Pacifiers

Parents of infants and toddlers are frequently asking me a mouthful of questions about pacifiers, so let me see if I can pacify everyone’s concerns with a few tips on this interesting habit.

First, all babies have a need for sucking as a means of calming and quieting themselves. When mom’s breast isn’t available, a pacifier can fill that need. But do not introduce it until breastfeeding is in full swing for at least a month, or it may confuse your baby who is trying to learn to breast feed.

There are even possible benefits to use of a pacifier. Recently there has been some evidence that it may reduce the risk of a child experiencing Sudden Infant Death Syndrome, although we are not sure why. It might be because babies with pacifiers are less likely to lay face down in bed, or because the muscles of the upper airway are stronger due to constant sucking.

If you are going to use one, select a sturdy one-piece model with ventilation holes and a base or shield that is 1½ inches across so baby cannot put it completely into her mouth and choke. Do not tie a string or ribbon to the device since this may get caught around baby’s neck and be a choking hazard.

If one is used, don’t make it a substitute for taking the time to communicate with your baby or use it to silence your baby so they cannot communicate with you.

We really are not concerned about pacifier use until the child is 6 or 7 years of age when the permanent teeth and bite come in. That being said, there is some evidence to suggest that children who use them after age one may have an increased frequency of ear infections.

If you want your toddler to stop using a pacifier after a year of age, here are some suggestions that I have learned from other parents:

1. Don’t call attention to the habit or distract your child if you see them going for it.

2. Never wean them from pacifiers at times of increased stress for your child, such as the arrival of a new sibling.

3. Consider wrapping up the pacifier(s) and giving it to a friend’s new baby, and have a gift for your child in exchange. Of course, you should tell the family of the new baby that you plan to do this.

4. Some parents may restrict use of the pacifier to the child’s room, or only allow use at bedtime as a way to wean them gradually.

5. Have peer pressure do its job. When your child’s friends aren’t using pacifiers, then neither will your child.

6. Praise your child if they are getting by without the pacifier.

Hopefully, tips like this will wean you of your concerns the next time you’re worried that your baby will end up going to college with his or her pacifier.

Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and on WCAX-TV Channel 3. Visit the First with Kids video archives at http://www.FletcherAllen.org/firstwithkids