Pacifiers & Safe Sleep

Caregivers should consider offering their baby a pacifier for every sleep (at naps and a night). Pacifiers have shown to be protective against SIDS and reduce the risk of death by 50%.

While the reason pacifiers offer a protective factor is not yet fully understood, experts theorize that it is because the pacifier triggers the sucking reflex, which helps to soothe the baby to sleep, but once asleep also helps the baby to maintain a regular breathing pattern while also keeping their airway open and unobstructed.

Once the baby is asleep, if the pacifier falls out of the mouth, the protective factor remains, and the pacifier does not have to be reinserted. If the baby is not interested in taking a pacifier, the baby does not need to be forced to take it, but you can offer it again at an older age.

Breastfeeding infants should delay pacifier use until breastfeeding is firmly established. The American Academy of Pediatrics defines “firmly established breastfeeding” as the following:

• Caregiver has sufficient milk supply
• Baby achieves a consistent, comfortable, and effective latch for milk transfer.
• Baby has appropriate weight gain according to medical providers and growth charts.

Pacifiers are safe to use in the sleep environment as long as they do not have any attachments. The pacifier should not be attached to the baby’s clothing. When the pacifier is attached via a string or strap, the pacifier will become a strangulation hazard.

Pacifiers also should not be attached to a stuffed animal or toy. Pacifiers that have a stuffed animal or toy can become a suffocation hazard if the toy covers the nose and obstructs the airway.