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A Pacifier by any other name...

The pacifier, the binky, the passy, the boo boo, the wonky….let’s be honest, I just made that last one up but it didn’t sound any sillier than the rest. The names for these little devices change with the seasons. When we had our first baby, I referred to it as a pacifier once in mixed company and people were looking at me like my head had been sewn on backwards. During that era if you didn’t call it a binky, it was akin to the social blunder of referring to flip-flop sandals as “thongs.” (Okay, I kind of get that one) It’s just something you didn’t do unless you wanted the neighbors snickering behind your back after dinner parties. I don’t pretend to know what’s in vogue these days, but the pacifier remains a family staple and healthy habits concerning its use are important.

I occasionally receive questions about pacifier use and I tend to follow the generally accepted recommendations. Like anything else, these recommendations change as “research” reveals new findings. I’m not sure which scientists have the courage to undertake this important study but we are the lucky recipients so let’s see what they have to say.

Generally, pacifier use has a lot of positive aspects in the first six months of a baby’s life. While probably best recognized for its calming effects, pacifier use can also reduce the incidence of SIDS (Sudden Infant Death Syndrome) and help with the development of jaw muscles in infants. Personally, the pacifier was indispensible in the early months of our children’s lives. There is a very strong possibility that I would not have been able to get a solid ten hours of sleep every night if my wife had not given the babies their pacifier every 15 minutes. I kid of course, I rarely got more than nine hours.

What is the right time period for pacifier use?

For infants, it is generally acceptable to use a pacifier after 1 month, allowing the infant to develop a healthy breast-feeding habit. However, like all good things, it must come to an end and no one wants to see a ten year old rocking a pacifier at school. Most experts recommend that pacifier use be discontinued after 2 years. For most kids at this point, pacifier use has become a habit rather than a developmental need. Research has shown that after 2 years, pacifier use is linked to a number of negative outcomes:

  • Increased chance for thumb-sucking

  • Higher risks of ear infection

  • Improperly aligned teeth including open bites

  • Improper mouth growth

Dispensing with the pacifier by age 2 can help parents avoid a very difficult weaning experience which results from strong emotional and habitual attachments.

What about use and maintenance of pacifiers?

There are a few good practices to consider for healthy pacifier use. Only use pacifiers that have been designed orthodontically(orthodontists straighten teeth) to minimize disruption of teeth alignment. Orthodontic pacifiers are well marked and easy to find. Examine them regularly for damage and dispose of those with cracks and tears. Never tie a pacifier around a child’s neck for obvious reasons. Pacifiers are fairly inexpensive so don’t feel like you need to keep old ones lying around. Practicing economy is highly recommended but keeping and re-using old pacifiers doesn’t have a good return on investment. (i.e. sick kids with crooked teeth.)

Wash pacifiers before use and clean them regularly. Their design makes them susceptible to bacterial growth for organisms like Staphylococcus, the cause of staph infections. Clean them at a minimum of once daily with a mild soap and water. Some pacifiers make it really easy and are approved for the dishwasher, just check the packaging for proper use. It’s important to be sure that no excess water is allowed to sit inside the pacifier. This provides a nearly ideal environment for bacteria.

Taking away the pacifier from my ten year old sounds like a nightmare, any suggestions?

I’ve never seen a ten year old with a pacifier, but it does sound like a nightmare. Even for infants, dispensing with the pacifier can be very difficult. There are no silver bullets, but just because something is difficult doesn’t mean it shouldn’t be done. For those kids who have formed an emotional attachment, giving them alternatives can be helpful. These alternatives might include toys, activities, or simply rocking them, or singing to them before bedtime. For those who are vocally challenged, I recommend playing soft music rather than adding insult to injury for the poor child. Research on the psychological damage of exposure to off-key singing is still in its infancy.

Some other helpful tips include gradually limiting exposure-time to the pacifier. You can also decrease the satisfaction your child gets from its use by piercing the nipple or coating it in a safe but disgusting flavor like white vinegar. If your child has a ready gag reflex, I might refrain from the latter…the results could be explosive. Finally, good old “cold turkey” is an always an option. Just keep a pair of ear plugs on your person at all times.

Take time to discuss pacifier use with your dentist or hygienist at your next appointment for more information.

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