Attachment to a Pacifier

The Basics of Pacifier Use

Babies are born with an innate need to suck, says Richard Dowell, PhD, a pediatric neuropsychologist at Evangelical Community Hospital in Lewisburg, Pennsylvania. Newborns rely on this “suck reflex” not only for sustenance but also for soothing. “Young infants have no other mechanism to control their distress,” explains Dowell. “They can’t get a drink; they can’t ask for a blanket; they can’t use their hands to control things. Sucking provides a way for them to calm themselves.”

Thus, babies will suck—if not on a pacifier, then on a thumb, finger, bottle, or breast, says Karen Breach, MD, a pediatrician in Charlotte, North Carolina. “If a baby needs to nurse more than every two hours, he’s using Mom as a pacifier,” she says, noting that, in such cases, a pacifier can help satisfy baby’s non-nutritive sucking needs while giving Mom a needed break.

Just be sure breastfeeding is well established before introducing the pacifier, cautions Kellen Glinder, MD, a pediatrician at the Palo Alto Medical Foundation, in Palo Alto, California. “For babies who do have trouble learning to breastfeed, the pacifier can teach bad habits.” Once baby is an expert at nursing and Mom’s milk supply is established (typically in a few days), it’s fine to bring on the binky.

What You Need To Know:

After 6 months, pacifier use is less helpful and more of a habit. Some doctors say 6 to 12 months is a good time to wean your child from the pacifier, especially if your child is prone to to ear infections.

Long-term pacifier use can cause a variety of problems such as dental problems, excessive drooling, impeding your child’s ability in learning or pronouncing speech, and it can harm their emotional development.

Long-term pacifier use can cause your child’s upper teeth to tip forward toward the lip, leading to dental problems. There’s no evidence that pacifiers cause permanent damage to baby teeth – they usually shift back into place after a few months of not using a pacifier. The bigger concern is permanent teeth, which start coming in around age 4 to 6. It’s a good idea to mention your child’s extended pacifier use to the dentist so she can check his teeth and jaw.

Even if your child has no trouble with ear infections and the dentist doesn’t see any potential problems, you might want to consider banishing the binkysooner than later. A pacifier habit can be difficult to break.

Pacifier Use Detrimental to Emotional Health

A study, conducted by psychologists at the University of Wisconsin, included three separate investigations that evaluated pacifier use and emotional health. A longer duration of pacifier use was associated with a greater degree of emotional incompetence leading to issues like separation anxiety. Each investigation led to the same conclusion: boys who used pacifiers frequently had lower emotional competence than other groups. The study, published in Basic and Applied Social Psychology, cautions parents to consider limiting pacifier use in order to encourage emotional health.

Sucking on a Pacifier Can Harm Speech Development

Some speech-language pathologists also assert that pacifiers impede normal development of tongue and lip muscles and movements due to the unnatural position imposed on these structures by the presence of the pacifier. If your child often has a pacifier in his mouth, he may be less likely to babble and practice talking, or the pacifier may distort his speech. Sucking on a pacifier locks a child’s mouth in an unnatural position, making it more difficult for him to develop his tongue and lip muscles normally, says Patricia Hamaguchi, a speech-language pathologist from Cupertino, California, and author of Childhood, Speech, Language, and Listening Problems: What Every Parent Should Know. If your child is just learning to speak, talking around a pacifier may also limit his opportunities to talk, distort his speech, and cause his tongue to unnaturally flatten at rest, says Hamaguchi. In some cases, using a pacifier frequently can cause the tongue to push forward between the teeth. This sets the stage for dental problems and the development of a “lisp” when producing the s and z sounds. Many children who have used a pacifier longterm have trouble pronouncing “t” “th” “s” or any sound where the tongue, teeth and lips meet to pronounce sounds because having a soother in their mouth has prohibited them from bringing the necessary parts of the mouth together in order to form the sounds.

“The use of pacifiers multiple hours a day, every day, can negatively impact language development, oral motor functioning, and the development of internal self-regulation soothing and coping mechanisms of any child.”
— Mayra Mendez, Ph.D.

Take it away early

To break the binky habit, doctors say taking the pacifier away sooner than later is the most effective strategy. Babies have their own powerful ways of protesting the end of a beloved habit like the pacifier. But taking it away when your child is too young to express his displeasure and negotiate with words can make the transition simpler and easier.

Parents’ voices

“I took both of my daughters’ binkies away at age 3 months. They didn’t seem to need the sucking anymore to soothe themselves, and they were too little to remember ever having it. Much easier to take something from a newborn than from a toddler. Take it away as soon as possible and save yourself a huge fight later on.”
— A BabyCenter member

“When our baby was around 5 months old, we started limiting the pacifier to bedtime. Then at 8 months, we took it from her cold turkey. She fussed at first when we put her down for a nap, but after a few days she got back to her regular routine and has been going to sleep fine. I figure it’s better to take it from her now when she doesn’t really notice than later when you have to explain it to her or make up a story.”
— A BabyCenter member

What To Do About It:

The sooner you wean them from a the need of a pacifier, the better. Do keep in mind that prolonged use may increase the risk of ear infections, affect incoming teeth, and delay speech and social skills. If your gut is telling you it’s time, here’s what to do:

Start setting limits. Suggest that now that your child is older, she should use the pacifier only at home; then one by one, make specific rooms off-limits until she can use the pacifier only in her bedroom. Or set time limits, such as only before naps and bedtime. (Don’t forget to praise her when she meets each challenge.)
Motivation is key. She’ll be more likely to leave habits from babyhood behind if she sees the benefits of being a big girl. Compliment her on other grown-up behaviors, such as buttoning a shirt or using the toilet, and gently remind her that big girls don’t use pacifiers.
Don’t push too hard. The more you nag or threaten, the more your child will stick to her sucking habit.
Keep her mouth otherwise engaged. Start a conversation or sing-along, provide a bubble-blowing wand, and offer musical instruments that are played with the mouth. Also, make sure she doesn’t go hungry.
Offer healthy snacks before she runs out of steam and turns to her binky instead.
Deflate that nipple. A few strategically poked holes in the pacifier nipple make sucking less satisfying.
Provide another source of great comfort — you! Shower her with attention and hugs, especially if she seems to be feeling down or insecure…

How to Stop: The Three-Day Plan

Your child can be binky-free in just three days, says Mark L. Brenner, author of Pacifiers, Blankets, Bottles & Thumbs: What Every Parent Should Know About Stopping and Starting (Fireside). Here’s how to do it.

Day 1: In the morning and at bedtime, tell your child that you can see she wants to do lots of things that make her older. Tell her that’s a good idea, and that in three days it will be time for her to say goodbye to her pacifiers. Tell her you know she can do it and that you’ll work together on it. Keep the talk to 30 seconds and don’t sound as if you’re asking permission. If your child responds, reflect back her feelings—”I know you don’t want to”—then move on. Don’t worry that your child will become anxious if given advance warning. “That’s a myth,” says Brenner. “Like adults, children like to prepare themselves physically, psychologically, and emotionally for change.”

Day 2: Repeat the same 30-second talk twice daily, only replace “in three days” with “tomorrow.” Don’t try to sell her on the idea. Keep your tone and manner matter-of-fact.

Day 3: Remind your child that it’s day three and time to gather up his pacifiers. Act as if you’re going on a scavenger hunt and ask your child if he’d like to help. Even if he refuses and protests, proceed to collect his pacifiers, place them in a plastic bag, and put them on the front step for “pick-up by the recycling truck.” Explain that the pacifiers will be made into new tires or toys. “Children recognize that recycling is purposeful and intelligent, and will be far less upset than if you throw their treasured pacifiers in the trash,” says Brenner. Which is not to say your toddler won’t have a meltdown. Be empathetic, but firm, Brenner says, adding that most children get over losing their pacifiers within 48 hours.

The Gradual Approach

Start by removing the pacifier in “zero-distress” situations, like when your child is home, happy, and playing. Once she’s used to not having her pacifier at home, eliminate its outdoor use. You don’t need to offer an explanation. “We sometimes over-talk to our kids,” Dr. Dowell says. “All you need to say is: The pacifier doesn’t leave the house.”

From here, it’s usually a painless leap to: “The pacifier stays in the crib.” Convincing your child to make the final break, however, may be more challenging. Some parents use the “Binky Fairy” or Santa to help smooth the transition. “Near the holidays, you might tell your child that Santa collects all the pacifiers for new babies and brings toys for all the big girls and boys,” suggests Ivy Faske, MD, a pediatrician in Palm Beach Gardens, Florida. Or you could tell your child that the dentist or doctor collects pacifiers for new babies, and that if she donates hers, she’ll get a special toy.

Don’t be surprised, however, if the child who traded her pacifiers for a Dora doll suddenly wails for her binky. “You have to be willing to put up with a few really bad nights,” says Faske. “But most kids soon find other sources of comfort.”

Weathering the Storm

Whatever method you choose, brace yourself for one to five nights of crying, and whatever you do, don’t give in. “If you give a child back the pacifier after he’s cried, screamed, and kicked for 45 minutes, you’ll only solidify that such carrying on will get him the pacifier—and everything else he wants,” says Glinder. If you’re tempted to cave, remember: Children (and parents) have endured this rite of passage for millennia. “We all get rid of our pacifiers eventually,” he says.