My baby uses a pacifier


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, especially babies who need a lot of soothing during their first few months.  Sucking often helps babies to calm themselves, and if parents discover that a pacifier brings instant relief from crying, it's hard to not to offer it.  There will be times when a pacifier can seem like a lifesaver, such as you’re your baby is fussy or overtired and you have to be out in public.  Some babies fall asleep better if they suck on a pacifier.  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.  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. *

In order to decide if and when to take the pacifier away, begin by observing your baby’s 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.  Some parents feel that since it is easier to get rid of a pacifier than to get a child to stop sucking her thumb, 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. 

* Note: this article was written before the American Academy of Pediatrics 2011 recommendation that infants be offered pacifiers as part of the overall  recommendations for the prevention of SIDS.

It is speculated that use of a pacifier heightens babies' arousal response by keeping them from falling into a deep sleep (because in deep sleep the pacifier falls out) or by adjusting the shape of the airway, or by interfering with bulky bedding being near an infant's face.  However, the researchers emphasize that the relationship is an association and cannot be considered causal. Parents are encouraged to offer a pacifier but not to insist.

Ask your health care provider for advice for your own baby.