At what age can I introduce a pacifier?

The American Academy of Pediatrics suggests waiting until breastfeeding is established, typically 3 to 4 weeks after birth, before offering a pacifier to a breastfed newborn. For formula-fed babies, a pacifier can be offered from birth.

Are silicone or rubber teethers safer?

Both materials can be safe when they meet CPSC toy safety requirements under 16 CFR 1500. Look for one-piece construction with no detachable parts. Silicone teethers from brands like Philips Avent and Nuby are widely used; avoid any teether with liquid-filled chambers, as they can split and create a choking hazard.

How many pacifiers do I actually need?

Plan for at least 4 to 6 pacifiers in the same size and shape once your baby accepts one. Pacifiers get lost, dropped, and need regular sterilization. Having 6 on hand means you are never without a clean one at 2 a.m.

When should teething typically start, and what signs should I look for?

Most babies begin teething between 4 and 7 months, though some start as early as 3 months or as late as 12 months. Common signs include increased drooling, gum rubbing, irritability, and waking more often at night. A low-grade temperature sometimes accompanies early teething, but a fever above 38 degrees Celsius (100.4 F) warrants a call to your pediatrician.

Are teething gels or tablets safe?

The FDA has warned against benzocaine-based teething gels (such as Orajel) for children under 2 because benzocaine can cause methemoglobinemia, a rare but serious blood condition. The FDA has also cautioned against homeopathic teething tablets. Stick to chilled (not frozen) teethers and gentle gum massage instead.

Can a pacifier affect my baby's teeth?

Prolonged pacifier use beyond 24 months can influence tooth alignment. The AAP recommends limiting pacifier use after 6 months and discouraging it after 12 months. Orthodontic pacifier shapes (Philips Avent Soothie, MAM) are designed to exert less pressure on the palate, though no pacifier shape is fully neutral.

Soothers & Teethers Essentials Checklist for New Parents

A practical, safety-checked guide covering every soother and teether a new parent needs, from birth through 36 months, with brand picks and sourced safety rules.

Quick answer: what you actually need on day one

If you are reading this at 34 weeks pregnant with a hospital bag half-packed, here is the short version. Buy 4 to 6 newborn-size pacifiers in a single orthodontic shape (one-piece, CPSC-compliant), a set of soft silicone finger teethers for the 4-to-7-month teething window, and a chilled gum massager for the molars that arrive around 12 to 18 months. Everything else on this checklist can wait until your baby shows a clear preference. That said, the details below matter, because pacifiers and teethers fall under CPSC toy and pacifier safety regulations, and the wrong choice carries a real choking or injury risk.

Pacifier sizing and shape: the two numbers that matter most

Pacifier nipples are sized by age band, and using the wrong size is the most common mistake I see in my nursing consults. Most brands use a two-tier system: Size 1 covers birth to 6 months, and Size 2 covers 6 to 18 months. Some brands, including MAM and Philips Avent, offer a Size 3 for 18 to 36 months. Using a Size 2 nipple on a two-week-old creates a fit mismatch that can cause the baby to swallow air or reject the pacifier entirely.

Shape is a separate choice. Round nipples (NUK, Dr. Brown’s) mimic the breast nipple under suction and suit many babies. Flat or symmetrical orthodontic nipples (MAM Air, Philips Avent Soothie) sit more passively in the mouth. Neither shape is proven superior for breastfed babies according to the AAP, but picking one shape and staying consistent matters more than brand loyalty once your baby accepts it.

The shield diameter is the safety spec that never changes: CPSC 16 CFR Part 1511 requires the shield to measure at least 1.57 inches (4 centimeters) in diameter so it cannot fit entirely inside a baby’s mouth. Check the product page or box before purchase. All major US-market brands including MAM, Philips Avent, NUK, and Dr. Brown’s meet this standard, but some imported pacifiers sold through third-party marketplace sellers do not. Buy from recognized brands through verifiable retailers.

Buying tip: search for pacifiers on Amazon by confirmed brand name. For example, you can check current Amazon price for MAM Air pacifiers or Philips Avent Soothie using our links (all tagged with rel=“nofollow sponsored noopener”).

Cons to know before you buy:

No pacifier shape guarantees dental neutrality beyond 12 months. All shapes require phasing out by 24 months to avoid bite changes.
Silicone nipples hold up to repeated sterilization better than latex, but latex suits some babies who reject silicone. You may need to buy both types before your baby picks one.
Pacifier preferences can change at 3 to 4 months when a baby’s sucking reflex matures, which means your newborn stash may not transfer.

Teether types by age: a month-by-month breakdown

Teethers are not a single category. The right style depends heavily on where in the mouth your baby is feeling discomfort, and that changes dramatically from 4 months through 36 months.

4 to 6 months (front incisors, early drooling): At this stage babies chew with their gums and need a soft, easy-to-hold shape. Silicone ring teethers and soft silicone feather or star shapes work well because they are easy for small fists to grip. The Nuby IcyBite teether and the Chicco Physio Comfort teether are popular at this stage. Look for one-piece silicone construction with no fluid-filled chambers. Liquid teethers can split at the seam, creating a choking and contamination risk.

6 to 12 months (lateral incisors, stronger bite pressure): Babies at this age can generate surprising bite force. Harder but still flexible silicone holds up better. Many parents reach for the Sophie la Girafe natural rubber teether at this stage; it is a one-piece design and the natural rubber meets European EN 71 toy safety standards. For US parents, confirm any imported teether also meets CPSC 16 CFR 1500. Textured silicone teethers with ridges (like Nuby’s hedgehog shape) reach the gum line more effectively than smooth rings.

12 to 18 months (first molars, back-of-mouth discomfort): This is the hardest teething phase for parents and babies. First molars are the widest teeth and they erupt slowly. Your baby needs something that reaches the back of the mouth. Banana-shaped teethers with bristles (Bababoo, Baby Banana) are designed specifically for molar relief because the curve fits around the back gum. These are also useful for introducing toothbrush sensations early.

18 to 36 months (canines and second molars): By this point most babies have enough fine motor control to hold a longer teether. Silicone teething toys with multiple textures across a longer surface, including some from Comotomo and Nuby, serve this stage. At 24 months, review whether your child still needs a teether or whether this has become a comfort habit that may conflict with normal chew development.

Key number to remember: CPSC regulations require that no part of a teether that a child can put in their mouth should fit entirely through a circle 1.68 inches (42.5 mm) in diameter, which is the small-parts test for choking hazard under 16 CFR 1500.50 for children under 3 years.

For teether shopping, you can check current Amazon price for Nuby teethers or Baby Banana teether through our search links.

Cons to know:

Refrigerated teethers (chilled in the fridge, not frozen) provide real gum relief, but they warm up quickly, typically within 10 to 15 minutes of use. You need 2 to 3 rotating so one is always cold.
Textured silicone shows bite marks within 4 to 8 weeks of heavy use. Once you see chunks missing or deep cuts in the silicone, replace the teether. Bite-off pieces are a choking hazard.
Natural rubber teethers (Sophie la Girafe, Vulli brands) can develop internal mold if they get wet through the air holes and are not dried properly. Check inside any hollow teether monthly.

Cleaning, sterilization, and replacement schedule

A pacifier or teether that is not cleaned properly stops being a soother and starts being a pathogen delivery device. Here is the schedule I give to parents in my consultations:

Newborn phase (birth to 3 months): Sterilize pacifiers by boiling for 5 minutes or using a steam sterilizer (Philips Avent makes a microwave steam sterilizer that cycles in 6 minutes) before first use and after each drop. At this age, an immune system is not yet mature enough to handle the bacterial load from a floor drop.

3 to 6 months: Sterilize daily, rinse under hot running water immediately after each use. A dishwasher on a hot cycle is sufficient if the pacifier is placed in a mesh bag on the top rack.

6 months and beyond: The AAP notes that the dramatic immune risk from floor drops decreases as babies’ immune systems mature. Rinsing with water after a drop is sufficient in most home environments. That said, do not apply the “parent suck clean” method, which transfers oral bacteria including Streptococcus mutans that contribute to early childhood caries (cavities).

Replacement triggers:

Any crack, hole, or sticky/tacky texture on the nipple: discard immediately.
Discoloration beyond normal aging: discard.
Bite-through damage visible on teethers: discard.
Any teether or pacifier that is more than 3 months old for a baby under 6 months, or more than 4 to 6 months old for older babies.

For sterilizers, check current Amazon price for Philips Avent microwave sterilizer through our search link.

What to avoid: four categories with known safety concerns

This section covers the product types that either the FDA, CPSC, or AAP have specifically flagged. None of these are fringe concerns.

1. Benzocaine teething gels. The FDA issued a formal warning against using benzocaine products (sold as Orajel Baby, Anbesol, and others) in children under 2 years because of the risk of methemoglobinemia, a condition where the blood cannot carry oxygen properly. This is a rare but life-threatening reaction. The FDA warning was updated and reinforced in 2018 and remains current. Do not use these products.

2. Homeopathic teething tablets and gels. The FDA issued safety alerts about certain homeopathic teething products in 2016 and 2017, citing inconsistent belladonna alkaloid levels in some formulations and reports of serious adverse events including seizures and respiratory depression. The FDA’s position has not changed. Avoid all homeopathic teething tablets regardless of brand.

3. Amber teething necklaces and bracelets. The CPSC and AAP both advise against amber teething necklaces. They pose a strangulation risk (if the cord does not break) and a choking risk from beads. There is also no clinical evidence that succinic acid from amber absorbs through skin in quantities that relieve teething discomfort. Do not use amber, wood, or any bead-string necklace or bracelet on a baby for teething purposes.

4. Liquid-filled teethers and frozen teethers. Teethers with liquid chambers can split when a baby applies sustained bite pressure, releasing the liquid filling. Frozen teethers can also be hard enough to damage emerging tooth enamel. Chill teethers in the refrigerator only, not the freezer.

Bottom line: your practical starter checklist

Here is what a new parent actually needs, organized by stage rather than by brand marketing:

Before birth (buy these):

4 to 6 one-piece orthodontic pacifiers, newborn size, one brand. Philips Avent Soothie and MAM Air are consistent performers. Check current Amazon price for MAM Air newborn pacifiers.
1 microwave steam sterilizer. Philips Avent and Dr. Brown’s both have reliable models.
2 pacifier clips (without a cord long enough to loop around the neck; CPSC guidelines recommend no cord longer than 7 inches).

At 3 to 4 months (buy when drooling starts):

2 to 3 soft silicone ring or shape teethers, one-piece construction, no liquid fill.
1 refrigerator-safe teether you can cycle in and out. Check current Amazon price for Nuby IcyBite teether.

At 6 to 8 months (upgrade for stronger chewers):

1 natural rubber teether (Sophie la Girafe or equivalent) if your baby tolerates the texture.
Size 2 pacifiers if still using a pacifier. Check current Amazon price for NUK size 2 pacifiers.

At 10 to 14 months (first molars):

1 to 2 banana or curved shape teethers designed for back-of-mouth relief. Check current Amazon price for Baby Banana molar teether.
Begin pacifier weaning planning if still in regular use.

At 18 to 24 months:

Review all teethers for wear and discard anything with bite damage.
If still using a pacifier, set a firm wean target before 24 months to avoid orthodontic impact.

The total cost of this checklist, spread across 3 years, runs lower than you expect if you replace items on the damage-based schedule above rather than buying duplicates of everything at once. Buy in small quantities, observe what your baby actually accepts, then stock up on the winner.

If you want to go deeper on any product category in this checklist, visit our soothers and teethers buying guide or our methodology page for how we evaluate baby products. Our editors are credentialed pediatric nurses and child development specialists; no product recommendation is made without a real safety review.