Few baby sleep objects attract quite as much judgement as the dummy.
Some parents are warned never to introduce one because it will interfere with breastfeeding. Others are told they should introduce one because it reduces the risk of SIDS. Then, once the baby likes it, somebody will inevitably warn them that they now need to get rid of it before it ruins their child’s teeth.
Meanwhile, some babies reject every dummy offered to them and calmly use their own thumb instead, which has the inconvenient feature of being permanently attached.
So rather than deciding that dummies are either good or bad, I think it is much more useful to look at what sucking does for babies, what we actually know about the benefits and risks, and whether it is causing a problem for your particular child.
Why does sucking help babies settle?
Sucking is not simply about getting milk.
Babies suck for feeding, but they also use sucking for comfort and regulation. You may see a baby continue sucking gently at the breast after active milk transfer has slowed, suck their fingers or hands, or settle rapidly when offered a dummy.
This is one reason feeding and sleep are so closely connected in early infancy. Sucking can be part of the transition into sleep, whether that happens at the breast, with a bottle, with a dummy or with the baby’s own fingers.
Calling all of this a “bad sleep association” misses what the behaviour is actually doing.
Does my baby need a dummy?
No.
Some babies love them. Some are completely uninterested. Others accept one from another caregiver but refuse it from you because they are perfectly aware that you possess the original version.
There is no developmental requirement to teach a baby to take a dummy.
If your baby settles well without one, there is no reason to introduce it simply because it appears on a list of things babies should supposedly use for sleep.
If it helps, however, there can be perfectly reasonable reasons to use one.
What about SIDS?
This is one of the more interesting parts of the evidence.
Observational research has repeatedly found an association between dummy or pacifier use during sleep and a lower risk of sudden infant death syndrome (SIDS). This is why some safer-sleep guidelines recommend offering a dummy at naps and bedtime once breastfeeding is established, if the family wants to use one.
The mechanism is not completely understood, and the evidence is observational, so we cannot say that the dummy itself has been proven to cause the reduction in risk.
It is also important to keep this in proportion. A dummy is not a substitute for the major safer-sleep recommendations. Sleep position, sleep surface, smoking, alcohol or sedating substances, overheating and the circumstances in which a baby sleeps remain important regardless of whether there is a dummy in their mouth.
And if your baby does not want one, you do not need to keep putting it back in.
If the dummy falls out after my baby falls asleep, do I need to replace it?
No.
If you offer a dummy when putting your baby down and it falls out once they are asleep, you do not need to spend the night repeatedly replacing it for SIDS protection.
You also do not need to put it back into a sleeping baby’s mouth.
Of course, your baby may have a different opinion about this when they wake between sleep periods and discover that it has disappeared.
That is a different question.
The 2 a.m. dummy-replacement service
This is where something that was extremely helpful at bedtime can occasionally become extremely annoying at night.
Your baby falls asleep beautifully with the dummy. Then they partially wake, the dummy is no longer in their mouth, and they call you. You replace it. They immediately fall asleep.
Forty-five minutes later, repeat.
If this happens once or twice and you do not mind, there is no problem to solve. If you are getting up ten times a night purely to replace a piece of silicone, it is completely reasonable to decide that the arrangement is no longer working for you.
That does not mean introducing the dummy was a mistake. Something can be useful for several months and then become inconvenient.
Can I teach my baby to replace it themselves?
Once your baby has the motor skills to find and replace their dummy independently, the problem may solve itself.
Rather than getting up repeatedly to put it directly into their mouth, you can give them opportunities during the day to practise picking it up, bringing it to their mouth and taking it out again.
There is no need to turn this into a training programme. Babies become increasingly skilled with their hands during the first year anyway.
Once your child can manage it themselves, you may find that the famous dummy-replacement service quietly closes for business.
For safe sleep, however, avoid dummy clips, cords, ribbons or anything that could become a strangulation hazard in the sleep space.
Will a dummy interfere with breastfeeding?
This question deserves more nuance than it often gets.
Observational studies frequently find that babies who use dummies breastfeed for a shorter time or are less likely to be exclusively breastfed. But observational research cannot easily tell us whether the dummy caused breastfeeding to end earlier.
Families may introduce a dummy because breastfeeding is already difficult, because the baby is unsettled, because milk supply is a concern, because the parent is trying to stretch time between feeds, or for many other reasons. In other words, dummy use may sometimes be a marker of an existing feeding difficulty rather than its cause.
Randomised trials have generally not found the same adverse effect on breastfeeding duration or exclusivity, and systematic reviews have highlighted this difference between observational and experimental evidence. A recent 2026 review reached a similar conclusion: observational studies often report a negative association, while randomised trials and systematic reviews have not confirmed that pacifiers themselves cause poorer breastfeeding outcomes.
That does not mean timing and context never matter.
In the early weeks, when breastfeeding is still being established, frequent access to the breast is important. If a dummy is repeatedly used to delay feeds or suppress feeding cues, that could reduce opportunities for milk removal and therefore matter for milk production.
So I would not ask only, Does my baby use a dummy? I would ask what the dummy is replacing.
If it provides ten minutes of comfort while somebody else holds your baby, that is very different from routinely using it to postpone breastfeeding in a newborn who is trying to feed frequently.
What if my baby sucks their thumb instead?
Thumb and finger sucking are also normal forms of non-nutritive sucking.
The obvious advantage is that the thumb cannot fall behind the cot at 3 a.m. Once your baby can reliably find it, they have access to their own source of sucking without needing you to replace anything.
The disadvantage becomes more relevant later: you can eventually remove a dummy, but removing a thumb is considerably more difficult.
This matters particularly when sucking continues strongly into later childhood, because prolonged sucking habits can influence developing teeth and bite.
For a young baby sucking their fingers or thumb, however, I would not start trying to prevent a normal self-comforting behaviour because of a dental problem that may never develop.
Will a dummy damage my baby’s teeth?
This is mainly a question of duration and intensity of use, rather than a reason to panic about a six-month-old falling asleep with a dummy.
Prolonged dummy use is associated with changes in dental occlusion, particularly when the habit continues into the toddler and preschool years. The longer and more intensively a child sucks, the more relevant this becomes. Reviews have not established that so-called “orthodontic” dummies reliably prevent these problems compared with conventional ones.
That means I would think differently about a baby using a dummy for sleep and a three- or four-year-old who has it in their mouth for much of the day.
As your child gets older, reducing daytime use first can be a very gentle place to begin. The dummy may gradually become something that stays in the bedroom or is used only around sleep before eventually disappearing altogether.
You do not necessarily need to remove an important source of comfort overnight because your baby has grown their first tooth.
What about ear infections?
There is an association between dummy use and acute otitis media, particularly as children get older and use continues.
A 2025 systematic review and meta-analysis found a modest association between pacifier use and otitis media, although the authors rated the certainty of the evidence as very low. That limitation matters: an association is not the same as proof that a dummy caused an individual child’s ear infections.
If your child develops recurrent ear infections, dummy use is therefore one of several things worth discussing with their healthcare professional. It does not mean that every baby using a dummy is likely to develop ear problems.
Do I need to remove the dummy because it is a sleep association?
Not for that reason alone.
If your baby uses a dummy to fall asleep and everybody is sleeping reasonably well, I would not remove something useful simply because it has been labelled a sleep association.
We all sleep with familiar conditions around us. Babies are no different.
The practical question is whether the dummy still helps more than it inconveniences. If bedtime takes five minutes because of it and you replace it once overnight, you may be perfectly happy. If you are crawling around the bedroom six times a night looking for it, you may feel differently.
You are allowed to change something because it no longer works. You do not need to change it because somebody has told you that your baby should not need it.
How do I get rid of it when we are ready?
There is no single correct method.
You can gradually limit it to sleep, reduce how often you offer it, help your child find other forms of comfort or eventually stop using it altogether. With an older toddler, you can talk about the change and involve them in what happens to their dummies.
If the dummy has been doing an important job — helping your child regulate, settle and move into sleep — expect them to notice when it disappears. Removing the object does not automatically remove the need it was meeting.
That means you may temporarily need to provide more of something else: cuddling, rocking, lying beside them, holding a hand or simply staying close while they adjust.
Responsive change does not mean your child has to be delighted about it. It means they do not have to manage the change alone.
Keep the tool in proportion
A dummy can soothe a baby. It may be associated with reduced SIDS risk during sleep. It can also become inconvenient, prolonged use can matter for teeth, and there is some evidence of increased risk of ear infections.
All of those things can be true at the same time.
You do not need to decide whether dummies are good or bad. You can decide whether one is useful for your baby now, use it safely if it is, and change things later if the balance changes.
And if your baby spits out every dummy you buy and immediately puts their thumb back in their mouth, they may already have made the decision for you.
Research
Hauck FR, Omojokun OO, Siadaty MS. (2005). Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics, 116(5), e716–e723.
Jaafar SH, Ho JJ, Jahanfar S, Angolkar M. (2016). Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database of Systematic Reviews, 8, CD007202.
O’Connor NR, Tanabe KO, Siadaty MS, Hauck FR. (2009). Pacifiers and breastfeeding: a systematic review. Archives of Pediatrics & Adolescent Medicine, 163(4), 378–382.
Tolppola O, Renko M, Sankilampi U, Kiviranta P, Hintikka L, Kuitunen I. (2022). Pacifier use and breastfeeding in term and preterm newborns — a systematic review and meta-analysis. European Journal of Pediatrics, 181, 3421–3428.
Castro-Cunha AC, et al. (2025). Influence of potentially harmful sucking habits on otitis media in children: a systematic review and meta-analysis. Brazilian Oral Research, 39.