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Pacifiers and Nipple Confusion: What You Should Know

Closeup of face of baby girl with pacifier sleeping

As a breastfeeding mom, you want to give your baby the best start in life. While pacifiers can seem helpful for soothing, they can also present challenges to your breastfeeding goals and your baby’s overall health. Here’s what you need to know to avoid common pitfalls and keep your milk supply strong.

What is a Pacifier and How Does it Affect Breastfeeding?

A pacifier is a silicone or plastic-based device designed to mimic the act of sucking, but unlike breastfeeding, it doesn’t provide nourishment. When your baby uses a pacifier, it can lead to confusion between the artificial nipple and your breast. The rigid structure of a pacifier differs significantly from the flexible nature of your breast, which may result in altered sucking patterns and reduced breastfeeding frequency.

Babies may also feel full after sucking on a pacifier due to the release of hormones like cholecystokinin, which signal satisfaction without the necessary calories. This decreases their desire to nurse, ultimately affecting your milk supply.

Young woman nursing her baby on bed at home

Common Problems Pacifiers and Bottles Can Cause During Breastfeeding

1. Breastfeeding on Demand and Milk Supply

Breastfeeding on demand is essential for maintaining a healthy milk supply. Every time your baby nurses, hormonal signals are sent to your body, telling it to produce more milk. Pacifiers, however, can reduce the time your baby spends at the breast. Over time, this decrease in nursing can lead to a drop in milk production as the necessary hormonal signals become less frequent.

2. Slow Weight Gain in Babies

If your baby is spending more time with a pacifier and less time breastfeeding, they might not get enough milk to meet their nutritional needs. Babies sometimes don’t show clear hunger cues, and pacifiers can mask their need to feed. This can lead to slow weight gain or poor growth, as they miss out on essential calories during critical feeding times.

3. Reduced Communication Cues

Babies naturally communicate their needs through facial expressions, sounds, and body movements. Overusing a pacifier can interfere with your baby’s ability to send important hunger or comfort cues, making it harder for you to know when it’s time to nurse. By breastfeeding on demand, you stay in tune with your baby’s natural signals and promote better early communication development.

Sleeping Baby with open mouth

4. Increased Risk of Ear Infections

Frequent pacifier use has been linked to a higher risk of ear infections in babies. The sucking action can cause fluid buildup in the ear, leading to infections that can cause discomfort and even long-term issues if untreated.

5. Early Weaning and Breastfeeding Challenges

Pacifiers contribute to early weaning. Babies may become frustrated with breastfeeding after becoming used to the ease of sucking on an artificial nipple. This can lead to shorter nursing sessions, less frequent feeds, and ultimately, early cessation of breastfeeding.

6. Pacifiers, Tongue Position, and Open Mouth Breathing

Pacifiers keep the tongue in a lowered position, which can lead to open mouth breathing. Over time, this can cause dental issues, dry mouth, and even developmental challenges like poor sleep quality and jaw growth problems.


Making informed choices about pacifiers and your breastfeeding routine can help ensure a positive breastfeeding experience for both you and your baby. If you’re experiencing challenges or feeling unsure, reach out to me—Nadine Daivandy, a certified breastfeeding and lactation counselor. I offer personalized guidance to support your breastfeeding journey and help you navigate the complexities of feeding, so you can maintain a healthy and nurturing bond with your baby.

Let’s work together to ensure a thriving breastfeeding experience that benefits both you and your little one!


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