Pacifiers and Teethers by Age: A Safety Guide (2026)

Pacifiers and Teethers by Age: What to Use, When, and What the FDA Warns Against

This is an age-by-age safety guide. To compare every pacifier and teether we recommend, see our Pacifiers & Teethers page.

A pacifier's rules change as your baby grows: when to start, how to use it at sleep, when to size up and when to stop. Teething adds its own list of things the FDA says never to use. Here is the short version:

Rare among sleep tools: offering a pacifier at nap time and bedtime is something the American Academy of Pediatrics actively recommends, because it's linked to a lower risk of SIDS.

Birth to about 4 weeks: wait for breastfeeding, then offer

If you're breastfeeding, the AAP's advice is to wait until breastfeeding is well established before offering a pacifier, which usually takes about 3 to 4 weeks. Established means feeding feels comfortable, your baby latches well, and weight gain is on track. Formula-fed babies can have one from the start.

Never use a pacifier to delay a feed. Offer it only when you're sure your baby isn't hungry. And there's no need to force it: many babies simply don't want one.

Good first pacifiers:

• Philips Avent Soothie → (~$12). One molded piece of silicone with no seams or joints, the construction the AAP calls particularly safe. It's the hospital-familiar shape many parents are sent home with, so it's the obvious first try.
• Nanobebe Pacifier → (~$6). A lightweight, curved newborn pacifier (0 to 3 months) with an orthodontic nipple. The cheapest reliable pick.
• Bibs Pacifier, natural rubber → (~$16 for two). A round "cherry" nipple in soft natural rubber on a vented shield, and the pacifier parents on r/beyondthebump most often mention for breastfed babies who refuse stiffer silicone. It's two parts, a rubber nipple on a plastic shield, and rubber wears faster than silicone, so inspect it before every use.

1 to 6 months: the pacifier and sleep

This is the pacifier's main job. The AAP recommends offering it at nap time and bedtime, and it's also clear on the limits:

• If it falls out after your baby is asleep, you don't need to put it back.
• Never hang a pacifier around your baby's neck or attach it to clothing during sleep.
• Never tie a pacifier to the crib, or to your child's neck or hand. HealthyChildren.org calls this very dangerous. Pacifier clips are for awake, supervised time only.

What a safe pacifier looks like, per HealthyChildren.org:

• It can't come apart. Pacifiers molded from one solid piece are particularly safe.
• The shield is at least 1½ inches across, so the whole pacifier can't go into the mouth, and it's made of firm plastic with ventilation holes.
• It's dishwasher-safe for easy cleaning.
• It isn't a bottle nipple. Don't use a bottle nipple as a pacifier, because hard sucking can pull it loose and cause choking.
• You inspect it. Pacifiers deteriorate. Replace one that is discolored or torn, and don't keep them past any date on the package.

About 4 to 7 months: teething starts

The FDA notes that babies usually begin teething around 4 to 7 months. This is where the most dangerous products turn up, so the FDA's list comes first.

What the FDA says not to use:

• Teething jewelry. The FDA has received reports of deaths and serious injuries, including strangulation and choking, from amber teething necklaces, bracelets and other teething jewelry.
• Benzocaine or lidocaine gels and liquids. The FDA warns these can cause methemoglobinemia, a serious and sometimes fatal condition. It says over-the-counter benzocaine products should not be used for children younger than 2, and the American Dental Association says numbing gels should not be used in children under 3.
• Homeopathic teething tablets. The FDA includes these in the teething products that can be dangerous.

What the FDA and AAP suggest instead: gently rub your baby's gums with a clean finger, or give a teething ring made of firm rubber. Keep it cold from the fridge, not frozen, because a frozen ring can be hard enough to hurt the gums. Skip liquid-filled teethers.

Two teethers that fit those rules:

• Sophie la girafe So'Pure Circle Teether → (~$20). The same natural rubber as the classic giraffe, in a solid ring with textured surfaces that reach the back gums. It has no squeaker hole, so water doesn't get trapped inside when you wash it, which is the classic Sophie's weak spot. On Amazon it was sold by a third-party seller at about $22.50 when we checked on October 21, 2026, above typical US retail, so compare prices first.
• Itzy Ritzy Silicone Teether → (~$9). Solid silicone rings with different textures, and nothing liquid inside to leak.

Our baby teething chart shows which teeth usually arrive when, and best teethers and teething remedies compares more options.

Around 6 months and up: size up on time

Pacifiers are sized by age for a reason. HealthyChildren.org warns that older children can sometimes fit an entire newborn pacifier in their mouth and choke, so follow the age range on the package. Around 6 months is the usual step up from a 0-to-6-month size.

• MAM Perfect, 6 to 16 months → (~$14 for two). An extra-thin orthodontic nipple sized for older babies, and a good next step once the newborn size looks small.

If your baby loves a newborn pacifier, check whether the same brand makes the next size up before switching shapes.

12 to 36 months: taper, then stop

The American Academy of Pediatric Dentistry advises stopping pacifier use by 36 months. Its policy explains why earlier is easier: using a pacifier after 12 months can raise the risk of ear infections, and after about 18 months it can start to affect how the teeth and jaw develop.

Most families taper to sleep times only, then drop the pacifier altogether. Our guide on how to wean off the pacifier has the methods that work.

Frequently asked questions

Do pacifiers cause nipple confusion?

For most full-term babies the evidence is weak. The AAP's approach avoids the question: establish breastfeeding first, then offer a pacifier at sleep times.

How often should I replace a pacifier?

There's no fixed schedule. Inspect it every time you clean it, and replace it at the first crack, tear or color change, or when your baby outgrows the age range. Natural rubber (Bibs, Sophie) wears faster than silicone.

Are water- or gel-filled teethers safe?

Skip them. The FDA's advice is a firm rubber teething ring rather than a liquid-filled one, and a liquid-filled teether can split and leak.

Should I put a pacifier on a clip?

Only while your baby is awake and supervised. At sleep, the AAP says nothing should hang around the neck or attach to clothing.

What actually helps teething pain?

A clean finger rubbed on the gums, or a chilled (not frozen) firm rubber or silicone teether. If your baby seems very uncomfortable, talk to your pediatrician before using any medicine.