Mom & Baby columnist Michel Cohen, M.D., author of The New Basics: A-to-Z Baby & Child Care for the Modern Parent (HarperCollins, 2004), answers readers' questions about pacifier use.
Q: I'm confused about pacifiers. If my baby uses one, will she become addicted to it?
Don't be afraid of making a pacifier addict out of your baby. This was an issue in the old days, when feeding on a rigid schedule deprived babies of sucking opportunities, but this is less of a problem now. That said, using the wrong type of pacifier can contribute to dependence. I always recommend the old-fashioned round type, because it's harder to keep in the mouth and will fall out right after your baby falls asleep, thus reducing dependency. The new "orthodontic" pacifier is so perfectly molded to a baby's mouth that it almost becomes an integral part of their anatomy.
At around 3 to 4 months of age, in my observation, the urge to suck decreases, and babies can satisfy what urges they do have with their own hand or thumb. At this point, if you make the pacifier less available, your baby will gradually lose interest in it without having to wean her from it.
Q: I've heard that using a pacifier can help prevent SIDS. Is this true?
The AAP has issued a statement that pacifier use may reduce the occurrence of SIDS in babies. However, SIDS is one of the most difficult conditions to study in babies, and statistics on the subject have been quite elusive. I would simply consider using a pacifier if your baby has a strong need to suck and is willing to take one (some babies are quite happy with their fists or fingers--or nothing at all). I wouldn't count on it to prevent SIDS.