Suckling on a pacifier can help calm and soothe a fussy baby, help them fall asleep and stay asleep, and even reduce the risk of sudden infant death syndrome (SIDS) (see the research here).
But pacifiers are also a bit controversial. Some parents want to avoid getting their baby too dependent on a pacifier, think that it might interfere with breast-feeding, or that it might cause dental problems or increase the rate of ear infections. At the bottom of this article, we go into depth on the pros and cons of pacifier use, including which pacifiers to use at what time, and how to transition away from a pacifier. These aren't opinions, it's all based on published research.
As a preview, there are only benefits to pacifier use in the first 6 months of life, and then there are slight risks as your baby gets older. In the meantime, let's get into our reviews of the best pacifiers of the year!
We begin with a table of our results, starting with newborn pacifiers and then continuing with orthodontic pacifiers that are typical for use in babies over 6-12 months old.
|Model and Link to Amazon||Our Rating|
|#1. Newborn: Philips AVENT|
|#2. Newborn: Dr. Brown's|
|#3. Newborn: Smilo Ortho|
|Model and Link to Amazon||Our Rating|
|#1. 6+ Months: MAM Ortho|
|#2. 6+ Months: NUK Ortho|
|#3. 6+ Months: Smilo Ortho|
Here are the Best Pacifiers of 2019!
You've probably seen these before and you might even have some, because they are the #1 pacifier distributed by hospitals across the country. That's not only because Philips has struck an amazing deal with hospitals, but also because they are a widely trusted pacifier for safety, effectiveness, acceptance, and low risk of nipple confusion. For safety, they are BPA-free, latex-free, have air holes around their shield, are durable and one-pieced, and are way too big for a baby to fit into its mouth! For functionality, they have a great shape that closely resembles a nipple so that they have high rates of acceptance and low rates of nipple confusion. They use a tab design for parents to grab and pull in or out, and do not have a ring to prevent newborns from accidentally pulling it out of their mouths. It's basically the same design as the slightly less popular First Years Gumdrop pacifier. They can be steamed, boiled, or dishwashed for sterilization, and the back of the nipple is completely hollow so water will never get trapped inside of the pacifier's nipple. The nipple is small enough to fit newborn's little mouths, the shield isn't large enough to bump up against the nose of *most* babies, and they adhere to the pacifier guidelines of the American Academy of Pediatrics. Oh, and they're only like 2 bucks a piece and come in pink, purple, blue, green, or yellow. What's not to love!? Well, they're not the cutest pacifiers, and as your baby gets a little more tongue control they will be able to easily pop it out of their mouths. So overall, this is an excellent first pacifier for newborn babies between about 0-6 months of age, though many babies will transition to an orthodontic pacifier around 4-6 months. Interested? You can check out the Philips AVENT Soothie Pacifiers here.
A close second-place behind the Philips AVENT Soothie, this is a fantastic pacifier that has some awesome features. This pacifier basically takes all that we love about the Philips and improves it with a butter-fly shaped shield that won't bump up against little baby noses, and definitely looks cuter than the big circle. It uses the same little venting holes, is BPA-free and latex-free, and is made of 100% silicone. Just like the Philips, it's easy to dishwash, steam, or boil, and has a hollow nipple that won't trap water inside. The nipple itself is exactly like the Philips nipple, so it's a great little size for newborns and is shaped much like mom's nipples. A big difference between the two options is that the HappyPaci uses a non-orthodontic nipple that's actually shaped just like the nipple used on Dr. Brown's baby bottles (one of our top rated baby bottles!). That means if you're bottle-feeding your baby, this is a great pacifier for combining with those bottles. Another big difference is that these pacifiers use a loop gripper that is super convenient for parents and can easily clip onto a diaper bag or anywhere else. They're about $2 each just like the Philips. The only down-fall of that loop is that babies can accidentally (randomly) swing their hands up and pull it out of their mouth. That's rare, but will become more intentional and common as baby gets a bit older. So this is a great alternative to the Philips AVENT, offering a non-orthodontic pacifier that is a little cuter and more functional, but that loop might cause some accidental removals. Interested? You can check out the Dr. Brown's HappyPaci Pacifiers here.
Here is a new take on the silicone newborn pacifier from Smilo, a new company making some waves in the baby feeding industry! And they've made an awesome newborn pacifier that is made of 100% hospital-grade silicone and is not only adorable but also super functional. In our testing, we found to be right in between a non-orthodontic newborn pacifier (like the Philips or Dr Brown's) and an extreme orthodontic pacifier like the ones we review below. In other words, it offers a relatively subtle orthodontic shape that is a bit more natural-looking (and feeling!) than typical orthodontic pacifiers. But it still does the job in an orthodontic sense, reducing the rate of dental misalignment and cross-bite development. The pacifier was designed by a pediatric dentist and uses an innovative patented nipple design that prevents the nipple from collapsing in your baby's mouth. The outer handle loop is comfy and we like the downward positioning. They are hollow from the back, just like the Philips and Dr Brown's, which means that you can dishwash and boil them without having to worry about water getting trapped inside the nipple. When we received these pacifiers, we were also impressed by the packaging, they are the perfect pacifier to give as a baby shower gift since they come in a really nice box. You can get these pacifiers direct through Smilo's website for about $3 each. They are also available on Amazon. The only downfall is the big loop that sticks up from the pacifier, which is a bit more a target for baby's swinging hands than the little tab on the Philips pacifiers. Interested? You can check out the Smilo Newborn Orthodontic Pacifiers here.
Best for 6+ Months:
Now let's move on to pacifiers for babies over 6 months old. This is when there is some small increased risk of ear infections with pacifier use, and there begins to be the risk of teeth misalignment due to excessive pacifier use. So for this stage, we suggest shifting to an orthodontic pacifier. The good news is that there are several fantastic orthodontic pacifier options on the market!
The MAM orthodontic pacifiers are one of the most popular overall orthodontic pacifiers on the market, and for good reason. Their new sensitive skin pacifiers are really excellent. The sensitive skin aspect keeps moisture from building up between the shield and the cheeks, to lower the risk of irritation and rash. It does this by opening up the shield entirely instead of having a few holes in it. In our testing, this design is very effective at reducing irritation in babies with sensitive skin, and all of our test babies loved these pacifiers. This wasn't especially surprising given a recent study showing a 94% acceptance rate of these pacifiers among babies. That's huge, and matches our experience. These are an orthodontic pacifier, which means that the nipple shape is designed to conform to your baby's mouth instead of pushing up against their upper and lower gums. The nipple also has an anti-slip "SkinSoft" surface to make it more comfortable in the mouth (more like skin) and make it less likely to pop out of the mouth unintentionally. The silicone is super soft, BPA-free, and is odorless and tasteless, even before boiling it. We loved these pacifiers and found them durable and reliable after several washes and boilings, and hours of suckling! Some other things we liked were how there is no up-side or down-side, so there's no risk of putting the pacifier in upside-down which is a risk with many other orthodontic pacifiers. We also liked the sterilizer case they come in: simply put some water in it and pop it in the microwave for 3 minutes - and voila, you have a sterile pacifier! Interested? You can check out the MAM Orthodontic Pacifiers here.
NUK and MAM make some of the best baby bottles on the market, and they are very competitive in the pacifier space as well. These NUK pacifiers have an interesting design for sensitive skin - rather than removing the majority of the shield, they left the shield but put grooves on the inside extending from the holes downward, so air can travel in and move along the cheeks. It's an innovative design that seems to help reduce irritation and rashes. There are a few differences between these and the MAM. First, the orthodontic silicone nipple is directional, meaning that there is a right-side-up for the pacifier. Second, the nipple is really awesome - it has channels on the top for up against the palate (roof of the mouth), and a contoured design that allows the tongue to move along the bottom of the nipple very nicely (they call this a "scooped" nipple cavity). The nipple is shaped just like the popular NUK bottles, which means that there's less likelihood for confusion or rejection when switching between the pacifier and bottle. The shape of the shield is a bit heart-shaped, which helps parents realize which side is up and which is down, but also is comfy against the lips and cheeks. They are really great pacifiers, and are also pretty cheap - usually under $2 each. There are only minor down-falls relative to the MAM. First, they are directional, which means that your baby might pull it out and put it back in upside-down, defeating the purpose of the orthodontic nipple. We forgive them for that, given how great the orthodontic shape is. Second, it doesn't come with a sterilizing container like the MAM (check out our full list of the best baby bottle and pacifier sterilizers of the year!), and the shields aren't as good at preventing irritation around the mouth. We're being picky here! Interested? You can check out the NUK Orthodontic Pacifiers here.
This is another awesome Smilo product. To be fair, we're a bit biased towards Smilo because they're local here in Massachusetts, and they're a small business and value every single customer. That and they make very high quality products, and these orthodontic pacifiers are no exception. Designed for babies from about 3-9 months old (they also have a 9+ month version), this is a symmetrical pacifier meaning that there is no right-side-up or down, similar to the NUK. Also, in our testing it did a great job preventing irritation and rashes, likely due to its semi-open shield that gives nice airflow without being too open and causing a "ring around the cheeks" look that sometimes occurs with the NUK. Just like with their newborn pacifier, Smilo uses a patented nipple design that's meant to prevent cross-bite, keep the nipple from collapsing (using little ridges), and reduce the risk of misaligned teeth with prolonged use. In our testing, all of our babies accepted this pacifier nipple, and we were confident in its BPA-free manufacturing and one-piece design. Just for fun we also tried it ourselves and thought that the subtle ridges gave nice sensory feedback against the tongue and roof of mouth. Also helped it stay in the mouth without accidentally popping out. We dishwashed, boiled, and steam sterilized and never had any issues with water getting inside the nipple, though we do note that some parent reviewers point out the possibility of that issue. So we're pretty positive on these pacifiers for several reasons, and we'll report back to let you know how they stand the test of time. Interested? You can check out the Smilo Orthodontic Pacifiers here.
Are Pacifiers Bad for My Baby?
Most of the concerns about pacifier use aren't based on facts. First, for healthy babies that are born at term (not prematurely) there is no relationship between pacifier use and breast-feeding (see the research here), so there is no evidence that it will reduce breast-feeding in otherwise healthy babies. Second, while some parents are concerned about the slight increase in ear infection risk, the Mayo Clinic states that lowering the risk of SIDS is much more important than a very small increase in the rate of ear infections that occurs in babies older than 6 months.
We do know, however, that prolonged use of pacifiers beyond 18-24 months, especially non-orthodontic pacifiers, can cause some misalignment of the teeth (see the research here).
Should I use a Pacifier?
That's really your call as a parent. If you want the benefits of a pacifier but are worried about over-dependence or anything else, then here's what we suggest. First, you don't need to worry about negative impacts of pacifier use from 0-6 months of age. According to the research, there are only benefits of pacifier use at this age. From 6 to 12 months, there is a slight increase in the risk of ear infections, and after 18 months there is a risk of misaligned teeth. If you choose to use a pacifier, here's our advice:
From 0-6 months: Our advice is to begin with a newborn pacifier that best resembles the shape and feel of mom's nipple. We list those pacifiers first in our list. If you are only bottle-feeding, then we suggest using a pacifier shape that matches your baby bottles. The Dr. Brown's bottles and pacifiers are a great example of that. Getting a pacifier that closely matches the shape of your primary feeding method (nipple or bottle) will reduce any difficulty switching between a pacifier and feeding. If you're breast pumping and bottle-feeding, this also applies to you!
From 6-12 months: This is the time frame when there is a slight increase in the risk of ear infections with pacifier use. If possible, this would be a good time to transition away from the pacifier, if that suits your baby and your lifestyle. If not, this time frame is when we suggest switching to an orthodontic pacifier.
From 12-36 months: If your toddler is still clinging to their pacifier and you're going to let them continue, we suggest trying to limit access and using only an orthodontic pacifier. With our babies, during the second year we transitioned away from a pacifier to something else baby could chew and suck on while relaxing or falling asleep. We used the Mombella Ellie Elephant Teether, which was an amazing little tool for transitioning away from the pacifier.