When to Introduce a Pacifier
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, AAP guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect when to introduce a pacifier, here is what the evidence says.
The short answer
Pacifiers can be introduced once breastfeeding is well established, typically around 3-4 weeks. For formula-fed babies, a pacifier can be offered from birth. Pacifier use during sleep has been shown to reduce the risk of SIDS. Never force a pacifier on a baby who does not want it.
Key takeaways
- Pacifiers can be introduced once breastfeeding is well established, typically around 3-4 weeks. For formula-fed babies, a pacifier can be offered from birth. Pacifier use during sleep has been shown to reduce the risk of SIDS. Never force a pacifier on a baby who does not want it.
- Usually normal when: Baby uses the pacifier to self-soothe and falls asleep with it
- Call your doctor if: Baby has a pacifier with a cracked, torn, or damaged nipple that could pose a choking hazard
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAP guidelines, pacifiers can be introduced once breastfeeding is well established, typically around 3-4 weeks. For formula-fed babies, a pacifier can be offered from birth. Pacifier use during sleep has been shown to reduce the risk of SIDS. Never force a pacifier on a baby who does not want it. At 0-1 month, if breastfeeding, the AAP suggests waiting until breastfeeding is well established (usually 3-4 weeks) before introducing a pacifier, to avoid interfering with latch and milk supply. However, recent research suggests that pacifier use may not significantly affect breastfeeding in motivated mothers. For formula-fed babies, a pacifier can be offered at any time. The AAP recommends offering a pacifier at nap time and bedtime because it has been associated with a reduced risk of SIDS. If the pacifier falls out during sleep, you do not need to replace it. Never attach a pacifier to a string or clip during sleep. Never coat it in sugar or honey. It is generally considered normal when baby uses the pacifier to self-soothe and falls asleep with it. However, you should contact your pediatrician promptly if baby has a pacifier with a cracked, torn, or damaged nipple that could pose a choking hazard.
Normal vs. Concerning
By Age
What to expect by age
0-1 month
If breastfeeding, the AAP suggests waiting until breastfeeding is well established (usually 3-4 weeks) before introducing a pacifier, to avoid interfering with latch and milk supply. However, recent research suggests that pacifier use may not significantly affect breastfeeding in motivated mothers. For formula-fed babies, a pacifier can be offered at any time. The AAP recommends offering a pacifier at nap time and bedtime because it has been associated with a reduced risk of SIDS. If the pacifier falls out during sleep, you do not need to replace it. Never attach a pacifier to a string or clip during sleep. Never coat it in sugar or honey.
1-3 months
This is often the sweet spot for introducing a pacifier if you have not already. If baby is breastfeeding well, offering a pacifier for sleep and soothing is reasonable. Some babies take to pacifiers immediately; others never accept one. Do not force it. Try different shapes (orthodontic, round) to find one your baby prefers. Sucking is a natural soothing behavior for babies.
3-6 months
Pacifier use is well established if baby has accepted one. Continue offering at sleep times. If baby has never taken a pacifier, it may be harder to introduce at this age. Begin thinking about not introducing a pacifier if baby has not used one, as breaking the habit later can be challenging.
6-12 months
Pacifier use can continue for sleep and comfort. The AAP recommends beginning to wean off the pacifier after 6 months to reduce the risk of ear infections and dental issues. Most experts recommend stopping pacifier use by age 2 to avoid dental alignment problems.
What to Tell Your Pediatrician
- Describe when you first noticed when to introduce a pacifier and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you are concerned about pacifier use affecting breastfeeding.
- Mention if baby seems overly dependent on the pacifier and cannot settle without it.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Baby uses the pacifier to self-soothe and falls asleep with it
- Pacifier falls out during sleep and baby continues sleeping
- Baby rejects the pacifier: not all babies want one and that is completely fine
- Baby seems to prefer sucking on fingers instead
- You are concerned about pacifier use affecting breastfeeding
- Baby seems overly dependent on the pacifier and cannot settle without it
- You notice recurring ear infections and want to discuss pacifier use
- Baby has a pacifier with a cracked, torn, or damaged nipple that could pose a choking hazard
- Baby has swallowed part of a pacifier
What You Can Do at Home
- Keep track of when you notice when to introduce a pacifier — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that baby uses the pacifier to self-soothe and falls asleep with it — this is generally within the range of normal.
- At 0-1 month, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if baby has a pacifier with a cracked, torn, or damaged nipple that could pose a choking hazard.
Related Conditions
Safe Sleep Position for Newborns
The safest sleep position for babies is on their back, on a firm flat surface, for every sleep. This recommendation from the AAP significantly reduces the risk of SIDS and sleep-related deaths. Always place your baby on their back until they can roll both ways independently.
Pain During Breastfeeding Latch
While mild tenderness during the first few seconds of a latch is common in the early days of breastfeeding, breastfeeding should not be consistently painful. Ongoing pain during latch usually indicates a shallow latch, which can be corrected with positioning adjustments. Other causes include tongue tie, thrush, vasospasm, or infection. Seeking help from a lactation consultant early can prevent pain from worsening and protect your breastfeeding goals.
newborn sucking reflex weak
Related Resources
Frequently asked questions
Is when to introduce a pacifier normal?
When should I call the doctor about when to introduce a pacifier?
When is when to introduce a pacifier normal?
What causes when to introduce a pacifier?
What should I mention to my pediatrician about when to introduce a pacifier?
Is when to introduce a pacifier normal at 0-1 month?
Is when to introduce a pacifier normal at 1-3 months?
Should I go to the ER for when to introduce a pacifier?
Does when to introduce a pacifier go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss When to Introduce a Pacifier.
Things to mention
- Describe when you first noticed when to introduce a pacifier and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you are concerned about pacifier use affecting breastfeeding.
- Mention if baby seems overly dependent on the pacifier and cannot settle without it.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- You are concerned about pacifier use affecting breastfeeding
- Baby seems overly dependent on the pacifier and cannot settle without it
- You notice recurring ear infections and want to discuss pacifier use
Urgent signs to report immediately
- Baby has a pacifier with a cracked, torn, or damaged nipple that could pose a choking hazard
- Baby has swallowed part of a pacifier
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of when to introduce a pacifier are normal. Talk to your pediatrician if baby has a pacifier with a cracked, torn, or damaged nipple that could pose 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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Safe Sleep Position for Newborns
The safest sleep position for babies is on their back, on a firm flat surface, for every sleep. This recommendation from the AAP significantly reduces the risk of SIDS and sleep-related deaths. Always place your baby on their back until they can roll both ways independently.
Pain During Breastfeeding Latch
While mild tenderness during the first few seconds of a latch is common in the early days of breastfeeding, breastfeeding should not be consistently painful. Ongoing pain during latch usually indicates a shallow latch, which can be corrected with positioning adjustments. Other causes include tongue tie, thrush, vasospasm, or infection. Seeking help from a lactation consultant early can prevent pain from worsening and protect your breastfeeding goals.
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