A Guide for Pacifiers and Baby Sleep

The quest for a good night’s sleep often leads to various strategies and tools, one of the most popular being the pacifier. Pacifiers can be a helpful tool for many parents, providing comfort and soothing to fussy babies beginning in the newborn stage and continuing into the toddler years for many families. In this blog, we’ll explore everything you need to know about pacifiers and their role in baby sleep, including their benefits, safety considerations, how to effectively use a pacifier and strategies to drop the pacifier (when you’re ready!). 

As with many aspects of parenting, it’s important to evaluate the strategy and its use for your unique family. Is pacifier use helping us get more sleep? Is pacifier use causing more challenges than benefits? Is this strategy working for us right now and we feel confident how to move forward in the journey? We tried briefly to introduce a pacifier to our first child, unsuccessfully. After a few attempts, we moved on and decided it wasn’t for him or us. For our second, we didn’t even introduce it!  If you’ve attempted the paci and it’s not going well, my best advice is not to spend hundreds of dollars on different ones but accept that may not be what your baby needs. If your child’s care provider is recommending a different approach for their oral motor development, always best to follow that advice for their unique needs.  

What you’ll learn from this blog:

• Benefits of pacifiers for baby and toddler sleep
• Why they are helpful during newborn stage
• Safety considerations for pacifier use 
• How to use a pacifier for your baby
• Strategies to drop the pacifier

The Benefits of Pacifiers for Baby Sleep

So what are the benefits of pacifiers?

1. Soothing and Comfort: One of the primary reasons parents turn to pacifiers is their powerful ability to soothe an upset baby. The sucking reflex provides them with comfort and this can be particularly useful during sleepy times when your baby needs to be calm and fall asleep. It’s called a soother for a reason ;) 
2. Reduced Risk of SIDS: Research has shown that pacifier use during sleep is associated with a reduced risk of Sudden Infant Death Syndrome (SIDS). While the exact reason for this is not entirely clear, it’s believed that sucking on a pacifier might help keep the baby’s airway open or encourage them to sleep in safer positions. See some research articles referenced below. 
3. Soothing Strategy: As babies grow, they start to develop the ability to put their own pacifier in their mouth. This milestone offers you an opportunity for them to regulate some of their own needs in the moment, particularly related to sleep. If their paci falls out, will they replace it and settle back to sleep without intervention from you?  

Pacifier use during the newborn phase 

Pacifiers are helpful, particularly in the newborn phase, because they work with your newborn’s primitive sucking reflex. This reflex begins early in gestation and doesn’t full develop until 32-26 weeks gestation. This development helps with their ability to latch on breast and bottle for nutritive sucking once they’re born. This reflex also allows your baby to suck for comfort, which is called non-nutritive sucking and is helpful for soothing a fussy baby! They can suck on a paci, fingers, breast, or objects to help them feel soothed. You can read a bit more on non-nutritive sucking in this article. 

Considerations for Pacifier Use

There are a few key factors I would encourage you to consider when introducing a pacifier:

1. The shape of the pacifier matters. Myofunctional therapists, dentists and IBCLC would encourage a pacifier that is rounded, gently sloped and made of flexible material, rather than pacifiers that are flat or bulb shaped. Some recommended brands include Avent Soothie, Dr Browns and the Ninni Co. Ensure the size of the pacifier is appropriate for your child’s age as well. 
2. Hygiene and structurally sound are important factors when using a pacifier. Ensure it’s kept clean and in good condition (no cracks or bites out of it). Do not cut the pacifier in an attempt to wean the pacifier from your child. 
3. If using a pacifier during sleep time, be aware that it’s not connected to any strings or clips that may be a hazard during unsupervised use. 
4. Try to keep the pacifier use to only sleep time, rather than awake time. This is to give your baby the opportunity to explore their natural environment with their mouth (like mouthing toys and teething objects) as they learn and develop. For toddlers and beyond, pacifier use should be limited to only sleep time to ensure their mouths are free for oral motor development in other ways (toy exploration, babbling, talking, singing, etc.) which can’t happen with a pacifier in their mouth. 
5. Prolonged use of a pacifier, beyond the age of 2-3, can lead to dental challenges such as misalignment of teeth. You can read more about dental care for your child in this guest blog by a family practice dentist. 

How to use the pacifier for your baby’s sleep journey

Pacifiers are typically introduced during the newborn phase and can be helpful tools to support the start of your baby’s sleep journey.

Around 4-5 months, pacifier use can be tricky as your baby may ‘drop’ their pacifier out of their mouth during their sleep cycle and be unable to replace it back themselves. This stage is what I refer to as, paci ping-pong. 

Here are a few thoughts to consider when using a pacifier for your child’s sleep journey:

1. Practice helping your baby replace their own pacifier by putting the pacifier into their hand and guiding them to bring the paci to their own mouth (rather than you replacing it directly in for them). This practice will help them develop the muscle memory needed to replace the paci themselves (which takes time, sometimes many months!).
2. Ensure their sleep space has many pacifiers available so that you’re not searching around for one in the middle of the night and they will have increased opportunities to find their own paci and replace it (if they’re able to). 
3. Be consistent with using the pacifier for all sleep situations. If you sometimes offer it for naps, and only sometimes at night,  your baby will be confused and confusion = protest (which no one wants or likes!). Stay consistent with the usage of a pacifier so your baby has predictability. When you’re ready to drop it, follow the tips below. 
4. Introducing teething toys during awake time is an alternative to pacifier use also. 

Strategies to drop the pacifier from your baby’s sleep: 

The 4-6 month range is an excellent time to drop the paci (or waiting till they’re 2+ years) as they can quickly be supported by other means at this age and adapt quickly to no pacifier available. 

Ok, you’ve decided it’s time to drop the pacifier – now what?

You have a few options and the most important aspect of this transition phase is to be consistent. Just like you want to offer the pacifier consistently for sleep situations when using it, when you’ve decided it’s time to drop it, you’ll want to ensure you consistently have it removed from all sleep situations. Consistency = predictability = less protest. 

When you initially remove the pacifier from your child, regardless of age, there is going to be some protest. This protest shouldn’t last long as your child learns the new expectations. Stay patient and present supporting them through this change. 

Ways to drop the pacifier:

1. Use a fading kit, like the FridaMom pacifier weaning kit. This reduces the size of the pacifier gradually until it’s faded away. For some babies, this is frustrating as the size of the paci doesn’t offer the feedback they’re looking for.
2. Remove the pacifiers and offer other support to guide them for sleep. Start this approach at bedtime and stay consistent with it for naps during the day. This strategy is quick to implement and usually after 1-2 nights, your baby will adjust to sleep without a soother. You can offer them other comfort measures when you make this change. Be patience, be present and be consistent.

For older children:

1. If your baby is old enough, before removing the pacifier, layer in other comfort items (like a lovey or small blanket) to ensure they have other objects available they can connect with when the pacifier is removed. This would be a suggestion for a baby over 1 years old.
2. Try the soother fairy approach. Have your child gather up all their soothers and leave them in a little bag beside their bed. That night, the soother fairy comes to take the soothers to a new baby and leaves behind a special gift for them to enjoy (like a new stuffed animal). Ensure there are no hidden soothers left behind in the house ;) This strategy would work well for children 3+ years old. 

To recap some key points:

• Practice pacifier use early on by guiding your baby’s hand to replace their own pacifier
• Have a plan to wean the pacifier and stay consistent with the plan
• Consistency is safety for your baby and will make the process kinder to them and easier on you with less protest
• When you make a change to pacifier use for sleep time, start at bedtime
• Use other teething objects and comfort items during awake time to limit pacifier use when awake

Pacifiers can be a great tool to support your baby’s sleep in the early months and they can also cause challenges for some families along the way. If sleep is difficult and you’re not sure of the next steps to supporting your baby’s sleep on the quest to get more sleep, connect with me here and see how I can help you go from surviving to thriving in a gentle and supportive manner.

Chelsea is Mom of 2 and a Baby, Toddler and Child Sleep Consultant. She has advanced certification in Infant and Early Mental Health and Pediatric Sleep Health and has a Master’s of Professional Education with a specialization in Applied Behaviour Analysis. She supports families within Hamilton and beyond with hands-on, no cry-it-out, responsive methods towards longer naps and better nights. Chelsea works collaboratively with families to empower them with the confidence and tools they need to reach their unique sleep goals. Hear from rested families here and book a free call with Chelsea here to discuss how she can support your family’s journey to more sleep.

 

Feştilă, D., Ghergie, M., Muntean, A., Matiz, D., & Şerb Nescu, A. (2014). Suckling and non-nutritive sucking habit: what should we know?. Clujul medical (1957), 87(1), 11–14. https://doi.org/10.15386/cjm.2014.8872.871.df1mg2 

Moon, R. Y., & TASK FORCE ON SUDDEN INFANT DEATH SYNDROME (2016). SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. Pediatrics, 138(5), e20162940. https://doi.org/10.1542/peds.2016-2940 

Moon, R. Y., Tanabe, K. O., Yang, D. C., Young, H. A., & Hauck, F. R. (2012). Pacifier use and SIDS: evidence for a consistently reduced risk. Maternal and child health journal, 16(3), 609–614. https://doi.org/10.1007/s10995-011-0793-x