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2023 Jun

Time to Ditch the Pacifier?

Tips for easing the transition for you and your toddler.

Your toddler is crying and asking for her pacifier. It would be so easy to hand over the passie. Should you give in to their demands or is it time to ditch the pacifier?

Pacifiers are a wonderful thing for infants and have many benefits. They allow the baby to self-comfort, decrease crying, and soothe the baby. They have been shown to decrease the risk of sudden infant death syndrome. The American Academy of Pediatrics (AAP) recommends their use for the first year because of these benefits. If they are so very helpful, when and why should they be discontinued?

Most infants will easily give up their pacifiers between 9 and 12 months. During that time parents will say, “They don’t really seem to need it, but I just give it to them for comfort or at bedtime.” If a child continues to utilize a pacifier past that time frame, it can become a habit.

Pacifiers can be a choking hazard. They should be firm and measure at least 1.5 inches across. Straps, cords, or attachments can pose a strangulation risk and should not be used.

Check your pacifiers regularly for any signs of wear that may pose a safety risk to your child. Do not use homemade pacifiers. Never dip a pacifier in honey, as honey is the one food that infants less than one year of age cannot have due to the risk of botulism. There were cases of infant botulism in Texas when infants were given honey-filled pacifiers.

Pacifiers can carry germs. They can spread oral yeast infections (oral thrush). This presents as a white patch on the sides of the cheeks or gums and needs to be treated by your pediatric healthcare provider. Passies should be regularly disinfected by boiling them for 15 minutes to sterilize them.

Pacifiers may serve as a risk factor for ear infections. The AAP suggests that discontinuing use between 6 and 12 months of age may decrease that risk. Some are concerned that pacifier use may cause or worsen speech delay, but there is not enough data to support this claim.

The American Academy of Pediatric Dentistry (AAPD) notes that pacifier use past one year of age leads to a higher incidence of a change in teeth shape (anterior open bite). This will likely improve unless the pacifier use is continued until after the age of 3 years. In order to prevent the changes in the bite, the AAPD recommended eliminating the pacifier use before the age of 18 months.

So how can you get that passie away from your child? Well, the earlier you start, the easier it will be. Some folks just go “cold turkey,” taking the passie away completely. If you decide to go with the “It’s lost” option, be sure to get all the pacifiers out of the house. I will be honest and say that I was once tempted to dig through the outside trash bin at 3 a.m. to find a pacifier so I could get some sleep.

Another choice is to gradually decrease the availability of the pacifier by first allowing it only at nap and bedtimes. Next you allow it only at bedtime. Next you allow it only every other night. Finally, you allow it only every third night, until they forget to ask for it.

Some parents prefer the “It’s broken” route by cutting the pacifier. It will certainly give it a flat tire, but a cut or broken pacifier is not safe to give to a child. This is not recommended as it will be a choking hazard and may have germs inside of it.

My favorite option is to use the “Passie Fairy” or “Binky Fairy.” This fairy, who is a cousin to the tooth fairy, will come and take all the passies from a basket and in their place, leave a new stuffed animal (that we will name whatever we used to call the pacifier). Whenever we take away one thing, we give another. If we take the bottle, we provide a cup. If we take the pacifier, we provide another comfort item.

It may help to read books such as Bye-Bye Binky and Little Bunny’s Pacifier Plan. These types of books help your child to understand that it is time to part with pacifier. You can begin with just talking about getting rid of the pacifier. You can explain, “It will soon be time to give up your passie. When the passie fairy comes, you will get a new toy that you can snuggle with for comfort.”

If you are not up to the binky battle quite yet, then at least keep the pacifier clean. Rinse it off when it hits the floor and wash it daily with soap and water. Routinely boil it to disinfect it. Remember that no one goes to school with their pacifier. This is just a stage, and this stage will pass. Helping your child ease this transition will benefit your child.

Melanie J. Wilhelm, DNP, CPNP

Dr. Melanie J. Wilhelm, DNP, CPNP, is a Doctor of Nursing Practice, and a Certified Pediatric Nurse Practitioner as well as core faculty member at Walden University. Her book, Raising Today’s Baby: Second Edition, is available on


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