Pacifiers and Sleep

By Maggie Moore


A love/hate relationship best describes how I felt about my son’s pacifier when he was an infant. In moments of non-stop crying, it was such a blessing to give him his pacifier in exchange for a moment of peace. Inevitably the pacifier would fall out and he would wake up screaming. I would pop it back in, just to have it fall out again. He soon became completely dependent on me replacing the pacifier for him and I eventually found myself doing the “paci return” ALL. NIGHT. LONG.

When my husband and I made the decision to sleep train our son, we also decided to go cold turkey and ditch his pacifier in conjunction with his training. That was a good decision in our case, but that doesn’t mean it is the right choice for every family. If you and your little one are hooked on the pacifier AND you find yourself doing the “paci return” more often than not, don’t worry! I am here to teach you how to have a love/love relationship with your child’s paci!

The Benefits

The American Academy of Pediatrics (AAP) recommends pacifier usage in infants during sleep for the first year of life. Several studies have consistently showed there is a reduction in the risk of Sudden Infant Death Syndrome (SIDS) associated with pacifier usage, especially if used when putting an infant to sleep.

The “why” for this is there is “protective effect” with pacifier usage. When using a pacifier, infants may have an increased arousal responsiveness. The position of the tongue when using a pacifier reduces the risk of oropharyngeal obstruction. Additionally, it may encourage mouth breathing if the nasal obstruction should occur during sleep.

Ditching the pacifier

Some of the families I work with decide to get rid of the pacifier all together in conjunction with sleep training because many changes are about to be made to the child’s sleep schedule and environment any way. Additionally, many parents have concerns as to how long-term use of a pacifier will impact their children’s oral health down the road. However, a Nelson review indicated that pacifiers don’t have a negative oral health impact if they are discontinued between the ages of two and three.

Some families choose to limit the time when their little ones can have the pacifier so they don’t become dependent on throughout the day. They allow their baby or toddler to have it during sleep times to help with self-soothe, but that’s it. It should be noted that it is often easier to transition out of using a pacifier at a younger age (before 12 months), as listening to a toddler protest the losing of a pacifier can be more challenging than listening to the protests of a baby.

Whatever age you decide to ditch the pacifier, it can be both a blessing and a curse, as my son learned to suck his thumb when we got rid of the pacifier.

Avoiding the “Paci Return”

Pacifiers can be a life-saver, helping to soothe a crying baby or upset toddler. They can also be a massive disruption to sleep when they fall out, leaving parents to return the paci throughout the night.

So, how can we use the pacifier, but also avoid a total sleep dependency to it? There are a couple of ways to do this:

  1. Newborn pacifier removal:I talk a lot about having your newborn be drowsy but awake when putting them down to sleep. If they are using pacifier to go down, we can simply remove the pacifier from their mouth right before we put them in the crib. This allows them to still receive the sucking to self-soothe benefit, but also decreases their dependency on their paci to fall asleep.
  1. Teach them to replace the pacifier:If your little one is dependent upon you to replace their pacifier, work with them during the day to learn to pick up a pacifier and put it in their mouth. Clearly this is difficult to do with a young infant, but if we start working with them around four months of age it will help them learn this valuable skill!
  1. Sprinkle the pacifiers: Hopefully now your baby knows how to fall asleep without the pacifier because you remove it before they fall asleep, and you have begun working with them during the day teaching them how to replace the pacifier themselves. Next, we increase their chances of finding a pacifier that has fallen out by sprinkling five to six pacifiers around the crib. The more pacifiers there are, the easier it will be for baby to find one. Because we have been working with them, baby can now return the pacifier themselves! Win/win for both baby and parents!

Just a note of safety, the American Academy of Pediatrics recommends that babies be placed in their crib alone and on their back. This means that plush stuffed animals attached to pacifiers should not be used for sleeping, as they are a safety hazard.

My goal when working with families is for infants and toddlers to learn to fall asleep independently. Pacifiers, when used the correct way, can be a great aid to your little one’s sleep. The key to success is to make sure they are not dependent upon you to replace the pacifier.


Maggie Moore is the Founder and Head Sleeper at Moore Sleep. She is a certified pediatric sleep consultant through the Family Sleep Institute, which means her sole focus and objective is getting your baby on a healthy sleep schedule so the whole family can get the sleep they need.

Like many parents, Maggie and her husband struggled with getting their son on a healthy sleep schedule and he was unable to fall asleep independently. As a result, her family was losing precious sleep every night.

Maggie became a firm believer when, shortly after hiring a certified pediatric sleep consultant, her son began sleeping independently at bed and nap times. It was a turning point that resulted in not only restful nights, but waking up fully rested with the energy to face the day. Maggie knew right away she wanted to become a certified consultant herself so she could help other families struggling to get the sleep they need.

Maggie and her family reside in Southern Indiana (near Louisville, KY). She received her bachelors in Journalism and a second concentration in Communications & Culture from Indiana University in Bloomington, IN.


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