How To Choose The Right Pacifier
Pacifiers can help comfort a cranky baby. But how to choose the right one for your baby? With a wide variety of sizes and styles to choose from, here are some factors to consider before purchasing.
By Amrita Gracias • 19 min read
Nisha’s two-month-old baby is often cranky. She’s been advised to give him a pacifier but she is rather doubtful about offering one to him. Are they really recommended? How safe are they for babies to use? Besides, with so many brands, sizes and styles, she’s unsure of which one to buy.
Do you also find it difficult to choose one amidst different types of pacifiers? Then, let’s help you and Nisha understand why pacifiers are used and help her make the right choice for her little one!
What is a pacifier?
A pacifier (often also referred to as a dummy, binky or soother) is nothing but a dummy nipple that is given to a baby to suckle on mainly as a means to soothe and comfort him. It resembles a mother’s nipple, which the baby can suck on. The sucking action keeps the baby calm and settled especially when she is cranky or perhaps when she needs to fall asleep. Babies are generally happy and comforted when they are sucking on something as the sucking action is self-soothing and allows them to feel secure.
Pacifiers allow the baby to experience the action of non-nutritive sucking as well, which happens to be a normal developmental requirement.
“Pacifiers are also used in selected cases of non-nutritive sucking – when babies are required to be trained for sucking when they are born too soon or in cases of severe neurologically abnormal status of the newborn”, says Dr Pooja Agarwal, Consultant Neonatologist and Paediatrician, Aditya Birla Memorial Hospital, Pune. “When there is mother and baby separation – for instance, the mother or baby are sick and need respective ICU care – this is another social reason for the use of a pacifier”, Dr Pooja explains. “To breast feed, babies need to have a suck–swallow–breathe cycle, that is, they should be able to suck milk out of the breast, swallow it and then breathe. Premature babies develop this reflex late and a pacifier gives enough stimulation, helping them learn to suck”.
Pacifiers and SIDS
Experts also widely believe that sucking on a pacifier can reduce the risk of Sudden Infant Death Syndrome (SIDS). In fact, the American Academy of Paediatrics recommends offering infants, who are one month and older, a pacifier especially during sleep time to reduce the risk of SIDS. A pacifier can also be useful while on an airplane – in particular during take-off and landing – as it can help any discomfort such as blocked ears (since babies are unable to pop their ears on their own by holding their nose or yawning). It also offers a distraction in situations like when a baby needs to have a vaccination, where baby might feel some discomfort. Pacifiers are also disposable; therefore it might be easier to break the habit as opposed to thumb or finger-sucking.
Different types of pacifiers
Pacifiers vary in colour, shape and material, but there are broadly two kinds of pacifiers based on the design of the nipple. Orthodontic nipples conform to the baby’s tongue and roof of the mouth so as to not interfere with oral development. “They are specifically designed to prevent tooth misalignment. These pacifiers feature a nipple that is flattened on the bottom and rounded at the top to help this purpose”, explains Dr Pooja. The conventional or rounded pacifiers on the other hand resemble a small ball on a stem. However, it is believed that these hamper proper development of the mouth, alignment of the teeth and even cause certain changes in the shape of the roof of the mouth.
How do you know if your baby wants a pacifier?
Your baby might actually display certain signs that indicate the need for a pacifier. She will be ready for one if she
- continues to suckle on the breast after a feed without actually drawing any milk or sucks on the bottle even after it’s empty
- gets annoyed when pulled away from the nipple
- tries to or sucks on the thumb, fingers or even toes
- sucks at other things like a blanket, rattle or other toys
- needs to suckle to fall asleep
However, do note that not all babies display these signs. More importantly, never force a pacifier into a baby’s mouth. But if your baby is increasingly fussy and cranky, you can try introducing a pacifier to soothe or calm her. One of the best ways to check if your baby is ready for a pacifier is to gently touch her cheek with it. If she instinctively turns to suckle, then she can be given one.
When to introduce a pacifier to a breastfeeding baby
If you are exclusively breastfeeding your baby, then it is advisable to hold off offering a pacifier till your baby is about a month to six weeks old – when she has most likely settled into a breastfeeding routine. Although there is no evidence to prove it, it is believed that introducing a pacifier earlier to a breastfed baby can cause nipple confusion. This occurs because the sucking action for a pacifier is different from sucking on the breast. Therefore, the baby could get confused about which action to use for which, and this can lead to him suckle at the breast incorrectly and not receive sufficient milk. Once your baby has settled into a nursing routine, you can try introducing the pacifier. Remember to offer it once she has finished a feed and has been burped.
However, there is another concern when offering a pacifier to a breastfed baby as Dr Pooja explains. “Introduction of pacifiers to babies who are breastfed has shown that it leads to stoppage of breastfeeding as early as two or three months. It can give false sense to the caregiver that baby isn’t hungry, and hence less milk is offered therefore leading to less milk production”, she says.
When to introduce a pacifier to a bottle-fed baby
If you are bottle-feeding your newborn, then you can introduce the pacifier almost immediately – a week to 10 days old – since the sucking action on both the nipples (bottle and pacifier) are similar. Infants who are bottle fed due to separation from the mother can be offered a pacifier for comfort. You can look for indicators from the baby before introducing the pacifier.
What are the factors to consider when choosing a pacifier?
Choosing the right pacifier is important; after all it is something that is going to offer your baby that much-needed comfort and soothing. While the market is flushed with a variety of pacifiers, you are sure to only want the best for your baby. Here are a few things to keep in mind while choosing a pacifier.
Size: Pick the right size of pacifier depending on your baby’s age and size. It’s best that you choose one that’s appropriate for your baby’s age. One that is too big can be unsafe as it risks being a choking hazard. And, your baby could reject one that is too small simply because it does not serve its purpose. Similarly, age-appropriate styles support oral development, teething and weaning. Here are the recommended sizes:
Small – under 6 months of age
Medium – between 6 and 18 months
Large – 18 months and older
Style: Pacifiers are available in two major styles – single piece pacifiers and multiple piece pacifiers. The former are made of a single piece of moulded piece of material and so don’t usually come apart thereby minimising the choking risk. The latter is the most common style available. It has three individual parts – nipple, guard and handle – that are put together.
Materials used: The three most common materials used for pacifiers are silicone, latex and specialised rubber.
a) Silicone is perhaps the most widely used as these pacifiers are sturdy, easy to clean and don’t usually retain any odours. But they aren’t too soft and are often rejected by babies for this reason.
b) Latex is softer and more flexible than silicone and is often seen to be the preferred choice for babies. However, pacifiers made out of latex can wear out faster than silicone ones owing to their soft texture. However, do make sure to check if your child has latex allergies before purchasing a pacifier made from latex.
c) If you are looking for pacifiers made of only natural materials, then those made out of rubber are the perfect choice. These are considered eco-friendly as sap or natural rubber is moulded into pacifier shapes. They are free from artificial colours, chemical softeners, polyvinyl chloride (PVC) and allergens.
Durability: The durability of a pacifier is also important as you certainly don’t want one that wears out easily. Those that aren’t durable tend to develop tears in the nipple. Or, a part can even break away posing a serious threat to your baby. However, despite their durability, pacifiers are bound to wear out with prolonged use and must be changed from time to time.
Nipple Guard and Cover: The plastic on which the nipple is attached is called the guard. “An inward curved guard sits on the mouth in the same shape and is more comfortable for the baby”, says Dr Pooja. Do also ensure that BPA-free plastic is used for the guard. “Also, choose a pacifier with a cap to prevent hygiene issues”, she adds.
Safety guidelines for pacifiers
Here are a list of do’s and don’ts to keep in mind when your baby is using a pacifier.
- Never tie the pacifier to the baby’s neck or crib as this can easily choke or strangulate him. You can instead attach the pacifier to the clothing using a pacifier holder or even a diaper pin.
- Always check if your baby is using the pacifier the right way. Don’t allow him to chew on it.
- DIY pacifiers are a big no. Don’t try and fashion one by using the nipple and ring from a feeding bottle as these can come apart easily and choke your baby. Simply invest in a good, durable store-bought one.
- Never force a pacifier on your baby. “Make sure that the baby is not hungry, doesn’t require a diaper change, is not feeling too hot or too cold before offering a pacifier so that you don’t miss out on the baby’s actual needs”, explains Dr Pooja.
- Since the pacifier is going into your baby’s mouth, keep it clean. Wash thoroughly and sterilise as per instructions. Keep it covered when not in use. “A pacifier that has been kept covered with a cap after use can be used again in a few minutes, but one that has been left open must be washed and sterilised as it may cause stomach infections, loose motion and vomiting”, adds Dr Pooja.
Choice of pacifiers
Age Group: 6 – 18 months
The design of this orthodontic soother helps in the natural development of baby’s palette, teeth and gums. The nipple is made from silicone (odour-free), is easy to wash and sterilise, and is long-lasting as well. It is a symmetrical collapsible nipple that allows the pacifier to be put into the mouth even upside down! The security ring handle makes it easy for the pacifier to be removed. This product also comes with a snap-on protective cover to keep the nipple free from dust and dirt when not in use.
Age Group: 6 – 12 months
The silicone and latex-free nipple on this pacifier is especially designed to promote the development of baby’s tongue and facial muscles along with the mouth and palette. The slim design of this pacifier also allows for it to fit snugly into baby’s mouth. The small ridges on the head of the nipple resemble the lines on the palette, and the base promotes the natural movement of the lips while sucking. The air holes also allow air circulation, therefore avoiding any skin rash or irritation.
Age Group: 0 months +
The nipple of this Mee Mee pacifier comes with a soft elasticity that makes it easy for baby to latch on. The slanted shape of the nipple encourages the baby’s tongue to move against it, directing the pressure of the tongue to the tip. The pacifier itself supports oral development, the natural sucking movement and action of the baby’s tongue. It is easy to clean and store with the protective cover, making it travel-friendly as well.
Age Group: 4 months +
Apart from keeping baby calm and soothed, this pacifier is also designed for self-feeding of mashed fruits, vegetables or even medicine. The anti-choking design of the sieve allows only tiny bits of food to go through, making it absolutely safe to use. The silicone mesh ‘nibbler’ comes in two sizes for babies of four and six months respectively. The safety lock also prevents any spillage of the food. This pacifier is also a teething toy that massages baby’s gums, stimulating development of teeth and mouth muscles.
Age Group: 6 months +
The advantage of this pacifier is that it can be used once lumpier foods are introduced as baby is being weaned. The mesh feeder allows bits of food of thicker textures to pass through while keeping baby safe from choking on bigger bits of food. The texture of this nipple/feeder also supports biting, chewing and help relieve irritation while teething.
Age Group: 4 months +
This pacifier is also designed to allow baby to suck on small bits of food. A soft silicone sack is gentle on baby’s gums and can be filled with small amounts of fruit or other foods giving him the opportunity to experience new tastes and textures. The smart safety mesh allows only small amounts of food to go through making sure baby is not hurt or choked. The food sack can also be covered with a special cap keeping it clean and free from germs. The handle encourages baby to grip the pacifier easily while the light weight allows him to hold it as well.
Age Group: 6–12 months
The physio air soother has several anti-irritation holes that ensure proper air flow, preventing saliva stagnation and allowing the skin to breathe. The ergonomic shape of the pacifier along with the tiny ridges on the nipple ensure proper positioning of the tongue, and the rounded edges don’t hurt baby’s skin. The wide base of the nipple facilitates the proper sucking action and movement of lips.
Age Group: 0–5 months
The size and shape of this pacifier is designed to fit perfectly into baby’s mouth, especially newborns. The length of the nipple also enables it to be sucked and retained easily. The raised base of the nipple also promotes the sucking action. The breather holes on the shield are an added safety feature.
Age Group: 8 months +
The key feature of this pacifier is that it promotes oral development. The thin lip contact area is perfect for a teething baby and it’s gentle gums. The design of this pacifier also promotes nasal breathing since babies tend to breathe through their mouths especially when they begin to wean and talk. Nasal breathing is more hygienic as it prevents germs and infections that can occur through breathing from the mouth.
Age Group: 5–8 months
The Step 2 pacifier is especially designed for weaning. The lip contact area facilitates correct mouth movement while the shape of the nipple promotes exercise of baby’s tongue and jaw. The size of this pacifier also suits the baby’s gums, growing mouth and oral development. The right size of the shield ensures a safe and comfortable fit in the baby’s mouth.
When should you replace the pacifier?
“Pacifiers must be discarded at the first signs of damage or weakness”, says Dr Pooja. “However, we do recommend that they must be replaced every month preferably for hygienic purposes”, she adds.
It’s time to replace the pacifier if
- you notice any discolouration, tears or cracks in the nipple
- the nipple is stretched and loose
- the nipple is sticky even after washing and sterilising
- and part of the pacifier is cracked, loose or seems like it might break away soon
While pacifiers aim to offer baby comfort and soothing, remember that they shouldn’t be used just to keep the baby quiet. “Babies cry when they need something – milk, comfort, cleaning or diaper change, warmth and security. Pacifiers are not the blanket answer to a baby’s crying. So rather than simply offering him a pacifier, make sure you first understand the reason for his crying or fussiness”, reiterates Dr Pooja. It’s best that you take the advice of a paediatrician as well if you plan to introduce a pacifier to your baby.
That being said, we hope that these tips and pointers help you choose the right pacifier for your precious little one!
About the author:
Written by Amrita Gracias on 5 December 2019.
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