It is generally safe and recommended to let a baby sleep with a pacifier in their mouth. The American Academy of Pediatrics (AAP) endorses pacifier use during sleep because it helps reduce the risk of sudden infant death syndrome (SIDS), and there is no need to remove it once the baby is asleep. Babies often spit the pacifier out during sleep on their own, and if they do, it is safe to leave it in the crib without replacing it. Removing the pacifier after the baby falls asleep is not required and might even disturb their sleep. However, around 6 to 12 months, parents are often advised to start gradually weaning the baby off the pacifier, especially to reduce dependency and to avoid potential dental or speech issues later on. By age 2 to 3 years, pacifier use should ideally be discontinued for dental health reasons. In summary, there is no need to remove the pacifier once the baby has fallen asleep, and keeping it in the baby’s mouth can be beneficial for safe sleep. The pacifier should be used with attention to safe sleeping practices, and parents can begin weaning when developmentally appropriate.
