Pacifiers and Sleep

Have you ever tried to get a straight answer when it comes to the pacifier? The sleep books dance around it, online information is so conflicting, and frankly there just isn’t a lot of research when it comes to the ifs, ands, or buts of pacifier use. Fortunately, Meg and Erin have thousands of hours of experience with this very issue and have created what has to be one of the most comprehensive blogs out there when it comes to the pacifier, babies, toddlers and sleep. If you find anything in this blog helpful and want to keep up with our daily tips, blog posts and product give aways please LIKE us on Facebook!

Now, about the paci….sucking is soothing. Not just the warm, snuggly breast feeding or bottle feeding sucking in someone’s arms, but non nutritive sucking on a pacifier too! It may also help reduce the risk of SIDS. As part of the American Academy of Pediatrics SIDS and sleep safety guidelines updated in 2011, pacifier recommendations expanded. As you make your personal journey with the pacifier and make informed decisions about its use, you should know that the AAP recommends using the pacifier when placing your baby down for sleep at all naps and night sleeps during the first year after breastfeeding has been established. Here’s the full link for your reference.

That statement has, quite literally, caused parents to lose sleep! Parents now feel guilt ridden if they don’t use a pacifier (or if their baby won’t take one) and yet in some cases find themselves being awakened 5, 10, even 20+ times a night to replace it if their baby is hooked, yet too young to find it on his own.

Of course, we recommend following the AAP guidelines on paci use, yet we know those recommendations aren’t always what families do. Some babies won’t take a pacifier. Some babies are in a bed-sharing breast-feeding dyad with their mother that doesn’t include pacifier use. Some babies love their pacifiers -too much – and their sleep -deprived parents aren’t able to take naps due to work demands or multi-aged children. Those parents may make the choice to STOP the pacifier before the age of one after weighing the risks of their own sleep deprivation while driving or performing their job tasks vs their baby’s individual risk factors for SIDS (of which the pacifier is just one small part)!

If you find yourself making an informed choice to stop using the pacifier due to extreme sleep deprivation, it’s typically best if you stop it sometime between 4 1/2-12 months. Here’s how it breaks down:

For babies under 4 1/2 months:

Keep the pacifier if she’ll take it! Even if you wanted to stop it at this young age, your options are very limited in terms of the type of sleep training you can do to help your baby learn to sleep and self soothe in a new way (without the pacifier). Your baby is very young and long bouts of crying or frustration are inappropriate. Don’t force it, but if the pacifier is soothing for your baby, please use it! For more information on newborns and sleep see our blogs on the four month regression , dream feeding, swaddling and common age by stage schedules. Safety note: never tie, clip, or attach the paci to your baby in the crib.

For babies between 4 ½ -7 months:

The Hardest Months: This is the age when sleep associations, such as sucking, are powerful and paci replacement wakings may be occurring as often as every nighttime sleep cycle (60-90 minutes) during the last half of the night. Your exhaustion is setting in because your baby is still too little to find and replace her pacifier on her own. But, she IS now old enough to start some first half of the night sleep training (using a method YOU feel good about) if needed.

Some parents stop the pacifier completely at this point because it’s just too tiring to keep replacing it so many times a night. You may choose to do sleep training in the first half of the night and/or rock , hold, or soothe your baby in another way as she gets used to the change. Expect several difficult nights.

Other parents opt to try a split night paci option (kind of like the split night swaddle) as a step on the path towards independent sleep. With a split night you would stop using the pacifier at bedtime and throughout the first half of the night, pairing any non-feeding wakings with a sleep training method that feels like a good fit for you and your baby. At this age your baby’s circadian rhythm is promoting deeper sleep in the first part of the night making it easier for your baby to learn this new skill. As you cross into the second half of your night, when sleep may still be maturing, sleep pressure is low, and lighter sleep dominates, you may find yourself using the paci and/or a feeding or two as a way to just survive the rest of the night until your baby gets just a little older and is ready for full night sleep training. You can end up with one LONG stretch of paci – free sleep, followed by the last irregular stretch of the night. It’s not perfect, but it’s a step in the direction of independence from the pacifier.

During this time, you may continue to use the pacifier during the day for naps! It’s actually important to keep your baby well rested during the day while you are working on nighttime changes so go ahead and keep using the paci during the day if it’s helpful for the daytime naps. Since babies are exceptionally good at compartmentalizing how they sleep during the day vs nights you can get away with this.