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Does Pacifier Size Matter? What about Shape? (Plus Buyer's Guide)

Does Pacifier Size Matter? What about Shape? (Plus Buyer’s Guide)

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When looking at pacifiers, you’ll be faced with different sizes, shapes, colors, and materials. Does pacifier size matter though? How about the other qualities?

Pacifier size and shape should be matched to your baby’s age and needs. Pacifiers come in cylindrical, cherry, butterfly, or orthodontic shapes and each option has pros and cons. Pacifier sizes, meanwhile, are broken down into small (6 months or less), medium (6-18 months), and large (18+ months).

What I’ve learned is that the best way to make these choices is one at a time and with a little bit of research. For more information about pacifier shapes and sizes, plus potential advantages and drawbacks, keep reading.

Does pacifier shape matter?

When you are first planning for a new baby, the list of things you need to buy – especially if it is your first child – can be overwhelming.

You need to make the big choices, like which crib is best, which car seat is the safest, and if you are actually going to take your baby jogging in that new stroller.

But after that, there are smaller purchases: clothes, swaddles, toys, diapers, bottles, pacifiers, and the list goes on and on. What do you do?

Baby with a pacifier in their mouth

Once upon a time, pacifiers were all basically the same, but in recent years the advances in materials have allowed manufacturers to create a staggering variety of designs.

Some babies are very easygoing and will accept any and every pacifier shape, but there are other babies who will need to try out several types before finding the one that works best.

You might be tempted to choose a pacifier based on which one has the cutest design, but there are many more important elements to take into account.

Most pacifiers have three parts, although some may be molded from a single piece of silicone or rubber, and are comprised of a grip (usually a ring or tab, something to hold on to), a shield (to keep your baby from choking on the pacifier), and a nipple (the actual source of comfort).

There are four general types of nipple shapes that you need to be aware of:

  • Cylindrical – This is probably the shape you think of automatically when imagining a pacifier. The nipple is relatively straight with a rounded end (think mom’s nipple, but much longer). 
  • Cherry – Similar to the cylindrical nipple, this one has a much more bulbous tip. This shape is often advertised as being the most natural option.
  • ButterflyThis nipple is flatter and wider than most, and should be avoided until your baby is already comfortable with his nursing routine as the shape is very different from any that he is used to.
  • Orthodontic – These may be beveled on one side or contoured symmetrically depending on the brand, but either way, it is designed to allow the tongue to move more freely and encourage natural jaw development.

Can certain pacifier shapes cause dental problems?

Pacifiers can be amazing for helping to calm a fussy baby, but overdependence on them can lead to big issues down the line.

While they are great for helping an infant sleep or satisfying a sucking reflex, as your baby’s teeth come in, pacifiers can cause them to slant or tilt.

Before the age of two, this is likely to be an insignificant issue that will resolve itself within about six months after he stops using a pacifier. 

Most children stop sucking their thumbs or relying on a pacifier between the ages of two and four, and continuing to suck on a pacifier after adult teeth start coming in can lead to long-lasting tooth misalignment.

Because of this, both the American Dental Association and the American Academy of Pediatric Dentistry recommend that pacifiers not be used after your child turns four

What are orthodontic pacifiers?

In an effort to offset the dental issues created by traditional pacifiers, some manufacturers have developed orthodontic pacifiers, which have nipples specifically designed to be less intrusive in your baby’s mouth while still offering the comfort he craves.

They may even help limit the development of an overbite or open bite (when the teeth do not make contact when the mouth is closed) when used properly.

Please keep in mind that the use of an orthodontic pacifier does not negate the concerns about using a pacifier, and the best thing you can do for your child’s dental health is limit the pacifier time and wean him off it as early as possible.

Does pacifier size matter?

Just like clothes and bottles, pacifiers come in different sizes, although it may not be as immediately obvious when your baby has outgrown his favorite pacifier as it is his cutest pajamas.

If the pacifier is too small, he could suck the shield into his mouth along with the nipple and choke; if the pacifier is too large, he will spit it back out.

Baby using an Avent Soothie pacifier

Depending on the brand and type of pacifier you settle on, you will want to select the correct size pacifier based on your baby’s age. For example, the very popular Philips Avent Soothie (the pacifier you are likely to have received at the hospital) is available in two sizes: 0-3 months and 3-18 months.

Other Philips Avent pacifier options are broken into 0-6 months, 6-18 months and 18+ months because of the difference in shield sizes. 

When to change or move up pacifier size

Generally, you want to adhere to the age recommendations on the pacifier package. If your child rejects the larger pacifier, it is possible that he is not yet ready to size up, but be sure to keep a close eye on his use of the smaller ones as a too-small pacifier is a choking hazard. 

Even if your child is not yet at the size change age, you should go ahead and introduce the larger size pacifier if your baby’s mouth is the same size (or larger) as the pacifier shield.

The best pacifiers for your baby

If your baby is anything like mine, he has opinions and is more than happy to let you know them, albeit not as clearly as I might sometimes want.

This is especially true for pacifiers since they are likely to be such a big part of his life for several months or years and there are so many relatively inexpensive options that it should be easy to find the perfect fit.

NUK Orthodontic Pacifier

You probably already have a Philips Avent Soothie from your time at the hospital, but if it doesn’t quite hit the spot for your newborn, try this one.

It is a single piece of BPA-free silicone with an asymmetrical shape designed to fit naturally into your baby’s mouth and promote healthy oral development by allowing the tongue to move freely and the jaw to work instead of locking in place.

Natursutten Natural Rubber Orthodontic Pacifier

This pacifier is made from sustainably harvested tree rubber, is naturally BPA free, and, unlike many pacifiers, has no artificial colors.

It comes in three sizes (0-6, 6-12, 12+) and is softer on your baby’s face than silicone. It is also available in a traditional rounded nipple and both types have a round or heart-shaped shield option.

Tommee Tippee Closer to Nature Daytime Soother Pacifier

This option is great for breastfed babies because both the nipple and the shield are designed to mimic the shape and curve of the mom’s breast, and even move in a similar, comforting way.

There is also a Nighttime Soother option that glows in the dark so it is easy for you to find in the middle of the night.

Should I skip the pacifier?

If you are breastfeeding, you may be concerned that using a pacifier will lead to nipple confusion.

Sometimes called nipple preference, nipple confusion happens when a breastfed baby is introduced to a bottle or pacifier nipple around the same time as Mom’s nipple and develops a sucking/feeding style that keeps them from being able to latch on and nurse properly.

The La Leche League, an international non-profit dedicated to breastfeeding education and training, recommends establishing a solid nursing routine before introducing the pacifier, which usually means waiting until they are about a month old. 

Overdependence on a pacifier can lead to major orthodontic issues as your child’s permanent teeth start to come in. As a rule, any shifting caused by the pacifier before the age of two will fix itself after weaning off the pacifier.

If you are still concerned about your child’s oral development, consider trying an orthodontic pacifier instead of a traditionally shaped one.

No matter what type of pacifier your child uses, continued use after the permanent teeth start to come in (usually around four years) can lead to major issues with teeth shifting and an incorrectly developed bite.

Pacifiers can reduce the risk of SIDS

Although most parents give their baby a pacifier because it helps to keep them calm, there is a much more important reason to use one: studies have shown giving your newborn to six-month-old a pacifier during sleep times can reduce the occurrence of Sudden Infant Death Syndrome (SIDS) by ninety percent.

Although scientists are not sure exactly why the pacifier helps, they point out that the grip and shield portions of the pacifier could create space that would not otherwise be there if your baby were to roll over into a blanket, decreasing the likelihood of suffocation, and that the regular sucking may strengthen the child’s breathing.

What is a good age to take away baby pacifiers?

Dentists recommend weaning your baby off his pacifier once he turns one and the risk of SIDS has abated, but there are unlikely to be any lasting ill effects if you wait until he is two.

There is not really a solid answer as to whether it is better to reduce his pacifier time slowly or take it away cold turkey, but you (and your partner, and everyone else watching your child) need to be consistent once you have made the choice. 

Older child with a pacifier

What worked best for us was taking it away all at once during playtime, but still allowing my son to keep it during nap time for a little while.

Once he was comfortable not having it regularly, we traded the pacifier out for a small toy he could hold and focus on while he was falling asleep.

While that particular method may not work for everyone, the key is to work with your child and find the option that works best for you and your family.


You’ll find that pacifiers come in many shapes and sizes, and determining the size may be the easy part! Manufactureres clearly label the age of intended use for their pacifiers.

Joshua Bartlett
Joshua Bartlett

My name is Joshua Bartlett I run this blog with my wife Jarah. We have more than 11 years of parenting experience including three girls and one boy. I started this blog in late 2018 when I realized that I was dealing with baby-related issues on a constant basis…please read more about me here!

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