Pacifiers: Pro Con

Pacifiers: They can be a source of intense debate among parents. Should they use a pacifier with baby, or banish them forever from the house?

While the issue isn’t quite so black and white, you’ll often hear from moms and dads who either rave over pacifiers or revile them. To understand the shades of gray, WebMD went to pediatricians, parents, therapists, and dentists to get the pros and cons of baby pacifiers.

Pacifier Pros: A Few Reasons to Use a Pacifier

There are lots of good reasons to use pacifiers -- just ask any parent who’s gotten a moment of quiet with the judicious use of one! But a bit of peace isn’t the only plus of using a pacifier. Others include:

• Protection against SIDS. The American Academy of Pediatrics recommends parents consider letting their child fall asleep or nap with a pacifier their first year, as it seems to have a protective effect against sudden infant death syndrome (SIDS). Use the pacifier when putting baby down to sleep -- don't put it back in baby's mouth once he's already asleep.
• Helping babies pacify themselves. Infants need ways to help soothe themselves, says Jennifer Shu, MD, pediatrician and co-author of Heading Home with Your Newborn: From Birth to Reality, and a pacifier can be a source of comfort for a crying or colicky baby.
• It satisfies the suck reflex. Some babies have a need to suck that exceeds the time they get on the bottle or breast, says Laura Jana, MD, pediatrician and co-author with Shu of Heading Home with Your Newborn. For these infants, a pacifier can meet this very real need.
• Easier weaning. When you’re ready for a child to stop, it’s much easier to wean them from a pacifier than off of their own thumb, says Shu.

Pacifier Cons: Reasons to Avoid a Pacifier

While some parents hope to avoid pacifiers all together, Jana doesn’t think that’s necessary. Yet there are a few issues to watch for when using a pacifier:

• According to a study reported in Pediatrics, pacifiers may lead to 40% more ear infections (called acute otitis media). Though researchers aren’t sure why this happens, they suspect it may be due to a change in pressure between the middle ear and upper throat.

Reinforcing this, one study showed that “children who stopped using pacifiers regularly after the age of six months had more than a third fewer middle ear infections than children who use them,” writes Rod Moser, PA, PhD, in his WebMD blog “All Ears.”

• If a pacifier is introduced too early, there’s the risk of nipple confusion for a baby who’s just learning to nurse, says Shu. If you want to give your baby a pacifier, wait until after their first month before starting.
• Parents can mistakenly offer a pacifier when baby really needs nutrition-based sucking, such as a breast or bottle.

Babies who are overzealous suckers may change their tooth alignment or delay speech. However, for children less zealous, pacifiers shouldn’t be a problem. They “can certainly be a godsend for fussy babies,” says dentist Kimberly A. Harms, DDS, an American Dental Association consumer advisor, and “as long as they are only used for a short period of time, they do little damage to the baby's teeth.”

Nah nah, sucky, paci, binky, nuk-nuk, tooky...whatever kids call them, one of the most important facets of successfully using a pacifier is knowing when to stop using it. Though some pediatricians suggest weaning from the pacifier at about nine to 12 months -- the same time you banish the bottle -- others believe aiming to wean by about 18 months is good, too.

Whenever you choose to wean baby, you can make the transition to being pacifier-free a little easier on you and your little one with the tips from the pros:

• State your intentions. “My first tip is to always, always prepare your child in advance for what you’re going to do,” says Mark Brenner, MFT, PhD, family therapist and author of Pacifiers, Blankets, Bottles, and Thumbs: What Every Parent Should Know About Starting and Stopping. “For example, I’ll say, ‘Jordan, in three days we’re going to be done with the pacifier and I know you understand and that you can do it.’ You don’t want the thing to just disappear.”
• Try the limit rule. If you want to take the weaning a little slower, Brenner suggests the limit rule. Pick rooms that the pacifier can be used in, for example, maybe the bedroom but not the living room. Or try limiting the time the pacifier is used -- perhaps only at naptime and bedtime. If necessary “give a substitute comfort object such as a small new toy or book that the child can carry around for security,” suggests Shu.
• Leave it out. When baby uses a pacifier at night, refrain from going into their room to put the pacifier back in. The recommendation for using pacifiers to help prevent SIDS only applies to a baby falling asleep. There’s no suggested benefit once they are asleep.
• Love the lulls. Take advantage of the natural lulls in a child’s attraction to the pacifier. For many babies that’s in the second half of their first year. And be aware that often babies don’t ask for a pacifier “as much as parents are quick to offer” it, says Jana.
• Go snippety-snip. When your child’s not around, cut the pacifier’s nipple a little, suggests Brenner, “then show your child that the nipple has been damaged.” Explain that the pacifier is now dangerous and has to be thrown away. Never cut a pacifier and give it back to your child -- a step some parents take in an effort to wean -- as it poses a very real risk as a choking hazard.?
• Don’t plan for emergencies. Some parents and pediatricians suggest cold turkey is the best way to go, especially for older children. But don’t keep an “emergency” pacifier on hand, says Jana. This only reinforces the idea that if your little one cries long enough their beloved binky will magically reappear.
• To keep pacifier use safe, never put the pacifier on a cord around baby’s neck or crib because of the risk of strangulation.
• Look for a pacifier with ventilation holes in the shield, suggests the Academy of General Dentistry, as they permit air passage.
• Look for pacifiers with symmetrical nipples, which help the pacifier stay in the right sucking position. Also look for those with a shield wider than your baby's mouth.
• Don’t share a pacifier between children, and don’t clean a dropped one with your own mouth. “Parents' mouths have plenty of germs,” says Shu, and can transmit viruses and bacteria to the baby. Shu recommends washing a pacifier with soap and water or at least giving it a good rinse.