By: Aileen Dunbar, Baby-Led Sleep and Well-Being Specialist
“Should my baby use a pacifier?” “When should I introduce one?” “How do I wean my toddler from one?” These are just some of the questions you may have regarding pacifier use for your baby or toddler. So, I did a deep delve into this topic for you including the pros and cons of using one, some guidelines for usage as well as different strategies for weaning based upon the age of your child.
What are the pros of pacifier use?
sucking motion is soothing for many babies as it moves body from a state of stress to a state of calm
can help babies fall asleep at night and release gas
studies have shown consistent use of pacifier at sleep times reduces risk of SIDS (sudden infant death syndrome) (Moon et al, 2012)
pacifiers can be thrown away when it’s time to give up so may be easier habit to break than sucking on fingers or thumb
What are some cons of pacifier use?
creates habit that can be hard to break
if soother falls out of child’s mouth while sleeping, they may wake and call for you to help them. (Note: it has been shown that babies can learn how to put it back in their mouths themselves by about 7 months).
possible increase in ear infections (particularly after 6 months of age) Pacifier use should be stopped or limited in the second six months of life to reduce the risk of otitis media.(American Academy of Pediatrics, 2004).
prolonged pacifier use might lead to dental problems such as misaligned teeth (i.e. past 3 years of age)
not all babies will take them
could lead to missing hunger cues if baby has pacifier in their mouth
Some guidelines on usage
1. Be cautious about using clips or strings. Never tie or hang pacifier around baby’s neck as this could strangle them. If you use a clip or string, make sure it is shorter than 22 cm and take it off when the baby sleeps. Also, ensure it is in good condition as if it breaks, your baby could choke on the small pieces.
2. Make sure pacifier is in good condition. Until your baby is 6 months old and his or her immune system matures, frequently boil pacifiers or run them through the dishwasher. After the age of 6 months, simply wash pacifiers with soap and water (Mayo Clinic). Replace it every 2 months or sooner, if you notice there are any tears or damage.
3. Limit its usage to sleep times when possible. For example, it can interfere with baby expressing emotions, communicating and showing hunger cues.
4. Be aware of potential impacts on breastfeeding. It is a good idea to wait to offer a pacifier until your baby is 3 to 4 weeks old and breastfeeding is well established.
Information about weaning from pacifier at different stages
A. Babies younger than 9-12 months
Before 9-12 months, most babies are still learning that their primary caregiver is a separate person from themselves and that objects still exist even when they can’t be seen (called object permanence). Therefore, they typically do not show strong attachments to objects during this period. This means it may be easier to wean them from the pacifier at this stage. Note: If your child was born prematurely, Dr. Feldman-Winter, a professor of pediatrics at Cooper Medical School of Rowan University, recommends waiting until at least 12 months after your original due date to wean since premature babies are at higher risk of SIDS.
Tips during this stage:
1. Reduce usage gradually to specific times. You could do this in stages depending on when your baby is using a pacifier. For example, you could start with only being allowed to use it in the car and when sleeping. Then, you could move to only naps and nighttime. Then the last stage would be to get rid of it at bedtime and overnight!
2. Make sure baby has other sleep associations other than the soother. It will make the transition smoother if the baby is used to other ways of falling asleep. So, before you begin the process of getting rid of the soother for sleep times, add in other sleep associations that your baby finds calming such as rocking, singing, patting their bum, etc. This will reduce their reliance upon the soother to go to sleep.
3. They may require extra support when agitated. Since sucking helps babies return to a state of calm if they are slightly agitated, they may require more assistance to down-regulate when trying to stop using the pacifier. Try to find other ways to help to comfort them such as using a soothing voice, singing to them, taking them outside, etc.
B. Babies older than 12 months
Babies older than 12 months may have developed more of an attachment to their pacifier, so it may be more challenging depending on your child’s temperament and how much they rely upon it. At this stage, it is more about setting loving limits as their caregiver and having compassion that is hard for them to give up something they have come to rely upon. It would be like if we were trying to give up our daily coffee to put it into context! Here are some tips/strategies you can try😊
1. Determine the strategy you would like to use and make sure all caretakers are on board with it for consistency. For example, if you have decided to go the route of getting rid of it in stages (ex. First only using it in the car and at bedtime, then no longer at bedtime), have a conversation with your partner and other caregivers about the expectations so it is less confusing for the child.
2. Have a conversation and/or read books with your child about the plan. Whenever there is going to be a change in their worlds, children benefit when they are made aware of what will happen as it reduces their stress. There are a variety of ways you can do this such as having a conversation with them or reading them books on the topic. (Ex. Pacifiers are not forever by Elizabeth Verdick; No more pacifier for Piggy! by Bernette Ford).
3. Validate their feelings about this big change and stay with them as they release these emotions. For example, if they are very upset they can’t use a pacifier, you can show them you are listening by getting to their level and nodding your head as they express their emotions. You could also tell them you understand what they’re feeling. For example, “I know it’s hard to give up your pacifier. I can see you are feeling very upset about it. I am here to support you through it.” In allowing them to release their emotions, it will help them adapt to this change over time.
4. Help them learn alternate strategies to calm down instead of sucking a pacifier. Since sucking helps the body move from a place of stress to calm, you can try different activities that your child finds calming instead. Some examples of things that many children find calming are moving them slowly over an exercise ball on their stomach, listening to calming music together, blowing water through a straw to make bubbles, playing with playdough or squeeze toys, or giving them a bear hug, just to name a few.
5. Be prepared that nighttime will likely be the trickiest time. If your child is used to having the soother to fall asleep and to help them go back to sleep if they wake overnight, then it is quite likely that bedtime will be more challenging as they become accustomed to this new way of doing things. Be prepared that bedtime make take longer than normal and if your child was falling asleep by themselves before, they may require you to say with them again as they adapt. Furthermore, you may need to support them back to sleep upon wakings if they are used to having the soother throughout the night.
6. Here are some specific strategies you can try:
a) Pacifier Fairy: It is similar to the tooth fairy in that the child leaves the pacifier(s) in a specific location and then the next morning, they receive a gift from the pacifier fairy. There are a few books that talk about this concept you could read to your child (Ex. The Paci Fairy by Melissa Burnett; Bea gives up her pacifier by Jenny Album). This would be better for an older toddler (2.5 and up) who can better understand the concept.
b) Gradual weaning for sleep: For this method, you could let toddler have pacifier until they are almost asleep, then gently break the seal and remove pacifier before they are fully asleep.If they wake back up, try to use other methods like rubbing their back or shushing to help them go to sleep without the pacifier. You could repeat the same process if they wake up looking for their soother. This could take several nights to work and requires patience and compassion.
Overall, there are pros and cons to your child using a pacifier and it is something that will need to be weaned from eventually. That being said, if you support your child’s unique temperament through this process, it can be a bonding experience for you and it is more than ok to be emotional about it!