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When should you introduce a pacifier and a bottle?

Updated: Feb 23, 2023

One of the primary concerns that parents have after delivery and breastfeeding is when and if they should start using a pacifier.

They are also usually concerned that if they don't give a bottle early enough, their baby may not take it. Or what happens if they start a bottle and their baby prefers it over the breast?

Depending on who you ask, pacifiers are either a savior or the devil—as with all parenting topics, educating yourself about when and if you want to use one is essential.

We recommend waiting three weeks before introducing a pacifier to ensure breastfeeding is well established. Try feeding your baby or other soothing measures first if your baby is fussy. It is more challenging to see feeding cues and know when your baby is hungry when using a pacifier. There is also some evidence of higher rates of ear infections and oral thrush when using a pacifier.

The American Academy of Pediatrics suggests that there may be a lower rate of S.I.D.S. or S.U.I.D. When using a pacifier for nap or sleep time, but also recommends waiting until after breastfeeding is established at around 3-4 weeks.
a baby wearing red cloth trying to reach a pacifier

What other experts say:

Bottles/ when and how to give one

Bottles are also concerning for many parents. They have heard from friends and relatives that sometimes their baby would never take a bottle. That is plain terrifying for a new Mom to think that she'll never be able to be away from the baby (no matter how much we love that precious little one, we all need that "me time").

First of all, it's generally recommended that you wait 3-4 weeks after birth to ensure that breastfeeding is going well. And the majority of babies will have no problem going back to the breast after the bottle.

It depends on how you give the bottle. If it's going too fast (because of the baby's position or too fast flow on the nipple), the baby will get used to that and then expects that same speed at the breast, putting his little foot down when it doesn't happen. So if it's more of a flow issue, what can you do?

Paced Bottle Feeding

This is a method of feeding your baby that helps prevent the preference for a fast flow and difficulty going back and forth from the bottle to the breast.
-Have your baby sitting upright so that he isn't lying down
-Use the slowest flow nipple you can find. Most babies do fine with a size 1, which is a newborn
nipple. There is also the ability to get a size 0 with some bottle brands, considered a preemie
-Hold the bottle parallel to the floor, tilted just enough to fill the nipple with milk
-As the baby drinks, tip the bottle down or take it out to help him go more slowly if he is going too
-A typical bottle feeding should last about as long as breastfeeding, about 15-20 minutes (although
many babies nurse for longer than that at most feedings)

Here is a video showing how to pace bottle feed:

As with most breastfeeding concerns, it can be helpful to speak with a Lactation Consultant. Our Wellspring Lactation consultants are here to help, offering virtual and in-home consults to address any of your questions and concerns.

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