Pacifiers & Breastfeeding: What’s Best for Baby and When to Say Goodbye
Choosing the right pacifier for your baby can feel like a mini research project—and it’s easy to get overwhelmed. With all the different shapes, styles, and advice out there, you might find yourself wondering: Should I even be offering one at all?
Here’s the truth: if your baby doesn’t seem to want or need a pacifier, that’s ideal. Pacifiers are not a necessity, and not offering one at all is perfectly okay.
All pacifiers, no matter how “natural” or “orthodontic” they claim to be, tend to encourage open-mouth breathing and hold the tongue down or back. From an oral development perspective, that’s not what we’re aiming for.
That said—there are situations where pacifiers can be helpful, and choosing the right one can make a big difference.
Why Use a Pacifier at All?
Some families choose to introduce a pacifier because studies suggest that using one during sleep may help reduce the risk of SIDS. Others use pacifiers to soothe a fussy baby in the car or offer comfort when breastfeeding isn’t possible.
They can also be helpful when:
A baby has reflux and needs the soothing action of sucking
A mom has oversupply, and baby can’t safely comfort nurse at the breast
A baby has a high suck need, but mom is dealing with nipple pain or damage
There’s no one-size-fits-all answer here—pacifiers are a tool, and sometimes, they’re the right tool for the moment.
When Should I Introduce a Pacifier?
If you’re breastfeeding, the official recommendation is to wait until baby is 3–4 weeks old, once your milk supply is established and baby is feeding well.
This waiting period allows baby to practice and master nursing without anything interfering with latch or oral motion. That said, nipple confusion is pretty rare in full-term, healthy babies. Most will still prefer the breast, especially when they’re hungry, because a pacifier just doesn’t deliver the goods!
That said, there are reasons some families use pacifiers earlier—if mom is in pain, if baby is in the NICU, or if baby simply needs extra soothing during a rough moment (like in the car or while being examined at a doctor’s office).
The key is to balance pacifier use with frequent breast access, especially in the first few weeks when your milk supply is being established.
Not All Pacifiers Are Created Equal
Some pacifiers are better for oral development than others. Here’s how to tell the difference:
Pacifiers that encourage lip pursing and tongue bunching (where the tongue is retracted and can’t move freely) are less ideal and can contribute to latch issues or oral dysfunction.
Pacifiers that allow for lip flanging (like at the breast) and tongue extension are better options, especially for breastfed babies.
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If your baby struggles with oral function—such as with a tongue tie, high palate, or other oral anatomy challenges—certain styles of pacifiers can even be used therapeutically.
Here are a few styles that may help, depending on your baby’s specific needs:
Flat pacifiers may support babies who cannot extend or cup their tongue well.
Bulb-tip pacifiers can help stimulate a high-arched palate and provide more feedback for sucking.
Orthodontic pacifiers may benefit babies with a bubble palate, offering a bit more structure to encourage proper tongue placement.
These should always be used with the guidance of a trained IBCLC or oral function specialist if you suspect your baby has underlying challenges.
What About Weaning Off the Pacifier?
While pacifiers can be helpful in the early days, we recommend weaning off around 4–5 months if possible. This helps avoid long-term dependence and supports more natural tongue movement and oral development as your baby grows.
This doesn’t mean you leave your baby without soothing tools—teethers are a wonderful next step and can support oral motor function as well. Even if your baby didn’t use a pacifier, many benefit from teethers as they enter the oral exploration phase. We have some favorites we recommend (check them out here).
Find some of my favorite teethers here
Final Thoughts
A pacifier can be helpful in the right situation, but it isn’t a must—and it’s okay to skip it altogether. If you do choose to use one, make sure it supports your feeding goals, is appropriate for your baby’s oral development, and fits your family’s needs.
💛 If you’re unsure which pacifier is best, or you suspect your baby has oral challenges like a tongue tie or high palate, we’re here to help. Book a consult with us and we’ll take a look at baby’s latch, oral function, and pacifier use—then help you make a plan that works.
👉 Click here to schedule your consult
You’re doing an amazing job. Whether you offer the pacifier or not, it’s just one piece of the puzzle—and your instincts matter. 💛