While perfecting his breastfeeding skills, a newborn should have nothing other than mother’s nipple in his mouth. Because babies suck on pacifiers as well as bottle nipples differently than on mother’s nipples, some newborns may develop nipple confusion when given a pacifier or bottle nipple at the same time they are learning to suck from mother’s breast. While it may seem that using bottles or a pacifier may give sore nipples a rest or comfort an insatiable sucker, it could cause more problems than it solves.

A pacifier has a narrow base, so baby doesn’t have to open his lips wide as he takes it into his mouth. When he applies what he has learned from the pacifier to the breast, the result can be poor latch-on techniques and sore nipples. Pacifier use can also cause you to inadvertently limit the amount of time at the breast, interfering with your milk supply. We advise you to avoid all artificial nipples, both bottles and pacifiers, until your newborn learns to latch-on efficiently and you have a good milk supply -- i.e., until at least four to six weeks postpartum. If your own nipples are wearing out (or the mom they are attached to is worn out), offer your baby a finger to suck, or better yet, get dad or someone else to give you a break. When your baby sucks on an adult finger for comfort, the skin-to-skin element is still there, and your index finger (or dad’s little finger) can be placed further back in baby’s mouth than a pacifier, simulating sucking at the breast. Many of our insatiable suckers have been soothed by sucking on Dr. Bill’s well-scrubbed pinky. Or try alternative methods of comforting your baby: walking, babywearing, patting her back, enjoying a warm fuzzy with dad. You want your baby to learn to seek comfort from people, not plastic.

Pacifiers are helpful for babies who have intense sucking needs and when the rubber sub is used in addition to, not as a substitute for, human nurturing. If baby is finished nursing but needs more sucking and won’t accept finger sucking, a pacifier may keep the peace.

To wean your toddler from the pacifier, try the trade-in technique. Take your child to his favorite toy store and "trade" the pacifier for a chosen toy (toystore clerks are used to this game). To help your child’s chapped lips, use an emollient that acts as a barrier cream to prevent chapped lips, such as an ultra-pure lanolin ointment, called Lansinoh, available at pharmacies and Walmart stores.

When possible, a person should always be at the other end of a comforting tool. Try not to fall into the habit of just plugging up the source of the cries. When baby cries, if you find yourself, by reflex, reaching for the pacifier instead of reaching for your baby, pull the plug. In a nutshell, if you have a baby who seems generally more comfortable with a pacifier, then use it, but don’t abuse it, and quickly try to lose it.