Best Preemie Pacifiers

There's a reason pacifiers are a universal symbol for babies: By offering something to suck on other than the breast or bottle, pacifiers can help soothe a fussy infant who isn't hungry, tired or in need of a clean diaper. And if your baby is born premature, pacifiers may still be a helpful tool, experts say.

"Pacifiers can help premature babies in a number of ways," says Anjuli Gans, M.D., a pediatrician at CHOP Karabots Pediatric Care Center. There are calming benefits, for one. "Premature babies in the NICU are often in a loud, busy environment," she notes. "Some research has shown that pacifiers help regulate their heart rate and oxygen levels, which can help buffer the stress of that environment."

Premature babies also often have to develop their sucking and swallowing reflexes, Dr. Gans adds, noting that pacifiers can help strengthen the muscles involved in this.

What’s more, pacifiers offered during sleep have also been linked to a lower risk of sudden infant death syndrome (SIDS).

Here’s what you need to know about choosing a pacifier for your little one, along with the best pacifiers for preemies.

How we chose the best pacifiers for preemies 

• We spoke to Dr. Grans and Daniel Ganjian, M.D., a pediatrician at Providence Saint John’s Health Center in Santa Monica, California, to learn about pacifier safety and what features to look for when shopping. Per their recommendations, as well as guidance from the American Academy of Pediatrics (AAP) and Consumer Product Safety Commission(CPSC), all pacifiers on this list:
  • Are molded from one solid piece of plastic
  • Measure at least 3.8 centimeters across to ensure they won’t be a choking hazard
  • Don’t come with any attachments, which could be dangerous
• We utilized reviews from What to Expect’s community of caregivers to learn which preemie-sized pacifiers parents felt were most comforting for their babies. Per their feedback, we made sure that every pacifier on the list satisfied the following criteria:
  • Available in a small enough size for a preemie baby to comfortably use
  • Easy to clean, e.g. dishwasher-safe
  • Made of safe, durable materials

Preemie pacifier features to consider

When shopping for preemie pacifiers, keep these features in mind:

• Nipple shape: Some pacifier brands have an orthodontic nipple, which is intended to better support baby's oral development. Other brands may have designed the nipple to look more like the “real thing” to feel natural in a breastfed baby's mouth. Many parents find that they need to experiment with a few different brands to learn which one their baby prefers. 
• Size: Not all pacifiers are the same, so start small. Look for pacifiers that are labeled for babies 0+ or 0 to 6 months, and keep an eye out for specific preemie sizing if the brand offers that. 
• Easy to clean: Look for pacifiers that can be sterilized easily. Dishwasher-friendly options, which you should be able to drop in the same cleaning rack you use to wash bottle parts, are especially convenient.

Do preemies need special pacifiers?

In short, it will depend on your baby. "Some may and some may not," Dr. Gans says. "Depending on a baby's size, oral anatomy — do they have a high arched palate or a tongue-tie? — or other medical conditions, they may do better with different shapes or sizes of pacifiers." If you’re unsure, ask your pediatrician what features your child might need.

Ultimately, though, you’re looking for a pacifier small enough for your preemie’s mouth, says Dr. Ganjian. When shopping, that means looking for a pacifier labeled 0+ or 0 to 6 months.

"As long as the pacifier is small enough and baby is comfortable, then go for it," Dr. Ganjian says. "Try a few different ones. They may hate one pacifier, but love another."

Can preemies sleep with a pacifier?

Yes, preemies can sleep with a pacifier (and in fact, offering one at nap- or bedtime may help lower SIDS risk) — but it’s critical to always follow safe sleep guidelines. 

Regardless of whether you’re offering a pacifier to a preemie or older baby, keep these safety tips from the AAP in mind:

• Keep pacifiers loose in the crib. Never attach a pacifier to your child’s hand or neck, to their crib or car seat, or to a lovey or stuffed animal. Pacifier clips and other such accessories that might attach to a pacifier (including ribbon, string, cord, chain, twine, leather or yarn) are incredibly dangerous.
• Look for one-piece pacifiers. Pacifiers molded from one piece of firm, solid plastic (as opposed to multiple small parts) are safest, according to the AAP. Pacifiers should also have ventilation holes.
• Check the measurements. According to the AAP, pacifiers should be at least 3.8 centimeters across to ensure they can’t fully fit into your child’s mouth.
• Never use the top and bottle nipple as a pacifier. They could come apart and pose a choking risk to your baby.
• Inspect your child’s pacifiers regularly. Make sure that the material isn’t deteriorating or torn, and if it is, replace ASAP.
• Keep size in mind. If your child continues to use a pacifier past the preemie stage (or even into the toddler stage), regularly replace them to ensure your little one is using an age-appropriate product.

When can I introduce a pacifier to a preemie?

If you’re nursing, you might choose to wait until breastfeeding has been established (usually around three or four weeks) before offering a pacifier, according to the AAP. If you’re bottle-feeding, you can introduce a pacifier any time you’d like.

Ready to shop? Look no further than these top picks.