Pros and Cons of Pacifiers

see larger photo

The pacifier—that time-honored baby accessory—is back in the news, being reexamined in light of a review of studies showing a relationship between pacifier use and a significantly reduced risk of sudden infant death syndrome, commonly known as SIDS. In fact, new American Academy of Pediatrics (AAP) guidelines state that pacifier use should actually be encouraged in children younger than one year of age. Here are some pros and cons of pacifiers.

According to review author Dr. Fern Hauck, MD, an associate professor of family medicine and public health sciences at the University of Virginia Health System in Charlottesville, Virginia, the benefits of pacifiers outweigh the risks. "We're not telling people they have to use a pacifier, but we want them to have the information to know that it is potentially protective, [so] they can make an informed choice whether to offer one," she says.

The Pros

"We're seeing a consistent protective effect from SIDS from use of a pacifier," says Dr. Hauck, stating that pacifier use offered a 61-percent reduction in risk of SIDS—clearly a lifesaving benefit, although experts aren't sure exactly how pacifiers lower risk. "There are several theories that have been proposed. None have been proven, of course, and also we still don't know the exact cause of SIDS."

"A leading theory is that the pacifier actually helps improve the arousability of infants who are potentially faced with a life-threatening challenge," says Dr. Hauck. "There are other theories that say that it might have a more direct mechanical effect." For example, the pacifier may actually help keep the oral airway open by pushing the tongue forward.

In addition, pacifiers make a baby feel good, says Dr. Cathryn Tobin, MD, pediatrician and author of The Lull-A-Baby Sleep Plan. Sucking stimulates the release of chemicals from the brain that actually decrease stress.

Of course, babies can self-soothe with their fingers or thumb as well, and both can become a habit—a habit that may damage teeth if allowed to continue when permanent teeth come in. But while it's not always easy to break a pacifier habit, it's a whole lot easier than breaking a thumb-sucking one, notes Dr. Hauck.

Before having her twin sons, Karen Spring had heard a lot of negative talk about pacifiers, but after deciding to use them to help her boys settle, she was pleasantly surprised. "One son used a pacifier for a couple of weeks, and the other used one for about three or four months," says Spring, of Deptford, New Jersey. "I had no problems whatsoever and would definitely use a pacifier again if I had another child."