Are Pacifiers Safe for Newborns?
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We asked several pediatricians to weigh in on common pacifier safety questions, including whether pacifiers are safe for newborns.
The consensus: Pacifiers are generally safe for newborns, premature babies, and kiddos up to about age 2 and may even prevent sudden infant death syndrome (SIDS) when used during sleep.
But parents do need to be aware of certain pacifier risks, such as choking, mouth infections, and even strangulation. We’ll explain it all below.
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Are pacifiers safe for newborns?
Yes, pacifiers are safe for newborns. That said, Dr. Pierrette Mimi Poinsett warns that breastfed babies may latch and suckle better if parents delay the introduction of pacifiers by two to four weeks.
“The mechanism of sucking is different for breastfed babies from babies that are bottle-fed or using pacifiers,” Dr. Poinsett explains. “Bottle-fed babies can use pacifiers from day one of life.”
Can premature babies use pacifiers?
Dr. James Walker, a Welzo Medical Officer, cautions that “parents should consult with their healthcare provider to determine when it is appropriate to introduce a pacifier, as premature babies may have unique health needs that need to be considered.”
Barring any individual health concerns, Dr. Poinsett says pacifiers are not only safe for premature babies but also beneficial. “Preemies that use pacifiers soothe better, have more stable vital signs, and make a better transition from tube feeding to oral feeding,” she explains.
Be sure to use a pacifier designed for premature babies, like the Tiny option in this Ryan and Rose Pacifier Set. As Dr. Bidisha Sarkar explains, “their immature mouths make them more prone to dental problems if they are given larger pacifiers. Preemie pacifiers have smaller nipples and are designed to fit more comfortably in babies' mouths.”
How long can children use pacifiers safely?
You can start weaning your child off a pacifier by the time they’re around 6 months old.
By that age, the risk of SIDS has largely passed and most children are capable of self-soothing. Dr. Sarkar also warns that “there have been some studies linking the use of pacifiers after 6 months of age with an increased risk of ear infections.”
Ideally, children will be pacifier-free by their second birthday. According to Dr. Walker, “prolonged pacifier use beyond age 2 can cause dental problems, such as misaligned teeth.”
Try the FridaBaby Paci Weaning System for convenient weaning.
Can babies sleep with pacifiers?
Yes, babies can safely sleep with pacifiers. In fact, pacifiers are the only accessories infants are allowed to sleep with according to the American Academy of Pediatrics’ (AAP) guidelines.
The AAP also notes that infants may have a reduced risk of SIDS if they use a pacifier during sleep. But according to Dr. Walker, “if the pacifier falls out of the baby's mouth during sleep, it should not be reinserted.” Likewise, if your baby refuses the pacifier at bedtime, don’t force them to take it.
Learn about other safe sleep practices in our Crib Safety Guide.
Do I need to clean my child’s pacifier?
Yes. Even though you’ve undoubtedly seen your child drop their pacifier onto a dirty floor and pop it right back into their mouth, you do need to keep it clean.
“Pacifiers that are not kept clean can introduce bacteria into a baby's mouth and cause infections,” explains Dr. Walker.
Dr. Poinsett recommends buying a few pacifiers so that there’s always a clean one around. “Frequently clean pacifiers by boiling them in water for five minutes,” she advises. “Ensure they have cooled off before using them.” She also notes that some pacifiers are dishwasher safe—be sure to check the label first.
When should I throw out a pacifier?
Pacifiers become unsafe whenever they rip or tear, which is more common once your baby’s teeth erupt. If you don’t spot this damage in time, the broken area could detach completely and cause your baby to choke.
Play it safe and toss any pacifier that’s not in tip-top shape—which, according to Dr. Poinsett, includes pacifiers that are discolored or sticky.
How do I choose a safe pacifier?
Each of the pediatricians we consulted emphasized the importance of choosing, as Dr. Walker put it, “a pacifier that is appropriate for the baby’s age and stage of development, as well as one that’s made of safe materials.”
According to Dr. Sarkar, parents should look for BPA-free pacifiers with no sharp edges.
Dr. Poinsett says to “check the age range of the pacifier on the package—newborn pacifiers are much smaller than pacifiers for older babies.” Getting the wrong size poses a choking or gagging risk.
Dr. Poinsett also recommends choosing a one-piece pacifier, since “two-piece pacifiers are prone to detaching and can pose a choking hazard.”
The Phillips AVENT Soothie and Tommee Tippee are two examples of BPA-free one-piece pacifiers available in different sizes. And they’re both dishwasher safe.
What are other risks associated with pacifiers?
“While pacifiers are generally considered safe when used properly, there are a few risks associated with their use,” says Dr. Walker.
We’ve already covered the choking risks and possible dental malformation risks associated with pacifiers. Let’s look at a few more.
Strangulation risk associated with pacifier strings
“Do not attach a string or clip to the baby's pacifier, clothing, hand, or crib,” says Dr. Poinsett. “This increases the risk of strangulation.”
Dr. Sarkar and Dr. Walker echoed this advice. It’s safer to keep extra pacifiers on hand in case one gets lost.
Smearing with honey represents a botulism risk
Some parents want to make the pacifier more tempting by dipping it in something sweet. That’s bad news all around because it can lead to tooth decay, but Dr. Poinsett has an extra note of caution regarding honey: “Babies under 1 year should not have honey due to botulism spore risk.”
Remember, if your baby doesn’t want a pacifier, it’s best not to force them.
Risk of speech delays not as significant as once thought
Prolonged use of pacifiers sometimes gets blamed for speech delays in young children, but a study published in the International Journal of Language and Communication Disorders suggests the correlation is minimal at best.
The study’s authors found that prolonged use of pacifiers (or “dummies,” as the UK-based researchers call them) during sleep has no effect on delayed speech development, while prolonged daytime use might have a minor effect.
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