Pacifier, binky, ninny, dummy, soother…. Whatever you call it, it can be a lifeline for exhausted parents trying to calm a fussy baby.  

There’s a lot of stuff out there about pacifiers—the good, bad, and ugly—and we’re going to break it down for you.  

Where did it come from?  For centuries—ever since Cain & Abel, probably—we’ve been trying to soothe our babies.  There’s a painting by Albrecht Durer, done in the 1500s, called Madonna with the Siskin, which shows Mary holding a baby Jesus while he sucks on a dampened rag.  

People used to soak cloths in all sorts of things to help with teething:  brandy, sugar water, wine. They could be made into pouches and filled with poppy seeds to soothe the gums (like an opiate!).  

In 1901, Christian Meineke patented what we think of as today’s pacifier, and it went through a couple of iterations, but not much has changed since the 1950s.  It’s pretty much the rubber or silicone nub attached to a plastic circle/ring of some kind.  

It starts early: Ultrasounds frequently capture babies in-utero sucking on their extremities; babies can be born tattooed with sucking blisters.

They — somewhat mysteriously — reduce the risk of SIDS: The American Academy of Pediatrics, in a highly controversial decision, now recommends pacifier use at night and during naps. The pacifier entry in a recent book on infant development includes this unconditional assessment: “Pacifiers provide comfort, promote physiological tranquility, and help in growth and development.”

Babies Suck

We know newborns are born with a strong sucking reflex/instinct. As newborns, babies can’t self-soothe. Their limbs lack muscle control and they flail and startle.  (This is why swaddling helps calm newborns…it keeps them all tucked in and cozy like they were in the womb.)   

You place a newborn directly on mom’s chest immediately after birth, and a lot of times they’ll start the “breast crawl” immediately…hunting and scootching around looking for that food source.  It’s clearly an innate instinct!

So, I’ve found that a lot of pediatricians actually recommend intermittent paci use to help newborns (up to 4 months) soothe.  

What if You’re Nursing?

If you’re nursing, a lot of breast-feeding moms choose not to use a pacifier in the beginning because there’s a school of thought that it can cause confusion as the baby learns how to latch on, suckle and feed correctly.  They need to learn that suck-swallow-breathe pattern.  (The WHO found that using a paci while breastfeeding didn’t have any effect on duration of nursing/weaning up to 4 months old.  So, I take that to mean that you shouldn’t worry that your baby will quit nursing if you’re using a pacifier now & then in conjunction.)  

While it may not make your baby stop nursing, Using a pacifier when they’re figuring out that pattern & YOU’RE figuring out their feeding cues CAN interfere….they’re hungry & you give them a pacifier which might cue them that they’ve had a meal, & then they’re fussy 15 minutes later b/c of a missed feeding cue.  

Is it Bad for Their Development?

Mouth Formation.  With a pacifier, baby is using different muscles in their face, cranium, and mouth.  Sucking doesn’t just involve your tongue.  Breastfeeding activates lots of muscles in the face, head, and tongue.  Even their foreheads move up & down while they’re nursing.  All these muscles being worked helps them grow/develop correctly.  

Pacifiers tend to cause a hyper function of the (“Buxinator”) buccinator muscle—the one in the cheek that helps with chewing, holds the cheek to the teeth.  Pacifier doesn’t require as much muscle to continue it, so that one muscle tends to get really strong and tight and can limit the growth of the mandible/chin.

The resting position of our tongue is supposed to be lying lightly on the hard palate (roof) of your mouth.  With a constant pacifier (during sleep or throughout the day) the tongue is not in its natural resting position; it’s forced down low. That can affect the growth & development of the roof of the mouth.  (can be an easy intervention for tongue ties—letting baby’s mouth close when they sleep, so their tongue rests/pushes on the roof of the mouth) 

Every month that you nurse, esp if you’re also using a pacifier, will help work those other muscles and help preserve that mouth structure. 

These muscle/mouth formation issues can also contribute to speech delay.  

Note about preemies (those unable to nurse) and NICU babies:  often given a pacifier b/c there’s no other way for them to work those muscles & get that process of suck-swallow-breathe right.  AAP recommends them for preemies/NICU for sure.

After 4 months old, once the newborn stage is over and babies can start to learn other ways to soothe, pacifiers can definitely become a sleep prop.  All the pediatricians I know and consistent data from babies to adults—shows that we as a culture are chronically sleep deprived.  CHILDREN/BABIES included.  One way to help teach babies the SKILL of self-soothing and healthy sleep hygiene is to drop that pacifier cold turkey around 4 months and (if you haven’t by then), help your child learn to fall asleep on their own.  

Cultural Trends

Culturally, at least here in the US, it’s common to see kids all the way up to older toddlers still using pacifiers, way past the early need/instinct for sucking. Past that point, we’ve taught them to need/want that tool.  

While more than 75 percent of Western babies use a pacifier, parents in some cultures, like the Aka Pygmy tribe in western Congo are totally fine with being used as a human pacifier. If mom’s not around to nurse, an Aka father or another family member will offer a breast to calm a fussy baby. While my husband was all about skin-to-skin contact to soothe and bond with our son when he was an infant, he drew the line at becoming a human pacifier, instead preferring to stockpile our son’s favorite binkies in bulk.

Just like everything, a little awareness helps:  how often are you actually offering that pacifier?  Like with your phone, is it just a knee-jerk ingrained reflex to hear a fuss/whine/cry and go digging in your bag for it?  (instead of figuring out what emotion/need they might have) 

Sleep

Use of a pacifier will cause big-time broken sleep (which means chronically not being well-rested…which means more fussiness the following day, for which you give a pacifier….cycle!).  They wake up looking for the THING that helps them go back to sleep, even if they find it and can put it back in themselves.  Parents often scatter 6-7 of them in the crib in the interest of helping their child find one quickly and not wake all the way up.  Or, they’re rushing down the hall to pop it back in before the baby wakes up all the way.  (that’s still broken sleep cycle for them and YOU)

Getting Rid of It

For toddlers 12 months & up:  talk to them about it. For 4 months, you can just chuck it and after a week of consistent sleep hygiene, they don’t care anymore.  12 months+ help them walk it to the trash and throw it out, noting they’re a big boy/girl now and they don’t need it.  They can do it.  Would they like the stuffed bunny instead?  If they’re using the Wub-a-nub, (little stuffy with paci attached), just cut off the paci part.

Sometimes a doctor can just tell them it’s time to stop & certain kids will listen to that.  Goofy walked away with my brother’s at Disney World & that was that. 

Pediatricians will say that fingers/thumb are better than a pacifier. They’d much rather have a kid suck their thumb for a minute before going to sleep than one addicted to a paci all day and all night.  They’re not waking up searching for a THING. You can’t make a kid suck their thumb—they’re either a thumb sucker or they’re not.  Some will go for the first 2 fingers or the 2nd/3rd finger combo.  

But MOST KIDS will transition out of this behavior naturally as they get bigger & busier. If not, you might face palate/orthodontic issues down the road.  Dentists can offer appliances, tools to help stop the habit if it becomes entrenched.  If an older child persists in thumb sucking, it’s time to look at other things:  that’s usually a sign of coping with high stress/anxiety, and they may benefit from counseling or help with emotional vocabulary/coping.  (C’s story)

Bonnie: I’ll just go on record here—I nursed both my children.  I breast-fed because of the health benefits it provided, and I did it for their nourishment.  I didn’t nurse them every time they fussed or needed comfort. We held and rocked them, walked around with them, patted and soothed them, but a quick milk snack from me was not their sole source of soothing.  They pretty quickly ate and slept on a good schedule—which gave me the assurance they were getting full meals each time and also gave me some freedom (especially since, despite my best efforts, I was never able to pump a drop.)

Once they passed that newborn stage, where they no longer needed/wanted swaddling, we did try a pacifier for both of mine.  They might have used it on and off for a couple of months, especially when we were out somewhere and they were particularly fussy, but then they refused it.  My daughter sucked her thumb for a couple of weeks when she was really little—4 or 5 months—then quit.  Both of mine preferred “lovies” or comfort objects.  

Renee: I also nursed both kids. And I’m pretty sure I NEVER nursed them for comfort. My bad. Instead, I used a pacifier, rocked them, walked them etc. We stopped using them during the day when they were toddling around. However, I was really reluctant to give up the paci at naptime/bedtime. After years of everyone sleeping through the night, I didn’t want to face the music! They had what pediatricians called a “sleep association” with the pacifier. Now it was a habit they needed to break. The kids were between 2-3 years old when I cut a hole in the tip of the nipple and that was it. The paci wasn’t pleasurable anymore. But I let it go way too long.

With comfort objects, if they are a big deal, you may find yourself having to help transition away from those, too.  We had a “replacement” pillow and blanket because both of mine were so attached…in case one got lost or left somewhere.  Around age 4, when they were old enough to start going to preschool/kindergarten, we had a party to say goodbye to the object.   Still have shreds left of each of them. 

Conclusion:

If you’re highly motivated to nurse & want to use a paci, you’re probably fine.  Might be good to wait until nursing is established for you both (whatever that looks like for you).  If you have a premature baby or one that needs help with reflex, paci will definitely help.  

It’s not a miracle worker for fussiness or sleeping and can actually aggravate those cycles. It’s really not NEEDED after 4 months and could affect speech, may need palate work later.  

In our experience, SHORT-TERM PAIN = LONG-TERM GAIN with most things involving parenting, including teaching sleep skills, using sleep props, and teaching kids to rely on objects.  (FF to adolescent phone use…) 

Bottom line: We use pacifiers for comfort. So let’s end with a few verses that we can speak over our children.

In peace I will both lie down and sleep; for you alone, O Lord, make me dwell in safety. Ps 4:8

May your unfailing love be my comfort, according to your promise to your servant. Ps 119:76

Whoever dwells in the shelter of the Most High will rest in the shadow of the Almighty. I will say of the Lord, “He is my refuge and my fortress, my God, in whom I trust.” Ps 91:1-2