What should parents consider when selecting a pacifier?

Question

There are a wide variety of pacifier styles and many boast claims of being more like the breast or more natural. What criteria should parents use in selecting a pacifier? Should it be based solely on finding the one that a child will accept?

Answer 1

Safety is the most important criteria (though most pacifiers you can find for sale meet safety guidelines). Other than that, all pacifiers are equally good/bad for your child depending on how responsibly you use them. Let your baby choose his favorite!

Safety

Make sure the nipple cannot detatch from the pacifier

The shield (the plastic part) should have holes to prevent rashes and asphyxiation

Don't use a string to tie the pacifier to your baby

Orthodontic vs. Rounded

All types of pacifiers were shown to cause dental problems with prolonged use (beyond the age of 5). This quote is from DrGreen.com, a maker of orthodontic pacifiers:

Studies indicate that children who use orthodontic pacifiers have a smaller chance of developing an open bite or an overbite than those who use conventional round pacifiers. This difference is hard to demonstrate, though, because neither type tends to cause problems unless sucked intensely for years. It’s more important to choose a shape your baby enjoys.

Silicone vs. Rubber

Silicone is sturdier and harder to chew through, it is easier to clean (because of its texture), and it doesn't retain odors like rubber does.

Latex isn't as sturdy, so teething babies can chew through it, and many cleanings will wear it out. However, some babies prefer the softer texture and the fact it retains odors.

Answer 2

After extensive research trying to locate information on criteria for selecting pacifiers for use with my patients, I found the following from "Food Chaining: The Proven 6 Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child's Diet". This team of physician, speech language pathologists, dietician, lactation consultants, and oral feeding specialist present internationally and are considered leading specialist in their field. Here is a quote regarding pacifiers from their book.

When choosing a pacifier for your baby, look for one that is similar in shape to a bottle nipple. A long and narrow-shaped pacifier will encourage correct tongue placement, tongue grooving and cheek-muscle activation when your baby is sucking. A pacifier that is too short will not provide your baby with enough input to her tongue. Her tongue may actually get caught behind the nipple, which will result in poor sucking. A pacifier that is wide and flat will encourage your baby's tongue to flatten rather than groove and cup.

It appears that selection of a pacifier should consider your child's oral motor skills as well as oral motor developmental patterns. Children can develop good oral motor skills no matter the design of the pacifier, however, the pacifier can be a tool that supports or interferes with development of oral motor skills. This is especially important for premature, low tone children and ones with feeding difficulties early in life.

Since most children learn to eat and talk, we sometimes fail to recognize that the foundation of these skills is established in the earliest stage. Selection of nipples and pacifiers will establish oral motor patterns that can impact a child for many years and even throughout their life.