is introducing a pacifier at all a good idea?

S

sh419ob

New member
hello! I’m a soon to be first time mom who is planning to breastfeed as much as possible and pump the rest of the time. Is it a good idea to introduce a pacifier once baby turns 6-12 weeks old? I’ve heard it’s best to wait for breastfed babies to get latching down before giving them a pacifier that utilizes a totally different sucking motion as it can confuse them or even lead to babies refusing the breast.

I’m most specifically concerned with the pacifier posing any developmental risks. I know it mostly becomes an issue once baby gets older and builds a stronger attachment so we would ideally wean sometime after six months. I don’t want to introduce a pacifier at all if it is proven to impact development - introducing a pacifier is meant to be a comfort to baby, my partner, and I as baby will be able to soothe with the pacifier and we’ll be able to get some longer stretches of sleep, hopefully. If the pacifier will only introduce bad habits and it turns out it’s best to avoid and have a pacifier out of baby’s mouth to practice cooing, making sounds, and eventually speaking, I’d rather not introduce it at all. Ideally, a pacifier would be an extra tool in our toolbox to help baby sleep better so they can spend more time during the day enjoying life and exploring the world, instead of being cranky and miserable.

I’m thankful for any advice!
 
@sh419ob
  1. Offering a pacifier for sleep decreases the risk of SIDS through unknown mechanisms - https://www.aapd.org/globalassets/media/policies_guidelines/p_pacifiers.pdf
  2. Pacifiers provide pain relief due to the sucking - (see above link)
  3. Pacifiers do not impact the success of breastfeeding even when introduced early - https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007202.pub4/full
  4. Risks to dentition occur with prolonged use (past 1 year of age) and can be mitigated with orthodontic pacifiers - (again see first link)
I've never seen anything about developmental risks re: making sounds. Trust me, the baby can spit the paci out when he wants to.

On a personal note, so far we got the most pacifier use in weeks 3-5 when baby was struggling with passing gas. He really needed any extra soothing he could get at that point. He is 8 weeks now and basically we just pop it in right before he goes to sleep and he may suck for a few minutes and then spit it back out or just immediately spit it back out. We also plan to use it when he gets vaccinated.
 
@javier_is_life The pain relief properties of the pacifier are huge! It was CRUCIAL for our newborn to cope with gas, and he would get a good suck going and then be able to fall asleep and stay asleep through the occasional toot. And I can’t even imagine trying to cope with vaccines without the pacifier! My LO was so unhappy for about 24 hours and the pacifier/cuddles were the only things that would help.

We started using a pacifier right away because of the SIDS protection, and had no trouble with bf.
 
@katrina2017 My 1.5 year old really only gets her pacifier at bedtime now, but you better believe I let her have it after her 18 month vaccines, and the day after she scraped her cornea, she was allowed it when she wanted it. I wish I had remembered to bring it with us to the eye doctor. Might have mitigated some of the screaming during the wait.
 
@javier_is_life This is an excellent overview of the research that convinced my husband and I to introduce a pacifier almost right away.

Anecdotally, the pacifier has been wonderful for us. My son is now 20 months and we will be weaning soon, but we'll miss it. It's been great through so many transitions of early baby/toddler life to have such a simple, portable soothing tool. It's been SUPER helpful for long travel days. Our son's dentist is not at all concerned about pacifier use at this point and told us he didn't wean his own daughter from the pacifier until age 2. We did combo feeding and kiddo had a great breast latch that was not impacted at all by regular bottle and pacifier use.
 
@sh419ob Pacifiers reduce the risk of SIDS so there is that to weigh in the balance at least for the first 6 months which is when the risk is highest.

I believe nipple confusion has mostly been debunked but I couldn't find the study.

Anecdotally, we used a pacifier from day one, had no issues with breastfeeding. We didn't make it a habit to push the pacifier, but it was helpful in social settings for example. Basically don't rely on it but have it as a just in case, it could save your sanity sometimes. Our son barely used it past 5-6 months old and we retired it by the time he was 8 months from lack of use.
 
@zjmcdon98 Pacifier use is correlated with a reduced incidence of SIDS, but it is far from settled science that pacifier use reduces SIDS risk. The evidence shows that it is specifically the pacifier being in the baby’s mouth at the onset of sleep that is associated with reduced risk of SIDS for the duration of that particular sleep episode (even if the pacifier falls out as soon as the baby is asleep), however there has not been any clear biologically plausible explanation found for this.
It can’t be pacifier use strengthening oral/pharyngeal muscles to improve the baby’s ability to maintain their airway, as you would not expect to see a difference between sleep episodes with vs without the pacifier in that case, as long as one was regularly used. It can’t be the pacifier holding the airway in a more favourable position, or the baby sleeping less deeply because of the pacifier, as the evidence shows the reduced risk of SIDS persists for the duration of the sleep episode even if the pacifier fell out as soon as the baby fell asleep.

It seems more likely to me that there is a separate factor, such as a baby being particularly unsettled, which both increases the likelihood of a pacifier being offered at the onset of a given sleep episode, and which also reduces how deeply the baby sleeps (which is known to be protective against SIDS).
 
@crucker2
as the evidence shows the reduced risk of SIDS persists for the duration of the sleep episode even if the pacifier fell out as soon as the baby fell asleep.
Click to expand...

I've seen it speculated that even if it falls out, it's still in the crib and baby can bump into it which may slightly wake them up.
 
@javier_is_life Thank you for including this! Breastfeeding is a large part of our parenting plan and we wouldn’t want to introduce anything to complicate that, so knowing the pacifier isn’t a villain makes me feel very relieved!
 
@zjmcdon98 I really want my son to use one because of the sids risk but he won't take it! There aren't really strong opinions either way in the UK but I read about it on reddit so wanted him to take one.
 
@annjro The research on SIDS risk reduction has it correlated if you offer the pacifier, not if he actually takes it. So you offer it at bedtime and then if he spits it back out nbd, just let it drop next to his head. It may be a correlation not causation thing but in case there is a causative link, I do it anyway since it's extremely low effort.
 
@zjmcdon98 Same here minus the breastfeeding, but she has feeding issues in general so I don't think the pacifier was the issue. She's 10 months now and she basically only has it for sleep, in the car, and in social settings because she's in a "I'm so excited but i dont have language to communicate so I'm going to scream my head off" phase! I'm so glad she likes it, but equally glad that if she doesn't have it she doesn't care.
 
@sh419ob I’ve recently read that nipple confusion is not actually a thing. Anecdotally, our baby got a pacifier when she was about 5 hours old and still got the hang of breastfeeding. She’s now 8 months old and hasn’t taken a pacifier since she was like, a month old.
 
@jthree With my first, I wanted to wait to introduce a pacifier because I had heard about nipple confusion. She was colicky and just screamed nonstop. About 3 days in, when I was truly close to losing my mind because of sleep deprivation and constant screaming, I went down the rabbit hole and could find no actual expert support for “nipple confusion”. We introduced a paci and it helped a lot. This time we used it from day 1. Both kids have breastfed well.

OP, don’t commit yourself to not using it. Have a couple on hand in case you have a colicky, tough baby. With my first, we needed every single trick in the book to soothe her, and I think we could have ended up in a really dark PPD place if I had committed to forgoing some soothing elements.
 
@jthree My baby is the same. I gave her a pacifier the first night in the hospital and breastfeeding has gone well so far (as far as latch goes, we've had other issues with thrush). She's 6 weeks now and doesn't really like her pacifier anymore.
 
@sh419ob As a parent, I can tell you that on the list of worries for a new parent, a pacifier is probably the last item. You want to use it, use it. Babies love them. Just make sure to use the appropriate size, wash/sterilize and replace regularly. That's about it.

Personal experience, when we wanted our son to wean from it, my wife just stopped giving it to him. He didn't like it for 2-3 days but then it was like he never used one.
 
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