Named of its function, the Cutie PAT is a Pacifier and Teether in one. The Cutie PAT Bulb was created for babies who prefer a bulb shaped nipple. This multifunctional pacifier is made with 100% medical grade silicone. The Cutie PAT pacifier is designed in the USA & made in China. Unlike other pacifiers on the market, the Cutie PAT Bulb is a true one piece design. Meaning, it does not contain multiple pieces or multiple pieces that are moulded together. Cutie PAT's are unlike any other pacifier and/or teether on the market. The Cutie PAT was created with a dual purpose in mind: the pacifier side was created to soothe an infant/baby, and the teether portion was developed to aid with teething relief. The Cutie PAT Bulb is for babies without teeth. Once your baby gets teeth, we recommend transitioning to the Cutie PAT Flat or the Cutie PAT Round Stage 2 which are for babies with teeth. U.S. Patent No. D887,014. The pacifier features a soft round nipple. Cutie PAT's one piece design is seamless, from end to end. It's large round shield mimics the comfort of mother's breast to soothe baby. Larger breathing holes provide increased ventilation and the perfect place to attach your favorite Cutie Clip. TEETHER Designed with a teething baby in mind, the handle ridges provide comfort to baby's gums. The teether handle makes it easy for baby to grip, hold, and learn to place in their mouthes. It also promotes the development of fine motor skills through the independence of self soothing. DIRECTIONS Before FIRST use, sterilize pacifier in boiling water for 3 minutes and let air dry. Before EACH use, wash with warm water and mild soap, and complete a pull test inspection by pulling the nipple in all directions. Check for damages such as cracks, tears, and/or excessive wear. If damaged, discard immediately. Dishwasher safe, top rack only. Colorful foods, dyes and/or other liquids may cause discoloration & staining.