Brush Up on Oral Health

Using Pacifiers Safely

Baby looking sideways with pacifier.This Brush Up on Oral Health tip sheet offers helpful advice Head Start staff can share with parents about using a pacifier safely and weaning their child from a pacifier.

Most babies have a natural need to suck, and most find it calming. This type of sucking is also called “nonnutritive sucking” because the baby is not being fed. Giving a baby a pacifier can satisfy a baby’s need to suck.

If a child continues to use a pacifier after 18 months, it can affect the way their teeth bite together and cause problems, such as an overbite. It can also affect the growth of jaws and bones that support the child’s teeth.

Tips for Parents About Pacifier Use

If parents choose to give their baby a pacifier, here is how they can do it safely:

  • Wait until breastfeeding is going well (usually after about three to four weeks). If a pacifier is given to a baby before then, nipple confusion may occur and make breastfeeding hard to establish. After a pacifier is introduced, it should never be used to delay or replace regular feedings.
  • Let a baby decide whether to use a pacifier. If a baby shows no interest in using a pacifier, do not force it.
  • Offer a pacifier at naptime and bedtime. If a baby uses a pacifier, the best times to offer it are at naptime and bedtime. Using a pacifier at these times may help lower a baby’s risk for sudden infant death syndrome (SIDS).
  • Don’t coat pacifiers. Sucking on a pacifier coated with anything, especially sugar, honey, or jam, increases a baby’s risk for tooth decay.
  • Attach pacifiers with clips that have short ribbons to keep from falling. Never tie a pacifier to a baby’s wrist or neck or to a baby’s crib. The string can get tangled around the baby’s neck and make the baby choke.
  • Clean pacifiers and replace them regularly. Wash a pacifier that has fallen on the ground or floor with soap and warm water before giving it back to a baby. Parents who clean pacifiers with their mouths pass bacteria that cause tooth decay to the baby. Carrying extra pacifiers is a good idea.
  • Check pacifiers for wear and tear. Over time, pacifiers can break down. Look at the rubber every now and then to see if it is discolored, cracked, or torn. If it is, replace it.
  • Do not share pacifiers. Each baby should have their own pacifier(s). Letting babies share a pacifier can pass bacteria that cause tooth decay and increase a baby’s risk for tooth decay.

Tips to Help Parents Wean Their Child from a PacifierMother holding and comforting child.

If a child shows no interest in self-weaning from the pacifier by 18 months, parents need to help. Here are some ideas to share with parents:

  • Take it away gradually. Limit pacifier use to certain times (such as naptime or bedtime) or to certain places (such as in bed). In most cases, when a child uses a pacifier in bed, it falls out of the child’s mouth during sleep. Parents can gradually increase the amount of time the child is not using a pacifier until the child completely stops using it.
  • Throw it away. Encourage the child to throw their pacifier away. If the child asks for a pacifier, parents can remind them that the child threw it away, the child is a big kid, and big kids don’t use pacifiers.
  • Trade it. Encourage the child to put pacifiers under the pillow for the “pacifier fairy” (or another positive cultural character) who will trade them for a gift, like a toy or something soothing. If the child keeps asking for a pacifier, remind the child that all the pacifiers were given to the pacifier fairy (or some other character), who gave the child a gift.
  • Poke holes in it. This alters the pacifier so it is no longer satisfying to suck on. It’s best to use a clean pin to poke two to three holes in the tip.

To help parents remember these tips, staff can share the Helping Children Stop Using a Pacifier handout. This handout is part of the Healthy Habits for Happy Smiles series, which provides simple tips that parents and pregnant people can use to promote good oral health.

Download a PDF version to print and share.