Saturday, March 24, 2012


Pacifiers, dummies, pacis, binkies, papillas, plugs, lifesavers

What is the thinking?

Although there is a long history of using pacifiers with babies, one that stretches back to ancient times, there has been some controversy over whether it is good for babies in the long run. The reports are conflicting and everyone connected with baby-rearing has an opinion and so, probably, do you. What is the latest information on using a substitute nipple for baby to suck on?

First of all, anyone can see that babies need to suck. Put anything near a baby’s mouth and he will suck on it. Research indicates that babies suck while eating (nutritive sucking) but also like sucking when they are not hungry. This is thought to be a self-regulating mechanism and theorists, including Piaget and Greenspan, agree that learning to self regulate is one of the first social and mental tasks facing a newborn. Non-nutritive sucking may be related to the fact that in the first months of life, the mouth area is also the most sensitive sensory organ (makes sense because eating is one of a newborn’s most important tasks) so babies explore through mouthing things, which that could trigger sucking responses.

Whatever the reason, sucking is something an infant needs to do so where is the controversy?


Feeding is the most important thing the baby needs to do, even before self regulating. The more the baby sucks on the breast, the more milk mother will make. This is especially important during the first months when the prolactin receptors are developing in the glands of the breast. It is important to put the baby to breast when there are indications of hunger, which includes sucking to insure that milk production will be adequate. In addition, breast nipples are not as pliable as bottle or pacifier nipples, which may cause some confusion as to how to suck for a very young baby. These two factors are why it is recommended that breastfeeding mothers do not give their babies bottles or pacifiers for the first month. Throughout breastfeeding, milk production is tied to the amount of feeding the baby does. If the baby empties the breast and continues sucking, more milk will be produced in the next feedings but if milk is left in the breast, production will be decreased.  This means that a pacifier can be used but should not be used to delay feedings or to decrease the time baby spends at the breast.


Pacifiers are rubber nipples and therefore will pick up and hold bacteria, just as any other toy. If baby is using the same pacifier everyday and it is not cleaned, it will carry bacteria that could be harmful for your baby. This is true. Also, if baby is mobile, she might drop her pacifier on the floor or poke it into the potted plant or even rub it up against the dog. Pacifiers need to be cleaned and not by sticking it in your own mouth. Research has shown that the most common way children get tooth decay is from their mothers putting baby’s spoons and pacifiers in her own mouth and then in your baby’s mouth.  Another concern about pacifiers is that they do wear out and that small particles can break off which will be swallowed by baby.  The point is that if you use a pacifier, you need to clean it more than once a day and to check it frequently and replace it often.


For years, dentists have been warning that using pacifiers can cause dental problems.  This depends on how often the baby uses the pacifier, how strongly he sucks and how old he is before he quits. Prolonged use of pacifiers may cause dental problems, asymmetrical growth of the mouth and face and buck teeth.  Thumb sucking will cause the same problems and thumb sucking is a much more difficult habit to break.  Dentists recommend that if you use a pacifier, you do not offer it constantly and that you wean your child from it by about 15 months of age. The weaning process can be a little stressful for you and for baby but it will be more stressful the longer pacifier use continues.


Sucking while congested can create a harmful pressure between the nose and the ear. Studies show that babies who use a pacifier are more likely to have ear infections than babies who do not.  Babies who only use pacifiers at bed time, however, are less likely to have ear infections than babies who use pacifiers all day. As with teeth and breast feeding, limiting use of pacifiers seems to be helpful to decrease the problem of ear infections.  The studies I have seen did not look at thumb-sucking.


Because sucking is such a calming feeling, many babies become dependent on their pacifiers and it is difficult to take it away.  Keep in mind that it is much easier to wean a baby from a pacifier than from the thumb.  It is also easier to wean a younger infant than a toddler.  Some babies have more trouble sleeping who use a pacifier because they become upset when the pacifier falls out.

So with the above concerns, what are the reasons for using a pacifier?


Self regulation is a very important skill which is a basis for most mental growth and social development. Sucking is one of the best techniques for a baby to use to regulate their emotions. Sucking on a pacifier has a calming influence. Babies who are calm can be more alert for learning.


Using pacifiers can help keep your baby calm and quiet in difficult situations, such as when you are in line at the supermarket and need just 10 minutes to get through. You and your baby should be out and about in society but there are times when you cannot get baby out of the public and she is not happy. There is nothing wrong with calming her with a pacifier until you can get her to a quiet place. The others around you will thank you.


Although the exact causes of Sudden Infant Death Syndrome are not known.  Aside from the use of a safe sleep environment (see previous posting), research indicates that babies who use pacifiers to go to sleep are at significantly less risk of SIDS.  The American Academy of Pediatrics has studied this phenomenon and has supported this finding.


Most babies will suck on something and will use their fingers or thumbs if they are not given something else to suck on. It is easier to wean a baby from a pacifier than from the thumb. You can pick up all the pacifiers in the house and put them in a bag and tell your child that you are taking them to the doctor’s to give to the new babies. You cannot do that with a thumb.

So should you or shouldn’t you?

Whether to give your baby a pacifier or not is up to the two of you. Some babies do not want a pacifier.  Some babies really do. There seem to be as many good reasons to use on as to avoid using one. If you decide to use a pacifier there are some guidelines you should follow which include:

1.       Wait until at least 1 month old before offering a pacifier to establish feeding, especially if breastfeeding.

2.       Be overzealous about cleaning the pacifier.

3.       Frequently check for wear and replace often.

4.       Don’t let the baby share the pacifier with anyone and don’t put it in your mouth and then baby’s.

5.       Be sure to use safe pacifiers. Do not use bottle nipples because baby will be sucking in air. Be sure the pacifier has a wide base so it cannot be sucked in.

6.       Try not to depend on the pacifier for your own convenience, though there are some times when you will need to but it should not be all the time.

7.       Never force a pacifier on a baby and never dip it into something sweet to encourage use.

8.       Never tie the pacifier to the baby.  The cord could wrap around his neck and strangle him.

9.       Try to avoid pacifier use if baby has a cold or sniffles.

10.   Let baby use pacifier to sleep but if it falls out do not place it in babies mouth while sleeping.

11.   Wean baby from the pacifier as soon as possible. Most babies can self regulate with a number of techniques by 8-10 months and most babies have many interests by that time so weaning could occur about that time but try to wean by about 15-18 months at the latest.

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