Using pacifiers with breastfed babies always seems to be a controversial topic. Can my baby have a pacifier? Should I wait to introduce one? Will it cause nipple confusion? What are the best pacifiers for breastfed babies? The questions could go on. The American Academy of Pediatrics (AAP) 2022 updated breastfeeding guidelines reports that a review shows introducing a pacifier before or after the mother and baby duo establish breastfeeding does not impact the duration of breastfeeding for a healthy, full-term baby up until four months of age.1
You may think, “This is great news, but is there a catch?” Not really, but here are some guidelines to make sure you and your baby use a pacifier appropriately to not interfere with breastfeeding. Ultimately, the decision is up to you, the parent — pacifier or no pacifier. Let’s dive into the benefits, risks, and guidance for how to pick the best pacifier for breastfed babies.
Benefits of Pacifier Use
It might be hard to believe, but there are benefits to infant pacifier use. Let’s start with one of the most important benefits. Research has shown that when an infant uses a pacifier when placed to sleep, it can decrease the risk of sudden infant death syndrome (SIDS). Pacifier use has also been shown to provide infants comfort, has been associated with helping infants when they’re in pain, and even can help premature infants develop a sucking reflex. And lastly, introducing the pacifier decreases the risk of developing a thumb- or finger-sucking habit.2
Risks of Pacifier Use
You must always weigh the benefits and risks to determine what is best for your baby. This is even true when deciding whether to introduce a pacifier to your breastfed baby. There are a handful of benefits to pacifier use but also risks. One of these risks includes the impact of pacifier use on developing otitis media as an infant and later as a child. Pacifiers also pose an increased risk of causing problems such as oral yeast infections due to carrying bacteria and other germs. And, after 36 months old, the risk of developing dental and orthodontic issues rises.2
Important Note for Pacifier Use for Breastfed Babies
Pacifiers are an excellent tool for helping babies soothe and calm down when upset. It is essential to pay close attention to your infant’s hunger cues. Do not delay or miss a feeding by giving your baby the pacifier. The pacifier should never be a substitute for the breast.
How to Choose a Pacifier for Breastfed Babies
The AAP gives the following guidance on choosing a pacifier:3
- The pacifier should not be able to come apart. Multiple pieces can increase the risk of choking. The pacifier should be of single construction.
- The pacifier should have ventilation holes and measure at least 1.5 inches across. This prevents the baby from fitting the whole pacifier in their mouth, helping prevent choking.
- Do not attach a pacifier to a cord or strap, especially around the infant’s neck. This could lead to an injury.
- Never use a bottle nipple as a pacifier. The full nipple could easily go into the infant’s mouth.
- Do not force a baby to use a pacifier if they do not want it.
- Regularly inspect the pacifier before giving it to the infant. Pacifiers can break and deteriorate.
Although the AAP gives guidance on what to look for in a pacifier, they do not specifically recommend a type or brand of pacifier. The vast pacifier market has many shapes, colors, nipple sizes, and materials. It may be a trial-and-error process to see what pacifier works best for your baby. A breastfeeding baby may benefit from using a pacifier that closely resembles the mother’s nipple, but no research supports this.
5 Options for the Best Pacifiers for Breastfed Babies
Here are five great options for pacifiers for breastfed babies.
1. Philips Avent Soothie
The Philips Avent Soothie, known to many as the “hospital paci,” is a one-piece design made of silicone. This pacifier has the bonus of being designed to support bonding through the ability to place a finger in the nipple to encourage suckling. The nipple slightly resembles moms with a straight nipple and broader pacifier base. Its silicone material also helps with oral development and makes it easy to clean and sterilize.
2. Dr. Brown’s HappyPaci
With a broader base and straight nipple, this pacifier resembles a mother’s nipple shape. This may be helpful when introducing the pacifier to the infant. The HappyPaci is lightweight, made of silicone, and has a unique “butterfly-shaped shield” that curves away from the nose and cheeks. As for safety concerns, the pacifier is made of one full piece, minimizing the risk of choking.
When deciding whether to use a pacifier for your breastfed baby, it is up to you. Do what is best for your little one. Finding the right pacifier fit might not happen immediately, but the market is vast. With the various materials, sizes, shapes, and textures, there is sure to be a pacifier to meet every baby’s need. When trying pacifiers with your little one, you may need to try a few before finding the best fit.
3. Evenflo Feeding Balance
This pacifier is designed by feeding specialists and has a cylindrical-shaped nipple, making it favorable for breastfeeding infants due to its resemblance to a mother’s nipple. The pacifier is made of 100% silicone and is one full piece, which is always recommended to decrease the risk of choking. The silicone material makes this pacifier not only flexible but also very lightweight.
4. Tommee Tippee Breast-like Pacifier
This is a pacifier specifically designed to mimic a mother’s nipple when it comes to its feel, flexibility, and ability to stretch. As a bonus, the base of the pacifier was created to curve away from the baby’s face to allow for better airflow and decrease irritation to the baby’s skin.
5. Nanobebe Flexy Pacifier
The Nanobebe Flexy Pacifier is a soft, flexible pacifier designed to fit snugly around your baby’s nose and to their baby’s help the pacifier stay in place. It is made of 100% silicone, providing the soft, familiar feel of a mother’s breast. The silicone material also makes it easy to clean and sterilize.
We hope this list gives you confidence in choosing the best pacifier for your breastfed baby.
1. Meek JY, Noble L. Technical Report: Breastfeeding and the Use of Human Milk. Pediatrics. 2022;000(0):e2022057989
2. American Academy of Pediatric Dentistry. Policy on pacifiers. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2022:86-9.
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