10 minute readSo, is it safe to use a pacifier at night?
Drum roll, please…
Yes — it’s safe for your baby to use a pacifier while they sleep.
In fact, research suggests that sleeping with a pacifier might actually reduce the risk of Sudden Infant Death Syndrome (SIDS) by keeping the airway open and preventing your baby from rolling into unsafe positions.
As well as this, using a pacifier at night can also help establish a strong sleep association for your little one to latch onto, helping them to settle down — though this second point is a bit of a double-edged sword, as we’ll discuss later.
But in summary, it’s generally considered safe to let your tot suckle on their pacifier while they nestle down in the crib; so if you find that it helps you both get a good night’s rest, don’t be afraid to use it!
However, as with any aspect of parenting, there are a few risks to considerder, and while they’re relatively rare, or may only occur in exceptional circumstances, they’re still worth being aware of.
Risks of sleeping with a pacifier
Before you swear off pacifiers altogether, remember that all the potential pacifier pitfalls listed below are quite rare — and the risks can be mitigated.
Dependency
One of the most common concerns with using a pacifier at night is that babies can become dependent on it to fall asleep. If your little one learns to fall asleep with a pacifier, they might wake up every time it falls out during the night and cry for it to be replaced. (Cue the endless trips back to the crib in the dead of night!)
Dental issues
Extended pacifier use beyond infancy can have negative effects on a child’s dental development. Prolonged sucking, especially past the age of two, can lead to misalignment of teeth and contribute to problems like an open bite or overbite. These conditions, sometimes referred to as “pacifier teeth”, may require orthodontic treatment later on if the habit isn’t weaned early enough.
To reduce the risk of dental issues, it’s recommended to start weaning your child off the pacifier by 12 months of age. Before that, pacifiers are generally safe for most babies as long as they’re used in moderation, and only during sleep rather than awake times. For guidance on how to wean your tot off their pacifier, check out our tips at the end of the article.
Ear infections
Research has shown a link between pacifier use and an increased risk of ear infections, also known as otitis media. The theory is that the sucking motion may affect the pressure in the ear, which can lead to fluid buildup and infection.
Although ear infections can be common in young children, frequent pacifier use — especially beyond the first year of life — can slightly raise the likelihood. Reducing pacifier use during daytime hours, and especially during sleep beyond the first year, can help lower this risk.
Choking and suffocation
Although rare, there is a slight risk of choking or suffocation if a pacifier breaks or becomes damaged. To minimize this risk, it’s important to regularly inspect pacifiers for any signs of wear and tear, such as cracks, holes, or loose parts. Replace pacifiers frequently to ensure they’re in good condition, and always follow the manufacturer’s age and size recommendations to avoid giving a pacifier that’s too small for your child’s mouth.
Also, avoid pacifiers that have any added features like cords or stuffed animals attached to them. While cute, these extras can pose strangulation or suffocation risks when your baby is sleeping.
Using pacifiers at different stages of your baby’s development
As with every other aspect of the parenting journey, pacifier use has distinct stages. How and when you use them will change based on your baby’s age, and what works for your newborn tot might not work so well once they’re a little older. Every child is different, of course, but below, we’ve included a rough guide to pacifier use by age.
Newborn to 4 months
While most babies will take to their dummies quite happily, it’s crucial not to force your tot to take their dummy if they have any objections — for example, you should never dip the pacifier into anything sweet to try to get your baby to take it.
If you’re breastfeeding, it’s generally recommended to wait until you’ve established a solid nursing routine before introducing a pacifier, as this will help to avoid nipple confusion.
What’s nipple confusion?
The reason pacifiers work so well is because they’re essentially artificial nipples. However, if a baby is introduced to a pacifier before they’re used to the real deal, this could cause some confusion. Since sucking on a rubber teat requires a different technique than nursing at the breast, some babies may get a little thrown off, and struggle to latch on once you start breastfeeding.
However, recent research suggests that there may be a weaker link between pacifier use and nipple confusion than once first thought. Instead, many experts now believe that nipple confusion is caused primarily by bottle feeds. So, it turns out that nipple confusion is as confusing for parents as it is for babies!
In any case, the current AAP guidelines recommend waiting until breastfeeding is well-established before introducing a pacifier. Around 4 weeks after birth is a good timeframe.
4 - 6 months
At this age, your tot might develop a strong affinity with their pacifier — particularly if you’ve been using it at certain times of the day, like just before bedtime.
Remember in the introduction when we mentioned that pacifiers create sleep associations? Well, there’s a chance that your baby might become dependent on their pacifier to sleep. This might prove troublesome, forcing you to replace their dummy every time they wake up.
For this reason, many parents choose to begin phasing the pacifier out once their tot reaches 4 to 6 months of age, opting to introduce other ways of bedtime soothing to encourage a greater sense of independence. Depending on the strength of the attachment, this stage can be challenging, but rest assured that sooner or later your tot will learn to live without their dummy!
Of course, there’s no obligation to throw the pacifier out once your baby hits the 6-month mark. If transitioning is proving troublesome, you can always switch focus and teach your tot how to replace their dummy all on their own. Do this during playtime when your baby is alert and happy, and place the pacifier just within their reach. Over time — and with a little encouragement — they’ll soon learn to grab it and pop it in all by themselves.
7 - 12 months
At this age, you’ll want to place more importance on independent pacifier use. Encourage your tot to take control by placing the pacifier within reach in their crib. If you want to be extra prepared, you can even place multiple pacifiers nearby, so that they’ll always have one in close reach when they wake up.
Verbal coaching can work wonders, too. Try holding the pacifier up in front of your tot and saying “get your dummy”, or, once you’ve set them down into their crib, gently ask them to find their pacifier and motion towards it — they’ll soon catch on!
12 - 18 months
While pacifiers are still safe for sleep at this stage, long-term use, especially beyond 18 months, can have some downsides. Prolonged use of pacifiers can sometimes lead to dental issues like misaligned teeth (commonly referred to as “pacifier teeth”) or speech development challenges.
By 12 months, your baby has likely developed other ways to soothe themselves, like cuddling a favorite stuffed animal or blanket. So, this can be a good time to begin slowly phasing out the pacifier. But don’t worry—there’s no need to go cold turkey if your child isn’t ready. Weaning can be a gradual process, and you can take it at your baby’s pace.
Tips for weaning off a pacifier at night:
Start by limiting pacifier use to sleep only. During the day, offer alternative soothing techniques like a lovey or a comfort blanket.
Introduce other sleep associations. Activities like reading a calming book or playing gentle music can help reduce reliance on the pacifier at bedtime.
Be patient! If your baby resists or seems particularly attached to the pacifier, it’s okay to take a slower approach.
18 months - 2 years and beyond
By the time your little one reaches toddlerdom, it’s usually recommended to wean off the pacifier completely. This is important for several reasons:
Dental health concerns. Prolonged pacifier use can lead to dental issues, such as misalignment or “pacifier teeth,” where your child’s teeth may become pushed forward, affecting their bite.
Speech development. Pacifiers can interfere with speech development by preventing your toddler from practicing their talking skills. Open-mouthed pacifier use can hinder the formation of sounds and words.
Dependence. By this age, your child might start relying on the pacifier for comfort in situations where they could be learning self-soothing techniques, making it harder to handle emotions without it.
Social readiness. As your baby grows up, a pacifier might start to seem out of place in social settings, like daycare or playgroups. Weaning them off now will reduce their chance of being singled out or picked on.
Fortunately, at this age, toddlers typically develop rapidly in terms of speech, and it’s easier for them to practice speaking clearly without a pacifier in their mouth all the time, so you already have a perfect excuse to phase the dummies out anyway!
This doesn’t mean the process will be without challenges, though. Weaning a toddler off their beloved binky can feel like trying to convince a cat to enjoy a bath, but it’s entirely doable with patience, persistence, and maybe a little creativity.
Tips for weaning a toddler off the pacifier altogether:
If your toddler is particularly attached to their pacifier, try a gradual approach by first limiting its use to naps and bedtime. Once they’ve adjusted, you can slowly phase it out during sleep, too.
Some parents find it helpful to “retire” the pacifier in a special way, like having a “pacifier fairy” come to take it away in exchange for a new toy. This can make the transition much easier.
Transition your toddler to other forms of comfort, like a stuffed animal, blanket, or even their favorite bedtime story. Help them understand that they’re a “big kid” now and don’t need the pacifier anymore.
You can take it from us — pacifiers aren’t just safe to use during bedtime, they’re often a complete lifesaver! But if your little one is still struggling to drift off, check out our guide to baby massage, or our comprehensive article on baby sleep regression; and remember — you’ve got this!
Reviewed by Sleep Consultant, Rosey Davidson in November 2024.