Behavior & Social

Pacifier Pros and Cons for My Baby

Content reviewed against published AAP, AAPD, CDC guidelines

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Behavioral development varies greatly from child to child. If you have noticed pacifier pros and cons for my baby, here is what you need to know.

The short answer

Pacifiers have both benefits and drawbacks. Benefits include: reduced risk of SIDS (Sudden Infant Death Syndrome) when used during sleep, effective self-soothing tool, and pain relief during procedures. Drawbacks include: potential breastfeeding interference if introduced too early, increased ear infection risk with prolonged use, and dental effects if used beyond age 2-3. The AAP recommends offering a pacifier at nap and bedtime once breastfeeding is well established (usually around 3-4 weeks).

Key takeaways

  • Pacifiers have both benefits and drawbacks. Benefits include: reduced risk of SIDS (Sudden Infant Death Syndrome) when used during sleep, effective self-soothing tool, and pain relief during procedures. Drawbacks include: potential breastfeeding interference if introduced too early, increased ear infection risk with prolonged use, and dental effects if used beyond age 2-3. The AAP recommends offering a pacifier at nap and bedtime once breastfeeding is well established (usually around 3-4 weeks).
  • Usually normal when: Your baby uses a pacifier at nap and bedtime and it helps them fall asleep — this is recommended by the AAP.
  • Call your doctor if: Your baby's pacifier has cracked, torn, or has pieces coming off — discard it immediately as loose pieces are a choking hazard.
  • Varies by age — see the age-by-age breakdown below

This is one of the most common questions parents ask. Searching for answers means you care.

By Age

What to expect by age

0-6 months

The AAP recommends introducing a pacifier at nap time and bedtime once breastfeeding is well established (typically by 3-4 weeks of age), as pacifier use during sleep has been shown to reduce the risk of SIDS by up to 90% in some studies. The mechanism is not fully understood but may involve keeping the airway more open and promoting lighter sleep. If the pacifier falls out after the baby is asleep, there is no need to replace it. For breastfed babies, wait until breastfeeding is going well before introducing a pacifier to avoid nipple confusion, though recent research suggests pacifiers may not actually interfere with breastfeeding for most babies.

6-12 months

Pacifiers continue to provide a SIDS protective effect during the first year. However, studies show that pacifier use beyond 6 months is associated with a slightly increased risk of ear infections (otitis media), likely because sucking affects the pressure in the eustachian tubes. If your baby is prone to ear infections, your pediatrician may recommend limiting pacifier use to sleep times only. This is a good age to begin setting boundaries around pacifier use — limiting it to naps and bedtime rather than all-day use. Cleaning pacifiers regularly (dishwasher or boiling water) is important; do not "clean" a pacifier by putting it in your mouth.

12-36 months

The American Academy of Pediatric Dentistry recommends weaning off the pacifier by age 2-3 to prevent dental problems. Prolonged pacifier use can cause an open bite (front teeth do not touch when the mouth is closed), crossbite, or narrowing of the palate. These dental changes are often reversible if the pacifier is stopped before age 3-4, but become more permanent with longer use. Strategies for weaning include gradual reduction, the "pacifier fairy," and trading the pacifier for a special toy. Abrupt removal works for some families. Do not dip pacifiers in honey, sugar, or anything sweet.

What Should You Do?

When to take action

Probably normal when...
  • Your baby uses a pacifier at nap and bedtime and it helps them fall asleep — this is recommended by the AAP.
  • Your baby sometimes refuses the pacifier — never force it.
  • Your baby naturally loses interest in the pacifier and self-weans, often around 6-12 months.
Mention at your next visit when...
  • Your baby seems dependent on the pacifier and wakes frequently when it falls out, causing sleep disruption.
  • You are concerned about the timing of introducing a pacifier relative to breastfeeding.
  • Your toddler is 2+ years old and you want strategies for weaning off the pacifier.
Act now when...
  • Your baby's pacifier has cracked, torn, or has pieces coming off — discard it immediately as loose pieces are a choking hazard.
  • Your baby has a pacifier with a cord, ribbon, or clip attached near the face during sleep — remove it immediately, as strings and clips pose strangulation and suffocation risks.
  • Your dentist has identified dental changes from pacifier use and recommends discontinuing — follow up with a weaning plan.

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Pacifier Pros and Cons for My Baby.

Things to mention

  • Your baby seems dependent on the pacifier and wakes frequently when it falls out, causing sleep disruption.
  • You are concerned about the timing of introducing a pacifier relative to breastfeeding.
  • Your toddler is 2+ years old and you want strategies for weaning off the pacifier.

Observations to share

  • Your baby seems dependent on the pacifier and wakes frequently when it falls out, causing sleep disruption.
  • You are concerned about the timing of introducing a pacifier relative to breastfeeding.
  • Your toddler is 2+ years old and you want strategies for weaning off the pacifier.

Urgent signs to report immediately

  • Your baby's pacifier has cracked, torn, or has pieces coming off — discard it immediately as loose pieces are a choking hazard.
  • Your baby has a pacifier with a cord, ribbon, or clip attached near the face during sleep — remove it immediately, as strings and clips pose strangulation and suffocation risks.
  • Your dentist has identified dental changes from pacifier use and recommends discontinuing — follow up with a weaning plan.

My notes

From ismybabyalright.com — free, evidence-based baby health guides

How to Wean My Baby Off the Pacifier

The American Academy of Pediatric Dentistry recommends weaning off the pacifier between ages 2 and 3 to prevent dental problems. Methods include gradual reduction (limiting use to nap and bedtime only, then eliminating), the "pacifier fairy" (leaving pacifiers for a fairy who brings a gift), cold turkey removal, cutting the tip to reduce satisfaction, and trading it for a special toy. The best method depends on your child's age, temperament, and attachment level.

Baby Won't Sleep Without Nursing

Nursing to sleep is one of the most natural and biologically normal things you can do - breast milk contains hormones that promote sleepiness, and the act of suckling is deeply calming. It is not a bad habit you have created. If it is working for your family, there is no medical reason to change it. If it is no longer sustainable for you, gentle approaches can help your baby learn other ways to fall asleep.

My Baby Pinches Me While Falling Asleep

Pinching, twiddling, kneading, or grabbing skin while falling asleep is a very common self-soothing behavior in babies and toddlers. Many breastfed babies pinch or twiddle the opposite breast while nursing to sleep. This behavior is a form of comfort-seeking and is not a sign of any developmental or behavioral problem. While it is normal, it can be uncomfortable or painful for the parent. Redirecting the behavior to a suitable alternative (a small blanket, stuffed animal, or taggy toy) can help.

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is pacifier pros and cons for my baby normal?
Pacifiers have both benefits and drawbacks. Benefits include: reduced risk of SIDS (Sudden Infant Death Syndrome) when used during sleep, effective self-soothing tool, and pain relief during procedures. Drawbacks include: potential breastfeeding interference if introduced too early, increased ear infection risk with prolonged use, and dental effects if used beyond age 2-3. The AAP recommends offering a pacifier at nap and bedtime once breastfeeding is well established (usually around 3-4 weeks).
When should I call the doctor about pacifier pros and cons for my baby?
Your baby's pacifier has cracked, torn, or has pieces coming off — discard it immediately as loose pieces are a choking hazard. Your baby has a pacifier with a cord, ribbon, or clip attached near the face during sleep — remove it immediately, as strings and clips pose strangulation and suffocation risks. Your dentist has identified dental changes from pacifier use and recommends discontinuing — follow up with a weaning plan.
When is pacifier pros and cons for my baby normal?
Your baby uses a pacifier at nap and bedtime and it helps them fall asleep — this is recommended by the AAP. Your baby sometimes refuses the pacifier — never force it. Your baby naturally loses interest in the pacifier and self-weans, often around 6-12 months.
What causes pacifier pros and cons for my baby?
Pacifiers have both benefits and drawbacks. Benefits include: reduced risk of SIDS (Sudden Infant Death Syndrome) when used during sleep, effective self-soothing tool, and pain relief during procedures. Drawbacks include: potential breastfeeding interference if introduced too early, increased ear infection risk with prolonged use, and dental effects if used beyond age 2-3. The AAP recommends offering a pacifier at nap and bedtime once breastfeeding is well established (usually around 3-4 weeks). Common explanations include: Your baby uses a pacifier at nap and bedtime and it helps them fall asleep — this is recommended by the AAP.. Your baby sometimes refuses the pacifier — never force it..
What should I mention to my pediatrician about pacifier pros and cons for my baby?
You should mention pacifier pros and cons for my baby at your next visit if: Your baby seems dependent on the pacifier and wakes frequently when it falls out, causing sleep disruption.. You are concerned about the timing of introducing a pacifier relative to breastfeeding.. Your toddler is 2+ years old and you want strategies for weaning off the pacifier..
Is pacifier pros and cons for my baby normal at 0-6 months?
The AAP recommends introducing a pacifier at nap time and bedtime once breastfeeding is well established (typically by 3-4 weeks of age), as pacifier use during sleep has been shown to reduce the risk of SIDS by up to 90% in some studies. The mechanism is not fully understood but may involve keeping the airway more open and promoting lighter sleep. If the pacifier falls out after the baby is asleep, there is no need to replace it. For breastfed babies, wait until breastfeeding is going well before introducing a pacifier to avoid nipple confusion, though recent research suggests pacifiers may not actually interfere with breastfeeding for most babies.
Is pacifier pros and cons for my baby normal at 6-12 months?
Pacifiers continue to provide a SIDS protective effect during the first year. However, studies show that pacifier use beyond 6 months is associated with a slightly increased risk of ear infections (otitis media), likely because sucking affects the pressure in the eustachian tubes. If your baby is prone to ear infections, your pediatrician may recommend limiting pacifier use to sleep times only. This is a good age to begin setting boundaries around pacifier use — limiting it to naps and bedtime rather than all-day use. Cleaning pacifiers regularly (dishwasher or boiling water) is important; do not "clean" a pacifier by putting it in your mouth.
Should I go to the ER for pacifier pros and cons for my baby?
Seek emergency care if your baby's pacifier has cracked, torn, or has pieces coming off — discard it immediately as loose pieces are a choking hazard, or if your baby has a pacifier with a cord, ribbon, or clip attached near the face during sleep — remove it immediately, as strings and clips pose strangulation and suffocation risks. When in doubt, call your pediatrician's after-hours line for guidance.
Does pacifier pros and cons for my baby go away on its own?
In many cases, pacifier pros and cons for my baby resolves on its own, especially when your baby uses a pacifier at nap and bedtime and it helps them fall asleep — this is recommended by the AAP. By 12-36 months, the American Academy of Pediatric Dentistry recommends weaning off the pacifier by age 2-3 to prevent dental problems. Prolonged pacifier use can cause an open bite (front teeth do not touch when the mouth is closed), crossbite, or narrowing of the palate. These dental changes are often reversible if the pacifier is stopped before age 3-4, but become more permanent with longer use. Strategies for weaning include gradual reduction, the "pacifier fairy," and trading the pacifier for a special toy. Abrupt removal works for some families. Do not dip pacifiers in honey, sugar, or anything sweet.
AAPAAPDCDC

References

  1. [1]American Academy of Pediatrics — Pacifiers and SIDS Reduction AAP
  2. [2]American Academy of Pediatric Dentistry — Policy on Pacifier Use AAPD
  3. [3]Centers for Disease Control and Prevention — Infant Safe Sleep Practices CDC

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Resources

Teething GuideEmergency ContactsBaby Tracker

Bottom line

Most cases of pacifier pros and cons for my baby are normal. Talk to your pediatrician if your baby's pacifier has cracked, torn, or has pieces coming off — discard it immediately as loose pieces are a choking hazard.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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How to Wean My Baby Off the Pacifier

The American Academy of Pediatric Dentistry recommends weaning off the pacifier between ages 2 and 3 to prevent dental problems. Methods include gradual reduction (limiting use to nap and bedtime only, then eliminating), the "pacifier fairy" (leaving pacifiers for a fairy who brings a gift), cold turkey removal, cutting the tip to reduce satisfaction, and trading it for a special toy. The best method depends on your child's age, temperament, and attachment level.

Baby Won't Sleep Without Nursing

Nursing to sleep is one of the most natural and biologically normal things you can do - breast milk contains hormones that promote sleepiness, and the act of suckling is deeply calming. It is not a bad habit you have created. If it is working for your family, there is no medical reason to change it. If it is no longer sustainable for you, gentle approaches can help your baby learn other ways to fall asleep.

My Baby Pinches Me While Falling Asleep

Pinching, twiddling, kneading, or grabbing skin while falling asleep is a very common self-soothing behavior in babies and toddlers. Many breastfed babies pinch or twiddle the opposite breast while nursing to sleep. This behavior is a form of comfort-seeking and is not a sign of any developmental or behavioral problem. While it is normal, it can be uncomfortable or painful for the parent. Redirecting the behavior to a suitable alternative (a small blanket, stuffed animal, or taggy toy) can help.

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