Introducing Pacifiers to your Newborn: Yes, No, When, Which ones?!
Ah, Pacifiers for Newborns.. Life savers? Breastfeeding sabotage? What’s the deal?!
First and foremost, you should know there is good quality research showing that pacifiers DO NOT have any negative impact on the length of your breastfeeding journey with your baby. Nipple confusion is BS. There is also some research to suggest that using pacifiers is associated with decreasing the likelihood of SIDS. Feel free to read the queen of parenting research, Emily Oster’s takes on the subject here as well!
So. Knowing this, as a postpartum doula and breastfeeding advocate, I say YES you should use feel empowered to use pacifiers. AND.
There are indeed a few specifics I think you should know before offering one!
WHEN should you offer your baby a pacifier?
Short answer: If breastfeeding is your goal, feel encouraged to go for it once an effective LATCH at the breast is established and/or when your nipples need a break in those first few days if they’re latching but it could use some improvement. If you are NOT planning to breastfeed your baby, feel encouraged to offer them a pacifier immediately after birth - in between feeds at the bottle or other supplemental feeding system!
Longer answer: The main danger of offering a pacifier within these first few days is NOT “nipple confusion” (again, BS), but rather, risking another cascade of interventions that can be detrimental to establishing a healthy breastfeeding relationship. If your baby is not being offered the breast frequently enough because they’re being offered a pacifier instead, they won’t be getting enough colostrum, which means you’re likely not stimulating your milk supply to come in, then your baby continues to not gain enough weight, so then your pediatrician offers formula, which can further limit your supply so they get more formula… and so it goes.
IF it is your goal to exclusively breastfeed, it IS a good idea to hold off on pacifiers until your baby’s latch is well established. You can determine this by listening for their swallows, monitoring their weight gain and asking for weighted feeds, monitoring their wet/poopy diapers, understanding newborn hunger and satiety cues, looking out for the “emptying” feeling in your breasts and monitoring your nipple damage, and more. PLEASE reach out to an IBCLC covered by your insurance via Lactation Network for support!
However, once your baby has established that they are effectively able to transfer milk from your breasts, it is perfectly fine, and often GAME CHANGING to offer your baby a pacifier! Y’ALL. Newborns are born with a non-nutritive suck reflex. This means that they are born with a NEED to suck on something, even when there is no milk coming out. At the breast, this typically happens when they’ve fallen asleep after a feed but are still happily latched and no longer swallowing, or just “hanging out” at the breast, content and awake. Have you ever heard the phrase, “Oh you’re just letting them use you as a pacifier?” Well… we WERE the o.g. pacifiers. It makes sense that they’d want to stay latched all day long… that’s what we were designed to do. We just don’t currently live in a society that would allow us to stay latched with our babies 24/7 in those first few days (though that WOULD probably be the best way to truly establish a perfectly synced relationship between your baby’s hunger and your milk supply, and is why we say to wait a few days until they’re getting the hang of eating). Not to mention our lack of breastfeeding education through proximity and available resources… but I digress.
So we all agree that once a good latch is established, or if your baby is bottle-fed, it’s completely fine to offer a pacifier in between feeds, yes? Good.
Now, which one should you offer?
Spoiler alert: the one they’ll give you in the hospital, that teal-ish green one? That’s JUST FINE. It is not “less than” because it was free - it’s actually the one I recommend more than any others (and the fancy ones are more likely to cause problems). Philips Avent, and many other brands, also make a few other designs I recommend too:
Philips Avent Soothie Hearts
Nanobebe - great for babes with smaller mouths
Dr. Brown’s - great for babes using narrow mouth Dr. Brown’s bottles, which I recommend
Ninni Pacifier - great for babes dealing with oral restrictions or releases
You might notice something about these pacifiers: they all look… the same. That’s right. You DO NOT need to try out one million different shapes of pacifiers. We really only want them to have ONE shape, and that is a SYMMETRICAL, non-molded pacifier (they’re also conveniently all single-piece pacifiers - much less risk of nasty bacterial growth in crevices!).
You might be saying, “But the bulb/shape at the end helps my baby keep the pacifier in their mouth!” And THAT, my friend, is THE problem for breastfeeding. We WANT your baby to have to work to keep the pacifier in their mouth, so that they are able to do the very real and hard work of breastfeeding. We do not want them to get used to a nipple that just magically stays the exact shape they like, losing oral strength in the process. Turns out, that’s not how human nipples work, and that can lead to your baby getting frustrated at the breast, and then only successfully feeding from a bottle that… also has a molded shape like their favorite pacifier… hmm (more on this in a later post, but I’m sure you can tell what I’ll say about bottle nipple shape). If your baby is struggling to keep a symmetrical pacifier in their mouth, or indeed if your baby is not soothed by a pacifier (and they are not hungry), I recommend that you seek lactation support from an IBCLC - remember, your baby has a NEED to suck, and if they’re having trouble, they’re asking for help! (PS. This simple, symmetrical shape that they have to WORK to keep in their mouth might also make it less likely that they’ll put up a fuss when it comes time to phase out pacifiers, if they haven’t decided to wean themselves all on their own by then!)
Offering a pacifier after a feed can be a great way to determine if your baby is “full” or not when they’re just hangin at the boob! If they accept the pacifier happily, maybe they just needed to suck! If the pacifier isn’t doin it for them, maybe you could do a little hand expression or toe tickling to get them interested in swallowing and finishing their feed. You can also use a pacifier to help stretch a baby’s feeding times out (under supervision of a lactation specialist, and as long as baby’s beyond their birth weight), in order to help them get FULL feeds rather than snacking throughout the day.
So my friends, long story short: YES I think you should use a pacifier, but not until breastfeeding is established, and I think you should DITCH the sample packs for simple, symmetrical pacifiers. Pacifiers can be a wonderful tool for getting YOU some much needed rest from being latched, and literally getting your baby’s NEEDS met!
I’m keeping this post focused on newborns! MANY babies wean themselves from their pacifiers! But if you have further questions about when and how to take the pacifier away eventually, I cannot more highly recommend this adorable Paci Fairy plan from my heroes at Big Little Feelings - works like a charm, every time!
And finally, as always, I’m here for you!! If you have any further questions or need support, please do not hesitate to book a quick FREE call with me here, and we’ll get you sorted.