Today, research shows that using a pacifier every time you place your baby down to sleep can greatly reduce the risk of SIDS. Doctors say that by using the following guidelines, pacifiers will not cause any problems for your baby.

Remember that using a pacifier does not replace other important recommendations on reducing the risk of SIDS such as putting your baby to sleep on his or her back in a crib that meets current safety standards and removing all  soft, fluffy or loose bedding and other soft items.

Some parents are hesitant to use a pacifier because of concerns about possible harmful effects such as breastfeeding challenges, ear infections and dental  problems. Rest assured, research clearly shows that the potential benefits of pacifier use in reducing the risk of SIDS far outweigh any potential negative affects.

Guidelines for safe and effective pacifier use:

• Offer a pacifier every time you put your baby down to sleep. This will maximize the protective benefits.
• If you are breastfeeding wait until nursing is going well (usually 3-4 weeks) before offering a pacifier.The risk of SIDS is very low during the first month.
• Limit pacifier use to the first year of life. This includes the peak ages for SIDS risk and the 1 to 5 month period when the baby’s need for sucking is the highest.
• Pacifiers should not be used as a substitute for nursing or feeding. The pacifier should be offered following a feeding session as you place the baby down to sleep.
• After the baby falls asleep, there is no need to reinsert the pacifier if it falls out. Experts feel that frequent pacifier users may undergo adaptive changes that are beneficial even when the pacifier is not in the mouth.
• Infants who refuse a pacifier should not be forced to take one.
• Pacifiers should not be coated with any sweet solutions.
• Do not use a string or other device to attach pacifiers around your baby’s neck or to clothing.

Common Concerns

• Otitus Media. The risk of otitis media is relatively low in the first year of life. Frequent cleaning and replacement of damaged pacifiers can further reduce this risk.
• Breastfeeding Success. In randomized, controlled trials, pacifier introduction after one month was not detrimental to breastfeeding duration. Other trials did not show an effect of pacifiers on breastfeeding duration among term or preterm infants. Mothers should receive regular support, encouragement and assistance with developing proper breastfeeding techniques to build confidence and ensure success.
• Dental Problems. According to the American Academy of Pediatric Dentistry policy on oral habits, pacifiers are unlikely to cause long-term problems if stopped by age three. In addition, it has been shown that infants not offered pacifiers were more likely to suck their fingers, a problem that is more difficult to break and more likely to cause dental problems.

Other Benefits

• Reductions in frequency and duration of crying spells
• Satisfies need for non-nutritive sucking considered normal in infants and young children
• Among preterm infants, non-nutritive sucking reduced the length of the hospital stay by an average of seven days and was not found to have any adverse outcomes
• Download position statement: Pacifiers Can Greatly Reduce the Risk of SIDS
• Download brochure: Pacifiers and SIDS | Reducing the Risk

• See also: Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis. PEDIATRICS Vol. 116 No. 5 November 2005, pp. e716-e723. Fern R. Hauck, MD, MS, Olanrewaju O. Omojokun, MD and Mir S. Siadaty, MD, MS.
• See also: Pacifier Use: Promoting a New Recommendation on Reducing the Risk of SIDS  for Health Professionals

Last Updated: Jan 10, 2010