breastfeeding & feeding

Pacifiers & Breastfeeding – The MAM-Expert Opinion

With Gabriele Stenz, Midwifery Teacher

Most babies love sucking on a pacifier between feeding times. MAM-expert Gabriele Stenz explains how to use the pacifier correctly in order to establish a good breastfeeding relationship at the same time. She trains midwives and has gained extensive experience with pregnant women and nursing mothers over the course of many years.

Meeting for the first time

Right after birth, babies want one thing above all else: to get to know their parents. All the baby's senses are focused on smelling, feeling, and hearing them. After just a short time, the newborn is ready to feed for the first time: it seeks out the breast and begins to suck. However, a little more practice is needed before breastfeeding works perfectly. But with a little time and patience, mother and baby will soon be a well-rehearsed team, says Gabriele Stenz, reassuringly. A pacifier can have a therapeutic effect on premature babies and is therefore helpful in certain cases.

The beginning of a good breastfeeding relationship

The breastfeeding expert recommends: "For the first two to four weeks after birth, all sucking attempts by the baby are considered feeding."

After that, feeding becomes routine: the baby has mastered the technique and the parents can often tell when it is signaling hunger. The occasional use of a pacifier in an already established breastfeeding relationship without breastfeeding problems (sore nipples, blocked milk ducts, mastitis, etc.) does not seem to have a negative effect on breastfeeding. However, if breastfeeding problems already exist, the pacifier can make the situation worse. 

"More often than feeding, relaxation and security are the reasons behind a child suckling."
(Gabriele Stenz, midwifery teacher)

Satisfying the strong urge to suck – even with a pacifier

A pacifier is the ideal aid to satisfy the non-nutritional urge to suck. Babies are experts at sucking: most babies can quickly distinguish between sucking on a pacifier and sucking in order to feed, says the MAM expert. And they like both – each has its place. International recommendations are provided by the American Academy of Pediatrics (AAP) in its Policy Statement on Breastfeeding (2012): they are to use pacifiers specifically and with a therapeutic background, and to offer the pacifier to aid in sleep once breastfeeding is successfully established.

Research has shown that pacifiers and breastfeeding are compatible.

In a large-scale study, Dr. Alejandro G. Jenik, head of Neonatology at the Hospital Italiano in Buenos Aires (AR), and his team of researchers were able to show that pacifiers and breastfeeding work well together. The study involved over 1,000 mother and baby pairs at five different hospitals. The findings are clear: as soon as breastfeeding is established, the pacifier does not interfere with it. The researchers therefore recommend the use of a pacifier, because it can protect against sudden infant death syndrome. The pacifier has a protective effect against SIDS – however, this seems to be especially true for non-breastfed children. Furthermore, the protective effect only applies to use when falling asleep, not to use throughout the day.

sleeping baby with pacifier

Important: Anatomically-correct pacifiers

A baby sucks on everything that comes along – from its thumb to a cloth diaper. But the pacifier offers the best unadulterated sucking pleasure: high-quality pacifiers are anatomically correct in shape. They ensure that the jaw, teeth, and palate can develop in a healthy way. Pacifiers are there when you need them. And they are gone again when their use needs to be restricted. The thumb always remains within reach – often right up to school age. Good pacifiers are also quality-tested and BPA and BPS-free. An advantage for the nursing mother is that fathers, grandparents, or babysitters can also calm the infant with a pacifier.

The correct use of a pacifier

Experience shows that most babies greatly appreciate sucking on a pacifier between feeding times. It does not interfere with already established breastfeeding if the mother is able to distinguish between the hunger signals and sucking simply for soothing. A tip from Gabriele Stenz: "It is important that the pacifier is used purposefully: a pacifier should not be offered constantly, nor should it be given to children to extend the time before breastfeeding."

A pacifier is a helpful aid in the following situations:

  • When circumstances make the child restless or cranky, a pacifier has a calming effect.
  • Tired babies find it easier to go to sleep with a pacifier (self-regulation).
  • Sucking can be soothing during teething.
  • Pacifiers can help parents to comfort their baby.

The perfect pacifier size

Pacifiers are available in different sizes, because there are big differences between tiny newborns and larger toddlers. The mouth and jaw are developing rapidly, and the pacifier needs to grow with your baby: the right-sized pacifier helps to support healthy development. 

And another important tip from the MAM expert: "Age information provided on the packaging is for guidance only, as every child is unique. Big, strong babies go up to the next pacifier size earlier than small, delicate infants. In case of doubt, it is better to offer one that is a bit too small than one that is much too big." 

Gabriele Stenz, portrait

MAM Expert

Gabriele Stenz, Midwifery Teacher 

Verden (DE)


Jenik, Alejandro (2009): Does the Recommendation to Use a Pacifier Influence the Prevalence of Breastfeeding? The Journal of Pediatrics.