Most babies spit out their pacifier because it’s the wrong shape, the wrong size, or they haven’t developed a strong enough suck reflex to hold it in place. The good news is that a few simple techniques can help your baby keep the binky in, and most of them take less than a minute to try.
Try the Gentle Tug Technique
This is the single most effective trick, and it works because of a built-in reflex. Once you place the pacifier in your baby’s mouth, give it a very soft, slow tug outward. Don’t pull it out. Just apply light backward pressure. Your newborn’s natural response is to suck harder to keep it in place, which strengthens their grip on the nipple and helps them learn to hold it on their own.
You can repeat this a few times per feeding or soothing session. The key is gentleness. If you pull too hard and the pacifier pops out, you’ve pulled too hard. Think of it as a tiny game of tug-of-war that your baby is supposed to win. Over days and weeks, this builds the oral muscle coordination babies need to keep the pacifier in without your help.
Find the Right Nipple Shape
Pacifiers come in three main nipple shapes, and babies can be surprisingly picky. If your baby keeps spitting out one type, switching shapes often solves the problem entirely.
- Orthodontic (anatomical): Rounded on top, flat on the bottom. The flat side rests against the tongue, encouraging a natural sucking motion. This is the most common shape sold in stores.
- Cherry (round): A cylindrical stem with a round bulb at the tip. This shape encourages the tongue to cup around the nipple similarly to how it cups a breast, making it a good option for breastfed babies who reject other shapes.
- Cylindrical: Shaped like a small hot dog, often wider at the base. This lets the lips rest in a slightly open position and promotes a different tongue placement that some babies prefer.
There’s no universally “best” shape. Buy one of each and see which your baby latches onto most naturally. You’ll usually know within a few tries. If your baby is breastfed, the cherry shape is worth trying first since it most closely mimics the breast.
Check the Size
Pacifiers are sold in age ranges, typically 0 to 6 months, 6 to 18 months, and 18 months and up. A pacifier that’s too large for your baby’s mouth won’t seal properly against the lips, and one that’s too small won’t give them enough to grip. If the shield (the flat part outside the mouth) seems to press uncomfortably against your baby’s nose and cheeks, or if the nipple barely reaches past the gums, you likely have the wrong size.
Replace Worn-Out Pacifiers
A pacifier that’s lost its shape won’t stay in your baby’s mouth the way a fresh one will. Both silicone and latex nipples should be replaced every four to six weeks, even if they look fine at a glance. Over time, the material swells, gets sticky, or loses its firmness, all of which make it harder for your baby to maintain suction.
Before each use, pull the nipple in all directions and look for changes in size, shape, surface texture, or any cracks. An enlarged or misshapen nipple is a clear sign it needs replacing immediately. Latex tends to degrade faster than silicone, but both wear out on a similar timeline with regular use.
Timing Matters for Breastfed Babies
If you’re breastfeeding, introducing the pacifier too early can make it harder for your baby to latch on both the breast and the binky. Clinical guidelines recommend waiting until about one month of age before offering a pacifier to a full-term, breastfed infant. This gives your baby enough time to establish a strong breastfeeding latch. After that point, a pacifier used for soothing is unlikely to cause nipple confusion.
What Not to Do at Sleep Time
It’s tempting to use a pacifier clip, a cord, or one of those small stuffed animals attached to a pacifier to keep the binky close to your baby’s face during sleep. But none of these belong in a crib with a sleeping baby. The CDC and AAP guidelines are clear: keep soft objects, loose items, and anything attached to cords out of the sleep area.
There’s also a specific concern with plush animal pacifiers. Research measuring the forces these toys exert on a baby’s mouth found that the weight of the attached stuffed animal transmits between 0.47 and 0.7 newtons of force to the nipple, compared to just 0.05 to 0.2 newtons for a pacifier alone. That extra force can exceed the threshold known to cause shifts in developing teeth and jaw alignment over time. These products are fine for supervised awake time, but they shouldn’t be used as a sleep hack.
If the pacifier falls out after your baby falls asleep, that’s normal and safe. You don’t need to reinsert it. The protective benefit against SIDS kicks in when the pacifier is offered at the start of sleep, not maintained through the entire night.
The SIDS Connection
One reason pediatricians encourage pacifier use at sleep time is its strong link to lower SIDS risk. A meta-analysis of case-control studies found that using a pacifier during the last sleep period reduced the odds of SIDS by about 70%. Researchers aren’t entirely sure why, but the effect is consistent across multiple studies. So while a binky that falls out at 2 a.m. might feel like a problem, offering it at bedtime is already doing its job.
When to Start Weaning Off
You don’t need to worry about dental effects in the first year or two. The critical threshold, according to the American Academy of Pediatric Dentistry, is age three. Children who stop using a pacifier before three have substantially lower rates of bite problems. Among children still using a pacifier past age three, 65% developed an anterior open bite (where the front teeth don’t meet when the mouth is closed), compared to about 19% of children who stopped before three. Posterior crossbite rates jumped from 22% to 36% past the three-year mark.
Children who continued pacifier use to age four saw even more dramatic effects, with some studies finding the risk of bite misalignment increased five- to fifteen-fold. The reassuring part: children who quit before three showed much lower rates of these problems, and many early changes in tooth alignment self-correct after the pacifier is gone. So for now, focus on helping your baby keep the binky in. You have years before weaning needs to be on your radar.