A comprehensive review of evidence and current recommendations related to pacifier usage

J Pediatr Nurs. 2012 Dec;27(6):690-9. doi: 10.1016/j.pedn.2012.01.004. Epub 2012 Feb 16.


Pacifier usage is controversial, and published recommendations are contradictory. The purposes of this literature review were to provide a comprehensive summary of risks and benefits of pacifier usage based upon the highest levels of evidence available and to provide a reference for nurses to utilize while assisting mothers in making an informed decision. Results indicated that benefits include reported ability to soothe/comfort, decreased risk of sudden infant death syndrome, and a probable synergistic role in adjunctive pain relief. Greatest risks are an increased incidence of acute otitis media, possible negative impact on breast-feeding, and dental malocclusion particularly if usage is greater than 2-3 years. The frequency, intensity, and duration of pacifier use are related to type and extent of all risks.

Publication types

  • Review

MeSH terms

  • Breast Feeding / statistics & numerical data
  • Evidence-Based Medicine
  • Female
  • Guidelines as Topic*
  • Humans
  • Infant
  • Infant Care / methods
  • Infant, Newborn
  • Language Development Disorders / etiology
  • Language Development Disorders / prevention & control
  • Male
  • Malocclusion / etiology
  • Malocclusion / prevention & control
  • Otitis Media / etiology
  • Otitis Media / prevention & control
  • Pacifiers / adverse effects*
  • Pacifiers / statistics & numerical data*
  • Prognosis
  • Quality Control
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Speech
  • Sudden Infant Death / etiology
  • Sudden Infant Death / prevention & control*