Pacifiers: The Good, the Bad, and When to Use Them

by | Nov 20, 2022 | Blog, Podcast, Sleep Challenges, Sleep Foundations | 0 comments

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If you are a parent of a baby or a young child, you might be wondering about pacifiers. As a sleep consultant, I get questions like “is it okay for a baby to sleep with a pacifier?” and “when should my baby STOP sleeping with a pacifier” all the time!

There’s SO much conflicting information out there that it can feel overwhelming!

In this blog article, I will be talking about why pacifiers are so fantastic, when you should introduce it to your little one, and when you should get rid of it. I will also be sharing an amazing insight from my pediatric dentist, Dr. Lori Goldenberg.

Are pacifiers good or bad for sleep?

Generally speaking, I’m a HUGE advocate of introducing a pacifier to a baby. Here’s why:

Pacifiers help calm fussy babies

Pacifiers are great for newborn babies because they help these little babies calm and sooth by activating their “calming reflex”.  This reflex is triggered when a baby sucks on a pacifier, their thumb, a bottle or a breast. The repetitive sucking motion helps to stimulate the nerves in the roof of the mouth, which sends signals to the brain to release calming hormones such as serotonin and endorphins.  

This calming effect can be particularly helpful for newborns, who are adjusting to life outside of the womb and may feel overwhelmed by new sensations and experiences.  When a newborn feels relaxed and destressed, it’s much easier for them to fall sleep peacefully.

This is why introducing a pacifier to a newborn first thing is a good option for calming a fussy baby!

The use of a pacifier helps reduce the risk of SIDS

The use of a pacifier is also known to decrease the risk of SIDS.  Pacifiers do this by promoting a safe sleeping position on their backs and by reducing the likelihood of accidental suffocation or choking.

When a baby falls asleep with a pacifier in their mouth, their tongue is positioned forward, which helps to keep their airway open. This position also encourages the baby to breathe through their nose, which is believed to be a safer way of breathing during sleep.

Additionally, pacifiers may also discourage the baby from rolling over onto their stomach, which is a known risk factor for SIDS.    

Pacifiers are wonderful sleep tools for older babies and toddlers

The benefits of pacifiers are not only for younger babies. The pacifier continues to be a wonderful sleep tool for older babies and toddlers because it’s inherently calming and soothing. Pacifiers can provide comfort and a sense of security to a child. Sucking on a pacifier can help soothe a baby or toddler, and the familiar sensation can help them relax and fall asleep more easily.

The main time a pacifier can become a sleep problem

While pacifiers are usually wonderful sleep tools for newborn babies, older infants and toddlers, they can sometimes create big sleep problems with younger infants.

When you have a younger infant who:

  • heavily relies on their pacifier to fall asleep,
  • is aware of when their pacifier falls out of their mouth;
  • and they don’t yet have the fine motor skills to put it back in their mouths on their own,

you could be faced with LOTS of unnecessary night wakings.

This is exactly what happened with Eliana when she turned 4 months old and went through the 4 month sleep regression. At this point, she was putting herself to sleep completely on her own with the pacifier. Except that she started waking up as soon as she realized it fell out of her mouth, relying on me to reinsert it…which was every 90 minutes ALL NIGHT LONG.

This left me NO choice but to remove the pacifier from bedtime and nighttime and teach her how to fall asleep without it (which is VERY possible when need be!)

**If you and your baby are both “falling on your face” exhausted, possibly because you’re stuck reinserting that pacifier ALL NIGHT LONG, and you’re feeling ready to get your baby sleeping amazingly…but you have no idea where to start, check out my free sleep masterclass here (or click the image below to sign up)**.

Free sleep masterclass for baby who needs pacifier

Is it okay for a toddler to sleep with a pacifier?

Generally speaking, if your little one is over 12 months of age and is using a pacifier for sleep, it is ABSOLUTELY okay for your baby to sleep with a pacifier.

In fact, I don’t recommend eliminating pacifier use from the sleep equation until your child is at least 3 years of age. This is because toddlers often can’t understand (or care to understand) why this big change is happening. And they’re NOT going to be happy about it!

As a result, taking a pacifier away from a toddler can be a bumpy ride and REALLY impact their night sleep. This is especially the case when you’re taking away something that they rely so heavily on to fall asleep.

With older children (developmentally and emotionally), this transition is often easier. Not only are they mature enough to understand what you’re explaining to them, they can often be incentivized with rewards charts. This allows the transition to go MUCH more smoothly for this age range.

That being said, we obviously don’t want to be compromising your kid’s teeth. Always speak to your dentist and listen to their personalized advice for your little one’s.

Baby with pacifier

The story of my two girls and their pacifiers

Lori has been our dentist since Emunah was just 2 years-old. When she was 3 years-old, we got rid of her pacifiers at her dental checkup and she got a toy in exchange. Everything, for the most part, went seamlessly.

We had the same plan for Eliana, who’s just 2 years younger than Emunah. But when it was time to take Eliana to the dentist, I had this bad feeling in the pit of my stomach that she wasn’t ready for this transition just yet.

See, Eliana as a 3-year-old was still very much a toddler. She was still throwing lots of temper tantrums, was very impulsive, and didn’t seem to understand the concept of a rewards chart. I knew that taking away her pacifier at this stage would be VERY challenging.

I took Eliana to Lori, explained my fears, and asked if it’s possible to keep the pacifier for another six months. Lori saw that her teeth were fine and that we could keep the pacifier for longer. Phew.

Because in that 6 month period, Eliana developed and matured quite a bit. She graduated that toddler phase and became a true preschooler. When it was time to go back to the dentist 6 months later, she was more ready to give up her pacifier. As a result, this transition went fairly smoothly!

An INCREDIBLY insightful piece of advice from my dentist

When I reminded Lori of this story as she was speaking to my Sleep Bible members, she made a very insightful comment:

“If her teeth were fine at age 3 despite using the pacifier, she was likely only using it for sleep. I’m assuming you weren’t offering it during the day for soothing purposes.” She was 100% right. I’ve always made a concerted effort to keep the pacifier in my baby’s crib as a sleep tool only. And because I limited her pacifier usage to sleep only, it meant Eliana could sleep with it for longer without compromising her teeth!

To sum things up

To answer the question “is it okay for a baby to sleep with a pacifier?”, the answer is absolutely YES. The pacifier is a wonderful sleep tool for newborns, infants and toddlers. As long as your little one doesn’t overuse the pacifier during the day, you’re good!

If there is any advice I can give you to maximize your little one’s pacifier usage without compromising teeth, it’s to limit pacifier usage for sleep purposes only. If your child is using the pacifier more frequently, chances are that it will begin affecting your little one’s teeth well before he turns 3. This means you’ll have to get rid of it sooner anyways!

Even though there are tons of children who get rid of their pacifiers by age 2, it’s often a VERY challenging process. It’s usually a much less bumpy process if you can keep their pacifier until age 3-3.5 without compromising their teeth.

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Other articles and resources on baby and child sleep

The truth about your teething baby and their sleep
Why settling for mediocre or “good enough” sleep could backfire
The latest research studies on the safety of sleep training
How to know when your baby is ready to drop night feeds
Day-night confusion- how to teach your newborn when it’s daytime and when it’s nighttime

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