My baby uses a pacifier, should we take it away?

Our baby loves her pacifier.  She’s four months old now, and she uses it just as much as she did when she was first born. She isn’t nearly as fussy as she used to be but she still seems to need it.  Friends have told us she shouldn’t be allowed to suck it so much, but it makes her so happy!  What should we do?

Some babies get very attached to their pacifiers!  Babies have different sucking needs from birth.  Some love to suck far more than is necessary to get fed.  If a nursing mom has a baby with a strong suck and who needs lots of sucking time (these babies are sometimes called “barracudas”!)-she will be very happy to be able to offer a pacifier to help her baby be content when he isn’t nursing. 

Sucking usually helps babies to calm themselves. When parents discover that their fussy baby gets instant relief from crying when they offer a pacifier, it's hard to not to offer it.  There will be times when a pacifier can seem like a lifesaver, such as when your baby is fussy or overtired and you have to be out in public or driving in the car.  

Some babies fall asleep easily if they suck on a pacifier.  In the early newborn period, when a baby is sleeping in short cycles throughout the day and night, this can be very helpful.  Unfortunately, once a baby gets used to falling asleep with a pacifier in her mouth she may become dependent on it for soothing herself throughout the night even when she could otherwise sleep for longer stretches.  Since she can't get the pacifier back without help, she is likely to awaken several times at night crying for a parent to pop it back in for her.  The trade off in soothing versus interrupted sleep may not be worth it. Although the American Academy of Pediatrics has recommended the use of pacifiers at bedtime only, many parents who try this approach find that their babies sleep less well with this inconsistent approach.

In order to decide if and when to take your baby’s pacifier away, begin by observing your her pattern of crying and fussing.  By about four to five months old, most babies are usually crying for a specific reason.  The  three most common reasons are hunger, boredom, and fatigue.  A pacifier will not soothe a hungry baby, but it will often calm a baby who is bored or very tired.  If your baby learns that every time she feels bored or tired her parents give her a pacifier to suck, she may eventually demand the pacifier whenever she has those feelings.  Over time, her need for the pacifier will grow.

I think it’s best if parents think of the pacifier as one way, but not the only way to  soothe their baby when she is very fussy.  It’s important to respond to a baby's cries in other ways as well.  For example, try to play with your baby or talk to her when she seems bored, and put her down for a nap when she seems tired.  Try to avoid situations where you have to “plug” her to keep her content--if she can’t make it through an afternoon of errands without her pacifier, maybe the errands are just too much.  You don’t have to make sweeping changes, just notice whether the pacifier is doing too much pacifying!

Keep in mind that since your baby is four months old, if she really needs to suck to soothe herself she will find her hand or thumb works quite well.  If she sucks her thumb she can control her need for sucking, rather than having to cry for a pacifier.  In fact, many parents discover that once their baby can suck her hand or thumb she can easily put herself back to sleep during the night.  Of course, if you stop using the pacifier and your baby substitutes her thumb, she may continue to suck her thumb for a while.  So some parents feel that if it will be easier to get rid of a pacifier than to get a child to stop sucking her thumb later, it’s better to encourage  pacifier use!  Like many child-rearing issues, there’s no right answer.  The simplest course for now may be to continue with the pacifier but try to minimize its use, and to wean your baby from falling asleep with it at night over the next few months in order to prevent later sleeping difficulties.