Choosing & Using a Safe Pacifier

DR. BILL'S BINKY ADVICE
In the early weeks, only the real nipple belongs in a baby's mouth. If you have a baby who really needs a pacifier, then use it, don't abuse it, and quickly try to lose it.

• Select a one-piece model that will not break into two pieces, allowing baby to choke on the bulb. Also, be sure it is dishwasher safe and easy to clean.
• Be sure the base of the pacifier has ventilation holes. Avoid large circular shields that may obstruct baby's nasal passages when baby draws in the pacifier during intense sucking.
• One size doesn't fit all. Choose a smaller, shorter, newborn-sized pacifier for the early months.
• Pacifiers come in a variety of nipple shapes. Some are symmetrically round, like a bottle nipple. Others are preshaped, supposedly to duplicate the elongated, flattened breast nipple during sucking. Preshaped nipples, however, may not always fit baby's mouth, especially if the pacifier turns during sucking or is inserted upside down. Some pacifier manufacturers claim orthodontic benefits, but these are questionable. Try various shapes and let baby's discerning mouth decide.
• Avoid attaching the pacifier to a string or ribbon around baby's neck or pinning the pacifier string onto baby's clothing. This is a setup for strangulation. "But it's always falling on the floor," you plead. Answer: Keep one hand on baby and the other hand on the pacifier. (Or pin the pacifier ring directly onto baby's clothing.) Perhaps babies are not meant to be left unattended with anything in their mouths. Good safety and good nurturing go together.
• Avoid making your own pacifier out of a cotton-stuffed bottle nipple. Baby may suck the cotton through the hole.
• Resist the temptation to sweeten the offering by dipping the pacifier in honey or syrup. If baby does not yet have teeth, he is too young for honey or syrup. If he has teeth, he is too old for the decay-producing sweets – and probably the pacifier, too. If he has to be enticed to suck by sweetening, he would probably benefit from some other form of comforting – having a change of scenery, going out in the fresh air, playing, cuddling with you, rocking to sleep, and being held more.