Best Pacifiers for Breastfed Babies

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The best pacifiers for breastfed babies are straight and symmetrical with a wide base. Ideally a pacifier should allow for the wavelike motion of the tongue to occur, which mimics tongue movement during breastfeeding.

With that said, no pacifier can actually imitate what it’s like to breastfeed! They can try and I do admit they are doing a better job of that lately! But breastfeeding is a very complex process and no piece of silicone will ever be quite the same as actual breastfeeding!

To skip ahead to see my favorite pacifiers for breastfed babies click here.

Should the Use of Pacifiers be Avoided for Breastfed Babies?

Absolutely not! Pacifiers can be a lifesaver for parents! For parents with particularly fussy babies, they can be a necessity!

The right pacifier can even support oral development as they can strengthen baby’s muscles and allow them to practice oral motor patterns needed for feeding.

The American Academy of Pediatrics (AAP) even recommends pacifiers because studies have shown they help to reduce the risk of sudden infant death syndrome (SIDS), particularly when used for sleep.

A meta-analysis of randomized controlled trials (the highest level of research!) completed by the Cochrane Review showed that the use of a pacifier did not cause early cessation of breastfeeding for full-term infants. This does not mean there are no risks associated with pacifier use (keep reading, we will cover this!), but when used mindfully, they do not harm the breastfeeding baby or mom.

Do Pacifiers Cause Nipple Confusion?

No! The term “nipple confusion” drives me a little nuts…The concern with pacifiers is not that they confuse babies. Babies are smart and they know that their binky is not feeding them. Sucking on a pacifier is not going to make your baby worse at breastfeeding.

Babies are capable of learning different oral motor patterns needed for the breast, the bottle, and a pacifier. They can even learn how to drink from a straw or open cup by 5-6 months of age!

However, if breastfeeding is your goal, I do agree that it is best to hold off for a few weeks if you can. Most professionals who are knowledgeable about breastfeeding will encourage you to prioritize breastfeeding over using bottles and pacifiers for the first few weeks. This is good advice and can help ensure a good latch at the breast.

The primary issue with pacifiers is that sometimes new parents are giving them when they should be offering a feeding! Especially during the early weeks, babies will often need and want to cluster feed. This helps to establish mom’s milk supply.

Babies also frequently go through growth spurts. So if your baby seems to want to feed endlessly, they may be growing! If you are giving a pacifier too much, they can miss out on necessary nutrition and growth and mom’s milk supply may take a hit.

With bottle feeding you can see how much baby is taking with each feed. But with breastfeeding, you don’t usually know. Your baby’s diapers and their feeding cues are your best indicators. Pacifying them too much and cause you to miss out on these cues.

In addition, although not very common, some babies will develop a preference for the firm material of bottles and pacifiers when used too often before breastfeeding is well established.

What Pacifier Shape is Best for a Breastfed Baby?

Pacifiers with a straight and symmetrical shape and a wide base are ideal for all babies, not just breastfeeding infants. Bottle-fed babies also benefit from this shape. This shape allows for cupping of the tongue which babies should do for successful breastfeeding and even bottle feeding.

Nipple shape matters with bottles too! Check out our article “The Best Bottles for Breastfed Babies” for bottle recommendations!

Avoid pacifiers that have a bulbous, flat, or slanted tip.

What else to look for in a pacifier other than shape?

• Be sure to pick a one-piece pacifier for safety purposes. If more than one piece, carefully inspect pacifier before each use to make sure it is adhered together completely.
• Find a pacifier that is a good fit for baby’s mouth (not too big or heavy, make sure it’s the right size!).
• Easy cleaning is a must, especially during the first 6 months when baby is the most vulnerable. If you can sanitize it in the dishwasher, that is a big plus!
• Avoid those cute little stuffed animals that are sometimes connected to pacifiers as these can be dangerous and can impact oral development.

What’s Wrong With an Orthodontic Pacifier?

Orthodontic pacifiers are flat and therefore promote a flat tongue posture. While the term “orthodontic” may sound appealing, don’t be fooled by this lingo. These pacifiers reduce the ability of the sides of the tongue to elevate and cup the nipple.

It’s common for babies with less than optimal tongue function to prefer an orthodontic shape or to only be able to keep this shape in their mouth. If your baby can’t keep a straight shaped pacifier in their mouth independently, you should be wondering why!

When to Start Offering a Pacifier

If you are breastfeeding, it is usually ideal to make sure mom’s milk supply and breastfeeding are well established before introducing a pacifier. Holding off a few weeks may be beneficial.

If you do want to use a pacifier, make sure you begin to offer one before 3-4 months of age. The sucking reflex begins to integrate after the newborn period, and it will be highly unlikely you will be able to get baby to take a pacifier after that.

Pacifiers can be helpful after baby is well fed but still has a strong sucking need. A pacifier may be particularly necessary if baby is separated from mom or if baby needs help to fall asleep, is fussy, or has gas or reflux/gastrointestinal discomfort. Non-nutritive sucking aids in digestion.

Sometimes moms just need a break and that’s okay too! If baby is thoroughly fed and mom needs to step away, that is also a valid reason to use a pacifier. Whether it’s to support mental health or to give cracked nipples a break from an overly vigorous baby, taking a break is okay!

If you do suffer from painful nipples, make sure you also work with an IBCLC to assess baby’s latch. Check out The Lactation Network to see if you qualify for a free evaluation.

When to Stop Using a Pacifier

While the American Academy of Pediatrics (AAP) recommends pacifiers for SIDS protection, they state that you should wean pacifiers by 2-4 years of age, but I think this is way too late.

The American Academy of Pediatric Dentists says that weaning by 6-12 months of age is ideal. I agree with this for a few reasons. Most importantly, as stated by the AAPD, when used beyond 18 months, pacifier use can affect the orofacial complex, including the jaw, palate, and teeth. There can also be an increase in otitis media (ear infections).

Another factor to consider is strong toddler opinions. The older a child is, the harder it will be to break the habit. Similar to prolonged bottle use, pacifiers are tough to ditch in toddlerhood. If they have been dependent on a pacifier for several years, it may be very difficult for older children to give it up.

The Best Pacifiers for Breastfed Babies According to a Feeding Specialist

There are so many different shapes when it comes to pacifiers, how can you decide which one is best?

Based on my experience as an occupational therapist, feeding and swallowing specialist, certified lactation educator, and mom of two tongue tied babies, here are my top choices!

Ninni Co Pacifier

In my opinion, the best choice currently out there when it comes to pacifiers, is the Ninni. The Ninni is made from medical-grade silicone and is easy to clean.

It encourages similar muscle activity that is required in breastfeeding. Babies need to use strong suction to keep this pacifier in their mouth. While babies can bottle feed by using a predominantly compression style pattern of feeding, the need for suction is one of the primary differences when it comes to breastfeeding. Using this pacifier is a way to help strengthen a baby’s suction.

The Ninni is made from material that is much more pliable than other pacifiers, which allows for greater tongue movement. You can visibly see the wavelike motion of the tongue when baby is using the Ninni which is a really cool feature.

The Ninni especially allows the tongue to elevate more than the average pacifier. Tongue elevation is often the most challenging movement for babies with tongue tie, so the Ninni is particularly beneficial for tongue tied babies and for babies who have had a tongue tie release.

While they are not cheap and can currently only be purchased directly from the company’s website, they do have frequent deals and free shipping to help cut costs.

For 10% off use my code: THRIVELITTLE10 at Ninnico.com.

Philips Avent Soothie Pacifier

The soothie is a great choice if you’re looking for the best pacifier easily found on Amazon or at Target or Walmart. It is a very affordable silicone pacifier that is probably the most widely used pacifier on the market. It is used in hospitals throughout the United States and in many family’s homes as well.

Philips even makes this pacifier in different sizes including an option for older babies, but I don’t recommend this one as it is quite heavy (as far as pacifiers go). And if you think about it, babies do not use larger breast or bottle nipples as they grow, so why would they need larger pacifiers?

Dr. Brown’s Happy Paci

While Dr. Brown’s may be known for their bottles, they also have a pretty great pacifier that is growing in popularity. It is the same shape as their bottle nipples (the narrow neck version), so if you are already using these bottles your baby may accept these pacifiers well.

Dr. Brown’s bottles are one of our top recommended bottles for breastfed babies due to their nipple shape, so their pacifiers are naturally recommended for breastfed babies as well!

These pacifiers come in a variety of colors and are very affordable!

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If breastfeeding is going well, the type of pacifier nipple shape you choose will unlikely significantly impact you or your baby. The most important thing is to use pacifiers mindfully. Use pacifiers minimally, primarily to aid with sleep and for intentional oral motor work. And remember to wean by 6-12 months!

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