The Truth About Pacifiers: How to Use Them Without Disrupting Breastfeeding

Ashli Daley, RN, CPST, Lactation & Infant Sleep Expert

This blog was written in paid partnership with Dr. Brown's.

Pacifiers often spark lively debates among parents and caregivers. Are they helpful or harmful? Do they cause "nipple confusion"? How do they impact breastfeeding? As a lactation expert and registered nurse, I want to provide clarity on this topic while offering practical, evidence-informed advice for using pacifiers in a way that supports your baby's needs and your breastfeeding journey.

The Innate Need to Suck

Babies are born with an innate need to suck. This reflex begins developing in the womb, as early as 32 weeks of gestation, and serves dual purposes: nourishment and comfort. Sucking helps babies regulate their emotions, lower stress, decrease pain and even stabilize their blood pressure. It's no wonder that many newborns seem happiest with a nipple in the form of a breast, bottle or pacifier nearby.

However, how this sucking reflex is triggered might surprise you. Contrary to common belief, simply placing a nipple on a baby's tongue often leads to a tongue thrust reflex (pushing the object out). To encourage proper sucking, the nipple should gently touch the roof of the baby's mouth where the hard palate transitions to soft. This principle applies across breastfeeding, bottle-feeding and pacifier use.

Why Timing Matters With Pacifiers

In the early postpartum period, your newborn is programmed to nurse frequently. This constant feeding isn't just about filling their tiny tummy, it's also nature's way of stimulating your milk production. Breastfeeding operates on a supply–and demand system: the more your baby nurses or milk is removed, the more milk your body produces.

Offering a pacifier during these critical early days can inadvertently interfere with this system. If your baby spends time sucking on a pacifier instead of the breast, they may take less colostrum (the nutrient-packed first milk your body produces) and provide less stimulation to your milk supply. The result? Potential delays in milk coming in or challenges establishing a robust supply.

For this reason, I recommend waiting to introduce a pacifier until breastfeeding is well-established and your milk supply has regulated—typically around two to four weeks postpartum.

But What About "Nipple Confusion"?

You've likely heard the term "nipple confusion" tossed around when discussing pacifiers or bottles. Let me put your mind at ease: nipple confusion isn't really a thing. Babies are incredibly smart and adaptable. What's often mistaken for confusion is actually preference. If one feeding method consistently delivers milk more easily (like a bottle), your baby may favor that method.

This doesn't mean pacifiers or bottles are off-limits for breastfed babies. They're simply tools that need to be used thoughtfully.

When and How to Use a Pacifier

Once breastfeeding is well-established, pacifiers like the Dr. Brown's HappyPaci can be used effectively without disrupting breastfeeding. How to use them:

1. Offer a feed first
   Always meet your baby's hunger needs before offering a pacifier. A well-fed baby who still wants to suck is seeking comfort, not calories.
2. Start at calm moments
   Avoid introducing a pacifier when your baby is frantic or crying intensely. This can lead to frustration and difficulty latching onto the pacifier. Instead, try offering it when your baby is calm, such as after a full feed or during a wake window.
3. Use for comfort, not substitution
   Pacifiers can be especially helpful for soothing fussy babies or during moments when breastfeeding or holding isn’t feasible (e.g., in the car seat).
4. In special circumstances
   There may be times when pacifiers are necessary early on, such as if your baby is in the NICU or separated from you for medical reasons. In these cases, pacifiers can provide much-needed comfort, and their use is entirely appropriate.

The Benefits of Pacifier Use

Sucking—whether at the breast, bottle or pacifier—is deeply calming for babies. Research shows that it helps reduce stress, lower blood pressure and decrease pain. This is why many newborns naturally seek the comfort of sucking, even after a full feed.

If your baby has fed well and still seems to want to suck, offering a pacifier can be a helpful tool to satisfy their need for comfort.

Balancing Pacifier Use With Breastfeeding Goals

Parenting is filled with choices, and there's no one-size-fits-all answer when it comes to pacifiers. Some babies seamlessly transition between breast and pacifier, while others may show a preference. The key is to observe your baby's cues and adjust as needed.

Here are a few things to keep in mind:

• If pacifier use begins to interfere with breastfeeding—such as fewer nursing sessions or difficulty latching—it may be time to reassess.
• If pacifiers work well for your family and breastfeeding remains on track, there's no need to feel guilty about using them.

As with all things parenting, pacifiers are only a problem if they become a problem.

When to Say Goodbye

While pacifiers can be invaluable in the early months, there will come a time to phase them out. Most experts recommend beginning this process between six months and one year to avoid potential dental issues and sleep disruptions. This transition doesn't have to be abrupt or stressful. When the time comes, a gradual approach often works best.

The Bottom Line

Pacifiers are neither inherently good nor bad—they're simply a tool. When introduced at the right time and used thoughtfully, they can complement breastfeeding while providing comfort to your baby.

Remember, your feeding goals and family dynamics matter. Trust your instincts, observe your baby's cues and know that there's no single "right" way to navigate this journey.

Disclaimer: The information contained is for informational purposes only and is NOT intended to be a substitute for professional medical advice, diagnosis, or treatment. You should not rely solely on this information. Always seek the advice of your healthcare provider.

About the Author

Ashli is a Registered Nurse, lactation consultant, and baby sleep expert with over five years of NICU experience. Passionate about empowering parents, Ashli provides evidence-based, empathetic support to help families navigate the challenges of feeding, sleep, and newborn care. Her expertise combines medical knowledge with personalized care, ensuring every family feels confident and equipped to meet their unique parenting goals.