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What's the Problem With Pacifiers?

What's the Problem With Pacifiers?

by Wendy Wright

A week ago


If you’re a breastfeeding mom, you may have been admonished not to use a pacifier (or any artificial nipple) as it can interfere with breastfeeding. But at the same time, you may have read that the American Academy of Pediatrics recommends pacifiers as a protective intervention against sudden infant death (SIDS).

Everyday as a lactation consultant, I hear moms say, “But my baby is using me as a pacifier ….” Or a mom will tell me a family member has said, “Don’t let him use you as a pacifier.” The funny thing is that pacifiers are designed to mimic the breast! Your baby isn’t using you as a pacifier, he’s using the pacifier as a less-than-perfect you!

Some babies just have a strong need to suck. Even if they are eating often and growing well, they seem to want to be attached to your body 24/7. A pacifier is just a tool, and like any other parenting tool, it can be overused and misused. Know the risks and benefits before you start using a pacifier:

The pros:

  • it does offer some SIDS protection, though the AAP recommends waiting until after 4 weeks to introduce it to a breastfed baby
  • it provides pain relief (though the same - or better - can be had with skin-to-skin contact and breastfeeding though procedures),
  • it can help a premature baby gain weight
  • it’s something another caregiver can use to calm your baby

The cons:

  • ear infections and thrush are more common when baby uses a pacifier\
  • frequent pacifier use can lead to crooked teeth and a changed palate shape
  • when overused, a pacifier can lead to poor weight gain
  • it may lead to plugged ducts or mastitis if the breast isn’t emptied often enough, or if baby’s suck changes
  • it’s possible that a latex pacifier may sensitize baby and increase his risk for latex allergy

Is nipple confusion really a thing? Some babies do form a preference for the rigid pacifier nipple. When faced with the soft, pliant breast, they aren’t sure what to do. But what we sometimes call nipple confusion is actually flow preference related to bottle use. Babies aren’t confused at all - they know which is easier.

If you decide to use a pacifier with your baby, keep these guidelines in mind:

  • wait until 3-4 weeks so you can get breastfeeding well established
  • never use a pacifier in place of feeding your baby, or to hold baby off for a longer stretch between feedings
  • use a one piece pacifier and never tie it to baby’s clothes, body, crib, seat or stroller (as this can become a strangulation hazard).
  • regular pacifier use can shorten the duration of breastfeeding and may cause the return of fertility
  • If you are experiencing low milk supply or sore nipples, or if your baby is having problems latching, you may want to avoid pacifier use until breastfeeding improves.

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