Pacifier Use & SIDS Prevention
AAP recommends pacifier at all sleep times - reduces SIDS risk by ~50%. For breastfed babies: wait until 1 month to establish nursing first. Doesn't need reinserting if falls out during sleep. Never attach to clothing or around neck (strangulation risk). Can stop when baby rolls over (3-4 months). Benefits outweigh nipple confusion concerns.
What to Do
- Offer pacifier at every sleep time (naps and night) after 1 month if breastfeeding
- Choose one-piece pacifier (no parts that can break off and cause choking)
- Have multiple pacifiers available - keep extras in diaper bag and by crib
- If pacifier falls out during sleep, don't reinsert - baby doesn't need it to stay asleep
- Clean pacifiers daily with soap and water (dishwasher safe ones are easier)
- Replace pacifiers every 2-3 months or if damaged (tears, discoloration)
- Don't dip in honey, sugar, or other substances
- Never attach pacifier to crib, car seat, or around baby's neck
- For pacifier weaning (after 6-12 months): Gradually limit to sleep only, then remove
- Don't stress about pacifier use in first year - SIDS prevention benefits are significant