Pacifier Pros and Cons

Is it good or bad to give your baby a binkie? We offer the latest news.

Pacifier Pros and Cons

Your baby is crying. She looks very unhappy: She has her mouth open, her eyes squeezed shut, her fists clenched. You've tried everything you can think of to calm her down—breastfeeding, walking her in the stroller, gently rocking her and singing to her.

In your palm you hold what you hope will be the answer—a pacifier. But before you pop that binkie in her mouth, consider the many ways using it could affect your baby's health.

The Pros

A way to soothe- The amount of time an infant spends crying increases from birth until about 6 weeks, when a baby cries for an average of three hours a day. "That's a lot of crying stress," says Cynthia R. Howard, M.D., M.P.H., associate professor of pediatrics at the University of Rochester School of Medicine and Dentistry in New York. Sucking undoubtedly helps calm a baby, she adds, which is why pacifiers are so popular. According to a 1999 study by Howard published in Pediatrics, approximately 75 percent of babies are given pacifiers to suck.

Health benefits- The only proven medical benefits linked to pacifiers have been seen in preterm babies. Preemies who suck on binkies gain weight faster, according to a 1992 study published in the Swedish journal Acta Pediatrica. Other research has found that preemies who use pacifiers shortly after birth show earlier sucking patterns and experience fewer health complications. "Sucking promotes oral-muscle function and muscle development," says Nina L. Shapiro, M.D., assistant professor of pediatric otolaryngology at the University of California, Los Angeles, School of Medicine.

Reduced risk of SIDS- Pacifiers are associated with a reduced risk of sudden infant death syndrome (SIDS), according to four recent studies. But since a cause-and-effect relationship has not been proven, researchers aren't sure how, or even if, pacifiers prevent SIDS. In the meantime, the SIDS Alliance refrains from recommending their use.

The Cons

Ear infections- Pacifiers were found to be responsible for 25 percent of ear infections in children under 3 attending day care, according to a study published in Pediatrics in 1995. Restricting pacifier use to just before a child fell asleep, though, returned the risk to almost normal, a follow-up study in 2000 (also in Pediatrics) found. Why the link? Pacifier sucking promotes fluid collection in the ears, which can lead to ear infections, Shapiro says.

Early weaning from the breast- Offering a pacifier to a full-term baby may keep her from what she really needs—food. Indeed, several studies have linked pacifier use with early cessation of breastfeeding. However, a study reported in the Journal of the American Medical Association found that pacifiers probably were not to blame for early weaning. The researchers concluded that their use is a sign of breastfeeding difficulties or reduced motivation to breastfeed.

While the pacifier-breastfeeding connection remains a question, if you do give a binkie, it's best to wait. "If you want to offer a pacifier, wait until four to six weeks, when your milk supply is established," Howard says.

Dental problems- Children who suck anything—thumb, finger or pacifier—past age 2 have a higher risk of developing protruding front teeth and/or a crossbite in baby teeth, according to a study published last year in the Journal of the American Dental Association. In some cases, these problems persist when permanent teeth come in.

So where does that leave you and your screaming baby? Prudent use of a pacifier—occasionally and briefly, after breastfeeding is established and before your child is 2—probably won't cause any harm. So if your baby is soothed by using a pacifier for short intervals, give it to her guilt-free. Or you could try another round of feeding, rocking or singing. Either way, your baby eventually will settle down.