Breastfeeding and pacifier use – are the two compatible? I have had three children breastfeed successfully, all while using a pacifier. Here is everything you need to know!
People are often surprised when they hear how passionate I am about breastfeeding…and about giving my kids pacifiers.
There’s a bit of debate on whether or not pacifier use interferes with breastfeeding – and if you choose to use one, when to introduce it.
All three of my boys have used and loved pacifiers.
Jack was given one in the hospital – before they came out with all the rules about not giving them in the hospital – and he was my best nurser from the start.
We tried to hold off for a few days with Andrew and Oliver, but we gave in after just a few days each time…because they ARE convenient.
Now, I don’t agree with the idea of a “baby using their mom as a pacifier.” Because I do believe that it’s important to remember a pacifier is a substitute for the breast – not the other way around.
But I do think pacifiers are helpful and worth using if you want to.
I think there are some things to take into account when deciding when and how to introduce a pacifier to a breastfed baby.
I have successfully breastfed my first two boys for two years, and my third seems to be on the same path, all while using a pacifier. So I hope that you will find this post helpful!
Thank you to Chicco for partnering with us on this post. All opinions and research below are my own. Nothing in this article should be taken as medical advice.
Pacifier for Breastfeeding Baby
First off, here is a little blurb from the AAP on pacifier use:
“Some people believe that using a pacifier can harm a baby. This certainly is not true. Pacifiers do not cause any medical or psychological problems. If your baby wants to suck beyond what nursing or bottle feeding provides, a pacifier will satisfy that need. However, a pacifier should not be used to replace or delay meals. It may be tempting to offer your child a pacifier when it is easy for you. But it is best to let your child decide whether, and when, to use it. Buy pacifiers that are one piece. The two-piece models can come apart and pose a choking hazard. NEVER tie a pacifier to your child’s crib, or around your child’s neck or hand. This could cause a serious strangulation injury, even death. When your child reaches one year of age, you may want to talk with your pediatrician about how – and when – to start weaning your child from the pacifier. “Source
I feel that is sound advice and are good guidelines for anyone to follow when considering pacifier use.
My “Rules” for Pacifier Use
These are some rules that I personally follow when using a pacifier – especially in the early weeks and months of my children’s life. I think that they’ve helped.
Offer the breast first
There’s a false notion that you should only breastfeed your child for hunger. The thing is – breastfeeding offers so much more to an infant than just nutrition.
Sometimes they just want to nurse, and that’s okay! So if you are in a situation where you can nurse and baby seems like they want to nurse – then let them!
I will say that Jack (my first child) was probably the most attached to his pacifier, and he’s the one that I thought I had to only feed every three hours. With Andrew, he will take a pacifier, but he much prefers nursing if I will let him. I don’t follow any particular feeding schedule with him.
There have been times where he was upset and did not want to latch for whatever reason- and a pacifier helped to calm him down to the point where he would latch again. So in those situations, I was grateful for the pacifier!
Remember that a pacifier is a breast substitute – not the other way around
I often hear mothers say “my baby is using me as a pacifier! What do I do!?”
And I always try to remind them that a pacifier was invented to be a substitute for the breast – not the other way around.
As I’ve already said, babies will want to nurse for reasons other than nutrition. And sometimes they will want to nurse close together (cluster feed) for reasons like increasing your supply, if they are going through a growth spurt, battling an illness, etc.
Cluster feeding is especially normal during the first few weeks and months, so I would encourage you to try and be patient through those times. It’s okay if you need a little break and offer a pacifier, but I would try not to think a pacifier should be the first thing you turn to if baby is wanting to nurse a lot.
Find a pacifier that baby likes…but not too much
As I was doing research for this post, I came across someone who said this – and I thought it was some good advice.
It’s good to find a pacifier that your child will take, doesn’t gag on, and seems to like. But you don’t want them to like it more than they like the breast!
We have used various brands, and typically my boys like Soothies. But with Andrew, we have been using the Chicco PhysioForma pacifier more often. It’s similar in softness and materials to the Soothie, but it has breathing and orthodontia benefits that were appealing to us. He likes it…but not too much 🙂
Start with the pacifier you want to use
Trust me on this one – babies gain preferences fast. Jack and Oliver wouldn’t take anything but Soothie pacifiers.
With Andrew, he does now take the Chicco PhysioForma pacifier I mentioned above. At first when I introduced it, he acted a little confused, but within a minute or so, he was happily sucking away on it. I’ve been able to switch back and forth pretty easily, too. So I think that this is a good alternative to the Soothie!
But the older your kid gets, the less likely they will be to take another pacifier. So definitely start off on the right foot with the pacifier you want them to use.
Pros and Cons of Pacifier
Whether or not you are breastfeeding, it’s important to be informed about the pros and cons of using a pacifier.
Decreases the risk of SIDS
Studies show that pacifier use during naps and bedtime can decrease the incidence of SIDS. The AAP does recommend all healthy, full-term infants use pacifiers during sleep.
I’m not sure why it does, but I think anything that can help prevent such a devastating event is worth using.
Can help a baby learn to suck
Some babies do need to learn how to suck, especially when they are preemies. A pacifier can be useful in assisting with that.
My IBCLC actually encouraged us to have Andrew use a pacifier occasionally to assist in some suck exercises. He had a tongue tie, and after that was revised, the pacifier helped him practice sucking.
Change in pressure
We have gone on a lot of road trips and airplanes with our kids as infants, and a change in pressure almost always bothers them.
Sucking can help to relieve that pressure and help them pop their ears. I will often nurse while we are taking off in a plane, but when we are driving through the mountains, I can’t really do that in a moving car!
When you just can’t stop
Sometimes baby wants to nurse or suckle and you just can’t stop right that second. And it’s okay! A pacifier can be a temporary satiation of that need until you are able to safely stop doing something.
You can take it away
I’m fine with my kids sucking on their hands as a way to soothe themselves – and none of them have been overly attached to their hands or thumb. But I know many people who have had kids who just can’t kick the thumb sucking habit.
It’s no fun to take a pacifier away, but it’s easier than taking away a thumb (which, obviously you can’t do!).
There are cons to using pacifiers. Personally, I haven’t seen many of these myself, but I know they happen. It’s important to be informed before you make any decisions regarding your baby!
Some people will refer to this as nipple confusion, but I don’t really believe that exists. Babies are smart, and they do gain preferences.
If given a pacifier all the time, they may start to gain preference for it if you aren’t careful. Just make sure you aren’t using a pacifier when the baby needs to eat!
There is some evidence to suggest regular pacifier use can be linked to early weaning. I could see this if baby is trained to want their pacifier for soothing rather than nursing, once they start to get more nutrition from solids, they may default to their pacifier instead of nursing.
Because pacifiers are exposed to a lot of different bacterias, if you aren’t careful, it can lead to thrush.
Some mothers/babies are more susceptible to recurrent thrush, and sometimes that’s due to not properly sanitizing a pacifier.
Increase in Ear Infections
Various studies link regular pacifier use to recurrent ear infections.
Pacifier use is linked to creating issues with the development of teeth and the palate. Choosing an orthodontic pacifier – such as the Chicco PhysioForma pacifier – can be a good option in this situation.
In some circumstances, this can also lead to speech problems.
Might Encourage the Earlier Return of Fertility
Exclusive breastfeeding can be a form of birth control, but if your baby is getting more of their sucking satisfaction from a pacifier rather than breastfeeding, it can decrease the effectiveness of this.
I think this is the one we have experienced the most – attachment to the pacifier! Thankfully, you can take them away – but it’s certainly not without protest (at least in our situation).
Many of these issues can be avoided if you try to limit pacifier use to bed and nap time.
Should I use a pacifier while breastfeeding?
It’s entirely up to you! Just make sure you are aware of the pros and cons and appropriate pacifier use, and it should be fine to use a pacifier with your breastfeeding baby.
When to Introduce Pacifier to Breastfeeding Baby
The Breastfeeding Friendly Hospital initiative suggests that babies should not be given any kind of artificial nipple (such as a pacifier or bottle) while in the hospital.
Most breastfeeding professionals also encourage this and would suggest not giving one until breastfeeding is well-established.
So when is breastfeeding well-established? That is going to look different for every mom and baby.
Kelly Mom suggests waiting until 3-4 weeks, though she said she feels it’s better to wait until six weeks, which is when mom’s breastfeeding supply is more regulated.
The AAP actually suggests that “mothers of healthy term infants should be instructed to use pacifiers at infant nap and sleep time after breastfeeding is well-established, at approximately 3 to 4 weeks of age.”
I was curious about when mothers usually introduced pacifiers, so I did a poll in my breastfeeding group. Here are the results from 164 respondents:
- 59% introduced a pacifier between birth and two weeks and experienced no issues with breastfeeding
- 18% introduced pacifier after two weeks and baby refused it
- 14% introduced pacifier after two weeks and had no issues
- 6% never introduced a pacifier
- 3% introduced a pacifier at four weeks and had no issues
And not one person said they had breastfeeding problems after introducing a pacifier. Obviously, this isn’t a scientific study, and there could be different variables, but I found the results interesting.
More often than not, people said that when they waited for more than a couple of weeks, their baby refused a pacifier. This seemed to be a lot more common than the baby having issues with breastfeeding.
When Should you Avoid Pacifier Use?
Ideally, a pacifier will primarily be used during bedtime and naptime, which will hopefully prevent a lot of the issues I’ve mentioned above.
However, we all know that sometimes that doesn’t always happen (and that’s okay!). But there are some times you may want to consider limiting or eliminating pacifier use:
- If the baby has reduced the frequency or duration of feeds
- If the baby is having issues nursing
- Weight gain problems that may be linked to baby not having enough time at the breast
- Low milk supply that may be due to baby not suckling enough.
- Repeated incidence of thrush
- Tepeated incidence ear infections
What to Look for in a pacifier
Not all pacifiers are the same and not all babies will accept each one the same.
As I mentioned above – start with the one that you want your baby to use. My big boys all started with the iconic Soothie ones…and then they refused any others that I tried later on.
Here are a few things to look for when selecting a pacifier:
- Made from silicone
- Ideally, select one that is just one piece (rather one that has a separate ring piece) to avoid choking hazards
- Rounded or orthodontic (have a flattened bottom)? It’s really up to you. Some believe that the rounded ones are “more like mom” and others claim that the orthodontic ones actually encourage sucking that is more similar to mother. Orthodontic pacifiers may help prevent some issues with teeth, but all pacifiers are shown to increase the cause of issues past the age of two.
- Pay attention to the size – most pacifiers will indicate the age range it’s intended for on the package.
The best pacifier for your baby is the one they will take.
As I mentioned, we have been transitioning to the Chicco PhysioForma pacifier. Not only is it designed to support proper teeth alignment, but it also is designed specifically to help with baby’s breathing.
Oliver has had some issues with his teeth due to pacifier use, and I am wanting to avoid that with Andrew. Below I share a review from a mom who said her child’s teeth went back to normal after she transitioned from a Soothie to the PhysioForma pacifier.
My interest was also piqued by fact that the nipple design was designed to position the baby’s tongue forward to help keep the airway open and support physiological breathing – which is linked to better quality sleep, reduced irritability, and oral infections.
It is made from soft silicone, is just one piece, and even has a nice ring on it. Andrew has been able to use that to push the pacifier back in his mouth when it falls out!
I’ll be sure to update this post, later on, to share our experience later on in Andrew’s life with the PhysioForma Pacifier.
Best Pacifier for Breastfeeding Baby
This is hard to say, because I don’t think there’s ONE pacifier that every breastfeeding baby will take.
If you follow the guidelines above, you should be able to find a pacifier that your breastfeeding baby likes (though be aware that some babies won’t take one, no matter what you do!).
We always like ones that have a hole you can put your finger in. Babies seem to love it!
What Pacifier We Use
I have been pretty impressed with the Chicco PhysioForma pacifier. It was easy to transition my son to this from the Soothie, and it seems to be a better option.
I’ve already mentioned some of the benefits of this particular pacifier, but I just wanted to emphasize them again:
- The pacifier is designed to mimic the shape of the mother’s nipple.
- The nipple shape uniquely helps support the baby’s breathing by allowing an open air way.
- The pacifier is also orthodontic to help development of the baby’s palate and teeth.
- Maintaining an open air way during sleep can improve quality of sleep, reduce irritability, help prevent infections of the oral cavity, and may help prevent SIDS
- The pacifier is less likely to fall from the baby’s mouth during sleep thanks to the breathable design, allowing the baby and mom to sleep for longer periods of time
I have been a long time fan of the Wubbanub, and it’s the main reason why we used soothies in the past.
The main downside is that you have to use the soothie pacifier, so if you want your child to use another one or they prefer another one, you are kind of out of luck.
Chicco has released their own version of the pacifier animal – the pocket buddies, and it’s compatible with ALL pacifiers. It’s so cute and soft.
I especially love how it has a little pouch that the pacifier can go in. It’s a little more lightweight too, and Andrew loves snuggling it.
I came across this review from another mom who was looking for an orthodontic solution for her soothie/wubbanub lover. So if you are in the same boat, definitely look into this.
5.0 out of 5 stars – Great orthodontic solution for soothie users!
February 17, 2019
My daughter has been attached to the soothie pacifier since a few months old. She specifically loved her wubbanubs. However, once she hit a year old and started getting more teeth I noticed the soothie pacifier making her teeth slightly crooked.
I then was on the hunt for a good orthodontic pacifier I could transition her to. The only problem was that my daughter would refuse any orthodontic pacifier I gave to her and cry for her soothie.
UNTIL I tried this Chicco orthodontic pacifier! Guys, this pacifier is THE BEST! It’s 100% silicone so it still has the feel of a soothie and another plus for me was the large handle on the front. I bought a dr brown animal pacifier holder (similar to wubbanub but you attach your own paci). With the handle I was able to attach the paci to the dr Brown plushie and my daughter is SO happy! And I am too! Her teeth have gone back to a natural position after using this orthodontic pacifier! They are super easy to clean. My only problem has been cracks appearing on the nipple BUT that is because my daughter chews on them relentlessly while teething, not because of the pacifier construction. If I notice a crack appearing I just replace the pacifier and go on. She will chew on them quite frequently while teething and one pacifier will still last 2-3 months. Which is pretty good imo.Link to original review