Pacifiers and Comforting Newborns

The nurses at the Birth Care Center wish to help you in comforting your newborn. There are many options. This is some information based on current research, about pacifiers and other related issues. The Birth Care Center would like to answer your questions and honor your choices.

Why does my baby need to suck?

Sucking is a normal newborn behavior. Early on, your newborn's strong suck provides food and comfort. When your baby wakes up, roots, sucks on his hands, or fusses, he is showing signs he wants to be fed.

  • Many feedings each day are important to help your infant regain the weight that is lost after birth, and continue to grow.
  • Newborns should feed when they show feeding cues.
  • The use of a pacifier may help satisfy sucking needs or calm your infant when fussy. It should not replace the feedings needed for normal growth and development

What can provide comfort and reduce pain for my baby?

  • At the hospital your baby may experience some uncomfortable procedures, such as blood tests or circumcision. During this time your baby can be comforted in several ways. Caregivers may provide a clean, gloved finger or a pacifier. Both are used with a special sweet solution (used in hospital only).
  • Breastfeeding before, during or after a painful event, provides comfort and reduces your baby's pain.
  • As sweet receptors on the baby's tongue come in contact with breast milk or the sweet solution, messages are sent to the brain that help to calm and reduce pain.
  • Holding your baby close and doing "skin to skin," is also comforting.

Do pacifiers carry germs and infections?

Pacifiers may carry germs that could lead to an infection. Parents can help by washing and replacing pacifiers often. Pacifier use after 6 months of age may increase the risk of ear infections.

What are special things to consider if I breast feed?

The American Academy of Pediatrics states that pacifier use should not be started until breastfeeding is going well, usually about 3-4 weeks of age.

If you are breastfeeding, starting a pacifier too early may lead to:

  • A change in your baby's suck
  • Poor latch and/or sore nipples
  • Lowered milk supply
  • Less feedings and poor weight gain

Does a pacifier help decrease the risk of sudden infant death syndrome (SIDS)?

The American Academy of Pediatrics (AAP) recommends:

  • Offering a pacifier to reduce the risk of SIDS when babies are laid down on their back to nap or sleep.
  • As the baby falls asleep and if the pacifier drops out, it should not be put back in the mouth.
  • Breastfeeding also can reduce the risk of SIDS.
  • The risk of SIDS is very low during the first month of life.  

How can pacifiers be helpful to babies in the NICU?

 Pacifiers are provided for sick or preterm babies in the NICU:

  • To calm their heart rate and breathing.
  • To comfort during painful procedures.
  • To develop sucking skills.   

If your baby is in NICU, the nurses can talk with you about this.

How do I wean my baby from the pacifier if I choose to use one?

Ways to wean depend upon the age of your baby.

  • Up until about 6 months old, the pacifier helps meet infant's need to suck. After this time, the pacifier gives a sense of security.
  • Removing the pacifier can be stressful for both the baby and parents.
  • Ways to help calm younger infants are: swaddling, rocking, soft music, massage, and breastfeeding. Older infants or toddlers may be distracted with activities, toys, or other objects of affection.
  • For questions about weaning, talk to your baby's doctor, health care provider, or lactation consultant.

What else do I need to know?

If you choose to use a pacifier, follow these safety guidelines.

  • Never put anything sweet on the pacifier. This could damage your baby's teeth.
  • Make sure the pacifier is safe. Pacifiers that come apart can cause choking.
  • Never use a string, ribbon or clip attached to the pacifier, which could become tangled around your baby's neck.
  • Select silicone instead of latex pacifiers to avoid allergies later in life.
  • The American Academy of Pediatric Dentistry says that pacifiers will not cause long-term problems for your baby's teeth if stopped between 2-4 years of age.
  • Avoid the orthodontic pacifiers. Try using a pacifier shaped similar to a mother's nipple, or that of the bottle.
  • Watch for pacifier recalls here

References used:

Risks and Benefits of Pacifiers - http://aafp.org/afp/20090415/681-s1.html

Where can I get more information?

  • St. Luke's Lactation Consultants   (319) 369-8944
  • American Academy of Pediatrics - www.aap.org
  • American Academy of Pediatric Dentistry - www.aapd.org
  • American Academy of Family Physician - www.aafp.org/afp