All About Pacifiers

Paci, nuk, binky, dummy, soother…there are so many names for a pacifier that you might be familiar with.

Should you give YOUR baby a pacifier? If so, when? Or should you leave it and let your baby suck on their thumb? Which is better?

Trust me when I say I’ve gone through the mental gymnastics of worrying about the horrors of unable to wean (and thus affecting dental development), or hearing that pacifiers increase the rate of ear infections, or my breastfed baby having “nipple confusion”…the works.

I’ll address all of these questions and more in this post all about using pacifiers with both of my daughters, including how I’ve successfully weaned my daughter from using pacifiers by age 2.

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Pacifier vs. Thumb?

So far, research doesn’t show that pacifier or the thumb is actually worse for your child. However, my family decided to go with the pacifier for the following reasons:

• Parent can control when pacifier is allowed to be used and when it can be taken away.
• Studies show that pacifier use during sleep help reduce the risk of SIDS.
• Thumb sucking is a difficult habit to break because it is always available. If this habit goes past age 3, the child can develop dental problems.
• Thumb sucking may expose the child to more germs.

Pacifiers Pros and Cons

Pacifiers have sort of a bad rep because of the many perceived cons like being dependent on it, unable to wean, developing dental problems, and getting ear infections.

Two books in particular eased my mind around using pacifier with my daughters: Happiest Baby on the Block and Precious Little Sleep.

In Happiest Baby on the Block, Dr. Karp includes “Sucking” as one of the 5 S’s to soothe babies. He says that sucking helps lower baby’s heart rate, blood pressure and stress levels. Whether it’s sucking on a pacifier, on a thumb or on the breast, sucking is calming.

Dr. Harvey Karp

• Scientific research shows that using pacifiers can reduce the risk of Sudden Infant Death Syndrome (SIDs).
• Pacifiers help soothe babies especially when combined with white noise and swaddling (See research here). This mimics the womb environment.
• Using an artificial nipple gives breastfeeding momma a much needed rest!

Using a pacifier is a powerful sleep tool that Alexis recommends ALL parents to use in her book Precious Little Sleep.

Alexis Dubrief

Pacifiers and Ear Infections

Research has shown that middle ear infection (otitis media) pacifier use in infants 12 months of age or younger is 2x greater with pacifier use, and 5x greater if bottle fed or attending a day care facility.

However, it is important to note this increase in ear infections is higher in continual users rather than occasional users. Meaning that IF your child is prone to getting ear infections, have medical concerns, OR you are giving them a pacifier continuously throughout the day, the rate of ear infections will be higher than a non-pacifier user.

If your plan is to give your child a pacifier only as a soothing tool for sleep, you shouldn’t have to worry. Speak to your healthcare provider if you are concerned for your child and your child has other medical concerns.

When to Start Using Pacifiers

I decided to use the pacifier with both of my daughters from birth right at the hospital.

I start with the MAM newborn baby pacifier and Philips ultra soft pacifier as I find these to be the best pacifiers for newborns because it is smallest in terms of nipple size and pacifier fit.

Some newborns will take to it right away, and others may not take it at all and just fall asleep on their own. Keep in mind that newborns are very sleepy compared to older infants.

I try to offer a pacifier consistently from the beginning at the beginning of when they are falling asleep so it forms a sleep association. This is part of their sleep routine that cues that it’s time to go to sleep. I use a pacifier, fan white noise and the love to dream swaddle in my ultimate sleeping tool kit.

[Related Post: “To Sleep Train or Not to Sleep Train: How I Survived Without Crying It Out“]

I know a few families who did not offer the pacifier, or offered a few different options and their baby did not take to any of them. This is also normal. There is no need to keep forcing a pacifier on your baby.

You baby may also have phases where they need additional soothing when they go through a developmental leap. Both of my daughters went through phases where they did not need the pacifier to go to sleep, and then needed it again. There’s no hard and fast rules around pacifier usage. Have it in your arsenal of baby soothing items.

How to Offer Pacifier to Newborn

1. Tickle your newborn’s lips with the pacifier nipple as you would if you are breastfeeding or bottle feeding.
2. Put pacifier into baby’s mouth and make sucking noises yourself.
3. Once latch is established, pull a few times so their sucking reflex is engaged.

Nipple Confusion

If you do a quick Google search, you’ll find proponents of nipple confusion say you should delay introducing artificial nipples until your baby is 3-4 weeks old when breastfeeding is established.

However, scientific research says otherwise. This paper indicates that offering a pacifier before breastfeeding is established DOESN’T negatively impact breastfeeding.

Using different nipples is a learned skill. I breastfed, used pacifier and supplemented with formula which introduced another type of artificial nipple through the bottle, and both my daughters had no issues switching between all 3 options.

The important caveat to note about switching between the various nipple options is:

1. Your baby will have their own preferences. They may want an artificial nipple more similar to your natural nipples if they are breastfeeding.
2. You have to learn how to latch properly in each of the different situations (breastfeeding, bottle feeding, pacifier) to switch between the different mechanisms.

Tips for Using Pacifier

• Use for sleep only. I recommend to offer the pacifier only as a sleep tool and not as something to “shut your baby up“. There are valid reasons why babies cry, or scream for attention (when they can). You don’t want to always put a pacifier in your baby’s mouth as it will hinder language development and increase dependence.
• Sanitize. After washing thoroughly with dish soap and warm water, put it in the sanitizer box. I do this extra step after every wash until baby is 6 months old. Then I sanitize every week. DO NOT put the pacifier in your own mouth or rub it on your shirt to clean it. It will only spread more germs! Always get a fresh, clean pacifier for your baby.
• Replace. When your baby ages out of the pacifier (some are for newborns, or 0-6 months), replace it. If the pacifier changes shape, colour, or has ruptures in the material, throw it away. If you use natural rubber pacifiers, these need to be replaced more frequently (it gets sticky!), about every 4-6 weeks. All silicone pacifiers can be used for much longer, but best to be replaced every 3 months.
• Get extras. If your baby has a preference for a certain pacifier (both of my daughters LOVE the Itzy Ritzy silicone pacifier from 4 weeks onwards), buy at least 6. They will for sure drop it, you will for sure lose it, and you want to have enough backups on hand (washed and sanitized, of course!).
• Pacifier clips only for travel. Do NOT use pacifier clips unless you are monitoring your child. The pacifier clips can be a choking hazard as it can wrap around your baby’s neck. I have many that were gifted to me but I rarely use it even when we are out and about. I prefer to just put the pacifier in a pacifier holder/container.

Types of Pacifiers

• Newborn Pacifier: small and flatter in nipple shape. Great for newborns and some have glow-in-the-dark options for parents to find it easily in the dark (because you will drop it!)
• Silicone Pacifier: all in one piece, easy to clean. The Itzy Ritzy one linked is both my daughters’ favourite. These are larger in size but very soft and malleable. My daughters prefer these from 4 weeks old onwards.
• Natural Rubber Pacifier: nipple and base are separate. I really did not like these because it was a pain to wash and dry. Soapy water would get inside the nipple part because it’s separate from the base. Also due to the nature of natural rubber material, it will become sticky and deteriorate much quicker. You’ll need to replace this every 4-6 weeks.
• Orthodontic Pacifier: shaped to minimize damage to the teeth. Flat and curved in shape so it doesn’t obstruct the teeth in the same way a normal pacifier would. My daughters did not like this one, presumably because the shape is not the same as a natural nipple. The material is also thicker (I’m assuming to maintain this shape) and more “rubbery”.
• Pacifier with Plushie/lovey: The wubbanub has the popular Philips pacifier attached, some are not detachable which makes washing the pacifier very annoying. The pacifier nipple is harder than the Itzy Ritzy one linked above even though it looks like it is similar in shape. This would be best to be offered occasionally. The hefty price is also a huge deterrent so if your child becomes attached to the lovey on the pacifier it could become a problem later on for weaning.

Pacifier Holder

When you’re on the go with the pacifier, you’d want to make sure it’s sanitary. If you don’t want to opt for specialized pacifier cases like the ones I’ve linked below, you can always just put the pacifiers into a storage container like this one.

Mushie’s silicone pacifier holder is large and fits 2 pacifiers easily. The only downside is that the “mouth” is open so it can easily get contaminated.

The melii pacifier case has a hard shell and is very compact, but even the Itzy Ritzy pacifier (which is on the bigger side), can fit with a bit of squish.

I also had a portable UV light sanitizer box pacifier case, and it was just SO bulky, needs charging, and difficult to use. I do not recommend it.

Alternative Sucking Toys / Teethers

Below I’ve linked my daughter’s favourite sucking toys/teethers that are tried-and-true.

These are great for babies that are over 3 months old, perfect to be grasped in their little fists.

I especially like the mombella mushroom chew toy because once my daughter’s fist wraps around it, she almost never drops it! The shape and the design just works so well for little hands.

There are other teethers like this one that can be easily held or stand on their own and easy to wash.

How to Wean Off Pacifier by 2 Years Old

It is important to wean your child off all pacifier use before the age of 3. By age 4, continuous pacifier usage during the day begins to affect speech articulation and dental development.

Below is how I was able to wean the pacifier completely with my daughter by when she turned 2 years old. Remember to give yourself and your child plenty of time and consistent reminders to minimize pacifier use.

I have separated the process into 4 different phases with the corresponding timeframe it took for my daughter. You may adjust according to your personal situation.

Step-by-Step Weaning Off Pacifier

• Age 12 months – [Phase 1: Pacifier is only used for sleep time: nap time and night time.]
  • Start by introducing the book, Pacifiers Are Not Forever and provide a lovey or plushie (one that you can buy multiples of!) at night as comfort item if child does not already have one. This provides a soother alternative for the child.
  • Set the expectation that the pacifier is going to be used only for sleep time.
  • If the child asks for the pacifier during the day, replace with lovey or redirect. Note why your child is asking for the pacifier – Is it for comfort? Is it habit? Are YOU the one offering it to them when they are screaming/crying/fussing?
  • Provide vocabulary exposure for the following words over the next 3 months: “broken”, “no more”, “all gone”, “garbage / trash”, “bye-bye“
• Age 15 months – [Phase 2: Wean all nap time pacifier use at daycare or outside of her bedroom. Night time use only.]
  • Note that my daughter has been attending daycare full time from Monday-Friday by 14 months.
  • I found this was easier because she was in a different environment.
  • Continue to read Pacifiers Are Not Forever at least once a week.
  • Tell the child the pacifier is used for night time sleep only. Consistently offer the lovey, make sure it is the only item in the bed for sleep.
  • Establish a firm night time routine you can stick to every night. For example: milk, brush teeth, books, pacifier/lovey, lights out.
• Age 18 months – [Phase 3: Weaning pacifier at night.]
  • Do not actively offer pacifier unless asked, or unless sleep is difficult to achieve. Redirect to using the lovey. Stick to the night time routine.
  • Continue to read Pacifiers Are Not Forever at least once a week, then read this book consistently every night a week before they turn 2.
  • Prep your child by talking about their upcoming 2 year old birthday. Talk about big girl/big boy things. Differentiate between baby and big girl/ big boy activities.
• Age 24 months – [Phase 4: Bye-bye Paci!]
  • After your child’s 2 year old birthday, tell your child it is time to say bye-bye to the pacifier. Put away all pacifiers. Make sure it’s out of sight.
  • Snip the tip of the pacifier and tell your child the pacifier is broken. If your child asks for the pacifier, give her the “broken” pacifier and let her suck on it. She will quickly realize it’s not the same and lose interest. Continue to offer her the broken pacifier if she asks, and reiterate that pacifiers are for babies only.
  • I was in my third trimester by this point, so I was able to link this transition with her transitioning into a Big Sister.

I know some parents choose to do cold turkey and just do Phase 4 and snip the tip of the pacifier. However, this transition will be very difficult if there isn’t enough prep leading up to it.

Providing ample heads-up and teaching your child the vocabulary to understand what is happening/ going to happen is crucial to the success of weaning using my method outlined above.

Plan B: Pacifier Fairy

I have not tried this method myself since my weaning process worked. This was going to be my plan B. If what I’ve outlined above has not worked for you, you can always try the “Pacifier Fairy” method.

• Introduce Florrie the Paci Fairy a week or two before you are going to take the pacifier.
• Read the book every night or every other night and get your child familiar with Florrie and the concept of parting with their pacifier.
• Plan a special night and tell your child Florrie is coming and will be taking all the pacifiers away.
  • Ensure you follow through and take out all of their pacifiers and get rid of all of them at once.
• Reiterate the story and celebrate that Florrie came and that your child is a big girl/big boy!

Transition Recommendations

• Space out any large life transitions (i.e. potty training, new sibling) by at least 3 months for the child to adjust.
• Provide ample opportunities for baby to learn about big girl or big boy activities and reinforce that pacifiers are not forever.
• Do NOT shame, blame, threat, or use any scare tactics around using and weaning the pacifier.
• Provide an alternative sleep association early on to create a subtle shift in routine.

This post was all about pacifiers: pacifier misconceptions, pacifier usage, pacifier types, pacifier pros and cons, as well as how to wean off pacifier completely for a 2 year old toddler.

If you are a concerned first time mom, just know that this is a tool you can have in your arsenal!

Best of luck to you if you are weaning off your toddler off the paci, and I hope my tips and method helped prepare you in this big transition.

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