Pacifiers and Sleep Training
Many families use pacifiers as a tool to soothe fussy babies and promote sleep. There seems to be still so much debate about how or when they should be use, despite how long they have been around.. While some swear by their effectiveness, others worry about potential drawbacks. I’m going to do a deep dive into the pacifier dilemma and explore the impact it can have on infant sleep, and how pacifiers can affect sleep training.
What are the benefits of using a pacifier?
Personally, I think it's fine to use a pacifier if that’s what you want to do, particularly through the newborn months. Newborns command higher levels of comfort and soothing throughout the fourth trimester. Therefore, a tool that could be helpful for parents of a newborn is a winner in my book! Just remember it’s not a requirement to use a pacifier, and surprisingly, your baby may not even be a fan of it at all! You can offer, but I definitely wouldn’t force it if it’s not something they are interested in.
Pacifier wins:
Fulfills a baby’s need for non-nutritive sucking, which is a natural reflex
Sucking a pacifier can be soothing for the baby, which would lead to a decrease in crying intensity/duration
Allows someone else to soothe the baby/gives the breastfeeding parent a break
Studies have shown that pacifiers help to reduce SIDS risk although the exact mechanism is unknown.
Reduces distress and pain when used during painful procedures such as heel sticks/shots.
Pacifier woes:
If a pacifier is used for sleep initiation, it can lead to extra wakings when it falls out of the baby’s mouth
May interfere with the baby’s ability to properly latch when breastfeeding
Correlation to recurrent ear infections.
Correlation to development of latex allergy.
Could alter the shape of baby’s oral cavity/teeth
A pacifier is just one more thing that would eventually need to be weaned
Is using the pacifier a “bad” sleep habit?
If you’ve been around for a while, you probably have heard us say that there are no “bad” habits when it comes to sleep. It all comes down to whether or not it’s working for your family and if it is a sustainable. There are, however independent and dependent sleep associations. Just like the name implies, an independent sleep association is one that does not require you to be present for it to still be there/accessible (I.e. white noise, dark, cool sleep environment, sleep sack). A dependent sleep association means that baby requires an action from you (the parent) for falling asleep (I.e. rocking, feeding, patting, etc).
How Do Pacifiers Affect Sleep?
Pacifiers can fall into BOTH of these categories! If your baby is able to find and replace their pacifier without your help overnight then it’s an independent sleep association. If they can’t replace it on their own then it becomes a dependent association, and they will need to cry to get you to come back and replace it. When your baby uses a pacifier to fall asleep and stays asleep for long periods of time, and doesn’t experience disruption then using one seems like it’s working fine for the moment! When a baby is having lots of extra night wakings and my clients and I have adjusted the timing, double checked the sleep environment, and fine tuned their response THAT is when I would have to take a closer look at the pacifier. If no other changes are “fixing” the sleep issues then that would be a sign that the pacifier could be causing the problem.
When are Pacifiers Most Useful?
Using the pacifier is probably the most helpful during the newborn stage (0-4 months). Due to the development of sleep cycles the pacifier falling out doesn’t usually disrupt sleep in newborns like it can in older babies and toddlers. In addition, the pacifier as a soothing tool is great for teaching your baby to fall asleep somewhere besides their parents arms, if you are thoughtful about it, like using it when you are helping your baby to sleep in their crib or bassinet.
Once your baby is older, around 4-6 ish months old, the sleep cycles have matured and the pacifier can actually begin to cause extra night wakings if it is used for sleep initiation (even if it was never a problem before!). This is due to your baby expecting the same conditions to fall asleep each time they wake up overnight in between sleep cycles.. If your baby is not yet able to physically replace the pacifier on their own, that means they will be signaling to you (aka crying out) to come back in and replace it for them (meaning you could be doing paci pops up to 8-10x a night!).
You can either:
Wean the pacifier completely
Reduce dependency-not really recommended by me unless your baby is super duper chilled out and easily goes with the flow. Because using it to soothe and then removing it before they’ve completely fallen asleep is likely to irritate even a fairly even-tempered baby
Keep using it, and accept your fate as the paci servant until they have the ability to locate the pacifier in their dark sleep space, grab it with their little squishy hands, and pop it back into their mouth on their own. (usually not until 6ish months old)
IF you’ve made it beyond 6 months with your baby using the pacifier, congrats! This is the stage of independent paci use that you’ve probably been dreaming about. Scatter the pacifiers around their crib like Oprah (You get a paci! You get a paci!) and during their wake windows help them practice finding and grabbing them and guiding it to their mouth. This is something that will take a bit to master so if they do end up waking up angry in the middle of the night, just try pausing at least 5-10 minutes before going in for a paci pop to give them some time to work it out on their own.
When should I ditch the pacifier?
If you are thinking about getting rid of it, there are some key ages that would be good to note. It may be clear in the earlier passages that I’m a fan of using the pacifier during the newborn stages (it can really make life easier for some families!). If you get to four months and you’re like okay I think I’m ready to get rid of the pacifer, then go for it! This is the stage when pacifiers can be more of a hindrance than a helper.
After 6 months, and once they are independent with it I say just keep it as long as you’re comfortable with them having it, AND as long as it’s not causing any sleep or feeding disruptions. Between 12-18 months I have found it to be fairly easy to drop the paci-with lots of distractions and then within a few days they will have likely forgotten all about it. Beyond 18 months though, I would hold on to your butts-and pacifiers-until at least 3 ish years old. The reason is if you try to take it away before 2.5 years old they will likely just stop napping altogether and nobody wants that in their life. Beyond 3, it’s a common age to be starting to drop the last nap anyways, so no harm done if they start refusing naps at the same time as you taking it away!.
Pacifiers can certainly be a helpful tool for soothing babies and promoting sleep (especially during the early months of your baby’s life!). Just as with any parenting decision, considering using one should be done by looking at the risk vs the benefit, and not just using it as a bandaid for any bigger issues at hand. Always consult with your pediatrician and/or your lactation consultant if you are having any concerns about your baby’s pacifier use. And if you’d like help navigating sleep with a pacifier in place, you can reach out to us at Heaven Sent Sleep! 🙂
