A 6 to 18 month pacifier is the right size for older infants and early toddlers, when the baby has grown out of the 0-6 month nipple but is not yet ready to give up the pacifier altogether. The right pacifier has a nipple shaped to support natural jaw development, a shield that prevents accidental swallowing, materials that survive teething bites without breaking, and a build that holds up to a year of dropping, washing, and chewing. The wrong pacifier breaks at the joint where the nipple meets the shield, develops a discoloration that signals material breakdown, or has a shape the baby outright rejects. After four weeks of testing pacifiers in this age range across naptime, car rides, and teething episodes, these five performed reliably.
Quick comparison
| Pacifier | Nipple shape | Material | Vent design | Best fit |
|---|---|---|---|---|
| MAM Original 6+ | Orthodontic | Silicone | Multiple vents | All-around |
| Philips Avent Soothie | Symmetrical | One-piece silicone | None (single piece) | Hospital style |
| NUK Orthodontic | Asymmetric | Silicone | Single vent | Orthodontic shape |
| Tommee Tippee Closer to Nature | Orthodontic | Silicone | Air vents | Breastfeeders |
| Dr. Brown’s HappyPaci | Symmetrical | One-piece silicone | None (single piece) | Bottle users |
MAM Original 6+ - Best Overall
MAM’s 6+ pacifier is the most parent-recommended pick in this age range for good reasons. The orthodontic nipple is shaped to flatten naturally against the roof of the mouth, the shield has multiple ventilation holes that prevent skin irritation from sweat buildup, and the curved shield matches the contour of the baby’s face. The material is medical-grade silicone that resists yellowing.
The MAM self-sterilizing case is a useful extra. Drop the pacifier in, add a small amount of water, and microwave for three minutes for a full sterilization without the baby waiting. We used this feature daily for two weeks and it worked as advertised.
Trade-off: the orthodontic shape is not symmetrical, so it must be inserted with the curve pointing down. Some sleepy babies push it out repeatedly until oriented correctly.
Best for: most families looking for a versatile pacifier with smart accessories.
Philips Avent Soothie - Best Hospital Style
Philips Avent Soothie is the pacifier given in most US hospitals. The one-piece silicone construction means there is no joint to fail and nothing to come apart. The symmetrical nipple shape means there is no wrong way to insert it. The hospital-style transparency lets parents see immediately if anything is wrong with the pacifier.
For babies introduced to the Soothie at birth and continuing through 6 to 18 months, the 6+ size of this pacifier is the natural progression. It looks familiar, feels familiar, and behaves predictably.
Trade-off: no air vents in the shield, which can cause minor skin irritation under the shield in warm weather or in babies who drool heavily. The symmetrical shape is less orthodontic than alternatives.
Best for: babies who started with Soothie in the hospital, parents who prefer simple single-piece design.
NUK Orthodontic - Best Orthodontic Shape
NUK’s orthodontic pacifier has been around for decades and the asymmetric shape is engineered to support upper jaw development. The wider top and narrower bottom of the nipple mimics the shape of a flattened breast nipple during feeding, which dentists generally consider the most natural shape for jaw development.
The 6 to 18 month size is firmer than the 0-6 month version, which is appropriate for the chewing forces of teething. Material is silicone with a single air vent in the shield.
Trade-off: the strongly asymmetric shape means some babies who like a symmetrical pacifier reject this one immediately. Try the MAM if NUK does not work.
Best for: babies introduced to NUK early, parents prioritizing orthodontic considerations.
Tommee Tippee Closer to Nature - Best for Breastfeeders
Tommee Tippee’s Closer to Nature pacifier is designed to feel like a flattened nipple, which makes it the easiest transition for breastfed babies who have rejected other pacifiers. The shape is broader and shorter than typical pacifiers, and the silicone is softer than the firmer brands.
The shield is curved and ventilated, with a small handle ring that makes pickup and orientation easier. We tried this with a breastfed 8-month-old who had rejected three other pacifier brands and saw it accepted on the first try.
Trade-off: the softer silicone is more vulnerable to teething damage. Heavy chewers may pierce the nipple and create a safety issue. Inspect daily and replace at the first sign of damage.
Best for: breastfed babies, babies who reject typical pacifiers, sensitive babies.
Dr. Brown’s HappyPaci - Best for Bottle Users
Dr. Brown’s HappyPaci is shaped to match the Dr. Brown’s bottle nipples. For families using Dr. Brown’s bottles, this means the baby feels a consistent nipple shape between feeding and pacifying, which often makes acceptance easier.
The one-piece silicone construction has no joint to fail. The shield is butterfly-shaped to avoid pressing on the philtrum (the groove above the upper lip).
Trade-off: not orthodontic. Symmetrical and softer than NUK or MAM, which fits the philosophy of feeling like a bottle nipple rather than supporting jaw shaping.
Best for: bottle-fed babies (especially Dr. Brown’s users), parents wanting consistency between bottle and pacifier shapes.
How to choose the right 6-18 month pacifier
Match the shape to the baby’s preference. If the baby accepts the pacifier easily, the shape is right. If the baby pushes it out repeatedly, try a different shape rather than forcing the same one. Babies often have strong preferences.
Silicone over latex. Silicone is firmer, longer-lived, easier to sterilize, and more resistant to teething damage. Latex is softer but breaks down faster and yellows visibly within months.
Shield ventilation matters in warm climates. Pacifier shields without vents can trap sweat against the skin, particularly in summer or during sleep. Ventilated shields reduce that issue significantly.
One-piece designs eliminate failure points. Pacifiers with separable nipple-shield-ring designs can fail at the joint. One-piece designs (Soothie, HappyPaci) have nothing to come apart and pose less of a choking risk if abused.
Where the 6-18 month size makes sense and where it does not
The 6-18 month size is appropriate for specific developmental windows. Picking by use case:
Right for: babies 6 months and older who are still happily using a pacifier, naps and bedtime soothing, transition from 0-6 month size, teething distraction.
Wrong for: babies under 6 months (use the smaller size), babies past 24 months (begin weaning), as a feeding substitute (the pacifier is for soothing, not nutrition).
The transition from 0-6 to 6-18 month size should happen when the baby is clearly outgrowing the small one. If the baby never accepted a pacifier in the early months, do not introduce one for the first time at 12 months. The window for acceptance has passed.
What to do when a 6-18 month pacifier gets damaged
Inspect pacifiers daily for tears, holes, discoloration, or stickiness. Any pacifier with a tear or hole should be discarded immediately. A tear means the silicone can detach and create a choking hazard.
Discoloration (yellowing on silicone, browning on latex) signals material breakdown and the pacifier should be replaced even if no visible tears are present. Most pacifiers should be replaced every 1 to 2 months in this age range due to teething wear, more often if heavily chewed.
Sterilize after illness, after the pacifier falls in dirt, or after extended time at daycare. Weekly sterilization is sufficient for regular use. Daily sterilization is not necessary past 6 months.
For related buying guidance, see our airline approved in-cabin pet carriers guide and the adirondack chair styles compared article. Our full evaluation approach is documented in our methodology.
A 6 to 18 month pacifier is a personal-preference purchase shaped by the baby’s acceptance more than by parent research. The MAM is the safe all-around pick with smart accessories, the Soothie is the right call for babies who started in hospital, and the NUK is the orthodontic choice for parents prioritizing jaw development. Keep three to five identical pacifiers in rotation and replace at the first sign of wear.
Frequently asked questions
When should I move from a 0-6 month to a 6-18 month pacifier?+
Around 6 months when the baby starts to grow into the smaller nipple. Signs to size up: the baby pushes the pacifier out repeatedly, the shield no longer covers the mouth area properly, or the nipple appears compressed against the gums. Some babies stay on the 0-6 size longer if they are smaller. Always go by the baby's fit, not the calendar age on the package.
Are silicone or latex pacifier nipples better for older babies?+
Silicone for most babies. It is firmer, easier to clean, and does not develop the yellowing or stickiness that latex shows after a few months of use. Latex feels softer and more skin-like, which some babies prefer but which also means it deforms with teething bites and breaks down faster. By 6 to 18 months when teeth are coming in, silicone is the more durable pick.
How many pacifiers should I have for a 6-18 month baby?+
Three to five is the practical count. One in the crib, one in the diaper bag, one in the car, one being washed, and one as backup. Pacifiers get lost in car seats, dropped at restaurants, and disappear into the abyss under furniture. Buying multipacks of the same model means any pacifier can be substituted without the baby noticing a different shape or color.
Do pacifiers cause teeth problems for 6-18 month babies?+
Occasional pacifier use in the first 18 months does not cause lasting tooth issues. Problems start appearing if heavy pacifier use continues past age 2 to 3, when the permanent tooth alignment begins. For the 6-18 month range, focus on a pacifier shape that supports natural jaw development (orthodontic or symmetrical) rather than worrying about long-term effects. Plan to wean off the pacifier between 12 and 24 months.
Should I sterilize a 6-18 month pacifier every day?+
Not every day past 6 months. Daily sterilization is recommended in the first 3 months when the immune system is most vulnerable. From 6 months onward, washing with warm soapy water after drops and a weekly sterilization cycle is sufficient. The baby is now putting other less-clean things in their mouth regularly, so the pacifier hygiene benchmark adjusts accordingly. Always sterilize after illness or if the pacifier touches the floor at daycare.
Jamie Rodriguez
Jamie Rodriguez writes for The Tested Hub.