Pacifier Pros and Cons: What Parents and Providers Should Know

Pacifiers—also known as binkies, pacis, soothies, dummies, or nuk—can provide significant comfort to infants and convenience for caregivers. While many families rely on them daily, it’s important to understand both the advantages and drawbacks. Understanding the pros and cons of pacifiers helps clinicians, therapists, and caregivers make informed decisions that support healthy development.

Below is an evidence-based examination of the key benefits and risks of pacifier use, along with guidance to support families.

Pros of Pacifiers

1. Supports Non-Nutritive Sucking

Pacifiers satisfy an infant’s innate need to suck, helping them self-regulate and calm during moments of stress, fatigue, or overstimulation.

2. May Reduce the Risk of SIDS

Research suggests that using a pacifier during sleep may be associated with a reduced risk of Sudden Infant Death Syndrome (SIDS).¹ Pacifiers may help maintain airway patency and promote lighter, more arousable sleep.

3. Helps Calm, Settle, and Improve Sleep

Many caregivers find that pacifiers help soothe fussy newborns, extend sleep duration, and make activities like car rides more manageable. When used thoughtfully, pacifiers can be a helpful comfort tool.

Cons of Pacifiers

Pediatricians and family physicians commonly recommend weaning pacifier use after six months to reduce certain developmental and medical risks.² Here are the key cons of pacifier use that clinicians should review with families.

1. Potential Impact on Speech Development

Some studies suggest a possible association between extended non-nutritive sucking and speech sound delays.

A study of 128 Patagonian preschoolers found that prolonged sucking behaviors outside breastfeeding were linked to negative effects on speech development.³ This may reduce speech intelligibility and affect early communication skills.

2. Increased Risk of Ear Infections

Pacifier use has been associated with a higher incidence of otitis media (middle-ear infections).

Because of this correlation, many pediatric guidelines recommend limiting or discontinuing pacifier use during the second half of infancy to help reduce this risk.

3. Elevated Risk of Mouth and Facial Injuries

Infants and toddlers who walk or play with a pacifier in their mouths face an increased likelihood of falls and oral injuries. A 2012 study found that a young child in the U.S. is treated in an emergency department every four hours for an injury involving a pacifier, bottle, or sippy cup.⁴

4. Emotional Dependence Can Make Weaning Difficult

After age one, pacifiers often shift from physiological soothing tools to emotional comfort objects. As reliance grows, toddlers may struggle with separation from the pacifier, making the weaning process more challenging for caregivers.

Final Thoughts on Pacifier Pros and Cons

Pacifiers offer meaningful benefits when used mindfully and within recommended guidelines. Understanding the pros and cons of pacifiers allows clinicians, therapists, and caregivers to support families with balanced, evidence-informed guidance.

By sharing clear information—not judgment—we empower caregivers to make decisions that reflect their child’s developmental stage, safety needs, and emotional well-being.

References

1. Mitchell EA, Blair PS, L’Hoir MP. Should pacifiers be recommended to prevent sudden infant death syndrome? Pediatrics. 2006;117(5):1755–1758.
   https://publications.aap.org/pediatrics/article/117/5/1755/70893/Should-Pacifiers-Be-Recommended-to-Prevent-Sudden

2. American Academy of Family Physicians. Pacifiers: When to Use and When to Stop.
   https://www.aafp.org/pubs/afp/issues/2009/0415/p681.html

3. Barbosa C, Vasquez S, Parada MA, et al. Non-nutritive sucking habits and speech pathology in preschool children. Revista Chilena de Pediatría. 2009;80(1):41–47.
   https://www.scielo.cl/scielo.php?pid=S0370-41062009000100006&script=sci_arttext

4. Keim SA, Fletcher EN, Teeters A, McKenzie LB. Analysis of injuries associated with bottles, pacifiers, and sippy cups among young children. Pediatrics. 2012;129(6):1104–1110.
   https://publications.aap.org/pediatrics/article/129/6/1104/31187