The Power of the Pacifier

I’m regularly questioned by concerned parents about pacifier use.  Some of them approach me with a shamed expression, clearly embarrassed about the situation they are in.  As a dentist, I understand these parents’ concern.   Others openly profess their love for their child’s fixation and assign pet names , such as “bubba,” “ginky,” “jar jar” or “pluggerdoodle,” to the one item they claim protects their sanity.  As a father, I understand this affection.  I often respond to both types of parents with the sentiment  “there is a time for everything . . . even the binky.  But, once that time has passed, move on. ”

I completely support the use of a pacifier by infants.   The action of rhythmic sucking optimizes an infant’s breathing and heart rate.  This explains why pacifiers are recommended to help prevent SIDS.  The use of a pacifier soothes a newborn.  In hospital nurseries, infants cry significantly less if they are given a pacifier between feedings.  Muscular movements of the digestive tract work most efficiently when a baby is sucking.  Sucking on a pacifier helps to re-regulate intestinal rhythms in babies with colic or digestive difficulties. 

 There is a point, though, when too much of a good thing spells trouble.  Children who have continued a sucking habit beyond infancy are regularly affected with crooked teeth, misaligned jaws and even speech impediments.   Problems with prolonged sucking can appear beyond the mouth, too.  One study has shown that children who did not use a pacifier had nearly one third less occurrence of ear infections.  Prolonged sucking habits can also affect a child’s interaction with others.  Children with a pacifier in their mouths can’t talk and for children who are shy, the pacifier creates an excuse to avoid expressing themselves.  This can stunt a child’s emotional and social growth.

So when is the right time to give up the binky?  Not during infancy.  There are both physical and psychological reasons to encourage the use of a pacifier through and beyond a baby’s first year.  Once a child has reached preschool age, however, there is no benefit to sucking.  Parents of children this age who haven’t given up the habit already should take measures to stop the habit before Kindergarten, especially if there are protruding, crooked teeth or their child’s lips are flaring and are difficult to close.  Another sign of an excessive habit is the continuation of sucking vigorously throughout the night.  If a sucking habit continues into a child’s school years, it is unlikely that the effects can be fixed without the help of an orthodontist.

There are steps that a parent can take at all stages of their child’s development.  Introducing the pacifier in the right way, early in life, sets up a child for successful weaning later in life.  Parents of infants should not offer a pacifier unless their baby is fussing.  When a child is fussing, they should first spend a moment to evaluate if something other than a pacifier might solve the problem.   To discover the underlying difficulty and then address it teaches even the youngest infant to deal with distress by problem-solving instead of mouth-filling.  Once a child has reached the status of toddler, a parent can introduce limits to the availability of a pacifier.  Offering a pacifier only at naptimes and at bedtime is one way to start the weaning process.  If a toddler seeks out his pacifier at other times, a parent can present distractions to help him engage in other, healthy activities.  As a toddler matures and starts to hone his reasoning and negotiating skills his parent can reinforce his lack of pacifier use with praise and rewards.   A parent can also foster an excitement about the process by introducing ceremonies to usher the child to a more mature and “grown up” phase of life.

What should you, as a parent, do to help your child move away from the use of a pacifier?  If it is time to say goodbye to your child's pacifier, there's lots of fun ways to do so.  You can call our office at 509-891-7070 and ask about our "Pacifier Fairy Tree" or visit our Pinterest Pacifier Fairy board for some ideas!