand. Whatever pacifier your baby enjoys is the right one for them! If your baby is using their pacifier only when needed for soothing (rather than around the clock), there’s no need to stress about choosing the “perfect” pacifier.
If you’re looking for some guidance, though, the American Academy of Pediatric Dentists (AAPD) recommends choosing a pacifier with either a flat shape and rounded top (sometimes called an “orthodontic pacifier”) or a symmetrical cylindrical shape.
For safety reasons, I look for pacifiers that are all one piece to reduce choking risk.
Here are some options I like as an IBCLC/SLP:
When should my baby wean from the pacifier?
The “official” recommendation: The AAPD recommends weaning from all pacifier use by age 2 to prevent dental issues. The AAP recommends weaning by age 3.
The SLP/IBCLC recommendation: Many pediatric feeding therapists, including SLPs, recommend starting to wean around age 6 months to align with oral motor skill development and support social-emotional skill development.
Oral Motor Skills: The sucking reflex begins to integrate when babies are 2-4 months old, and is replaced by the phasic bite reflex that prepares babies to start chewing food around 6 months. Teething toys should replace pacis.
Social-Emotional Skills: Babies & toddlers can be soothed using a wide variety of strategies using all their senses. Prolonged pacifier use as the primary mode of soothing may limit development of new skills and strategies for soothing.
Pacifier Weaning Strategies for Babies & Toddlers
Wean from pacifier use slowly and respectfully. The pacifier has been a source of comfort and emotional regulation for your child, and it may take them some time to fully transition away from it.
Babies may do well with slowly swapping out the pacifier for other soothing strategies. Try offering a favorite lullaby, a backrub, a lovey or beloved blankie, fresh air, swinging or rocking, or teething toys.
Toddlers may benefit from more conversation about the weaning process. Even if your child isn’t talking yet, they can understand social stories. Read books or talk about why the paci is going away, and decide on a day when you two can throw it away together and say goodbye. Some families plan a goodbye party for the paci—have fun with it!
Struggling with feeding your baby? I can help! I offer in-home feeding therapy and lactation support for little ones age 0-5 in the Vancouver, WA and Portland, OR area. Explore my services and reach out to schedule an appointment!
