Suck to soothe: Is a pacifier right for your child?

They’ve been around for hundreds of years as soothers for babies and have fallen in and out of favor in different generations. Parents have debated over whether or not they’re lifesavers or germ carriers. They inspire confusion and strong opinions in parents, grandparents and strangers you pass with your stroller. Yep, you guessed it, we’re talking pacifiers here.

One of my frequently asked questions as a sleep coach is if I think pacifiers are okay to use. Before giving my opinion, I always want parents to know that using a pacifier is not a moral issue. A pacifier, like many other things, is a tool. It is not a good thing or a bad thing, nor is it indicative of parenting philosophies or flaws. However, it has been a controversial topic at times, so lets take a look at the pros and cons.

Pros to pacifier use:

  • Help decrease risk of SIDS

  • In their most recently published safe sleep recommendations, the American Academy of Pediatrics includes offering a pacifier at bedtime and nap times in order to reduce incidence of SIDS. While it is not fully understood, research has shown that infants who use a pacifier to get to sleep have a significantly lowered risk of Sudden Infant Death Syndrome. Some theorize that the active motion of sucking keeps the baby from falling into too deep a sleep, while others posit that a pacifier in the mouth creates a barrier against suffocation. Even without the reasons why, researchers have enough evidence to conclude that pacifiers are useful in infant sleep safety.

  • Provide a means of soothing a baby

  • As anyone whose ever had a baby knows, they can be fussy little creatures. Babies go through periods where they are tough to calm. Be it a developmental phase, the witching hour, teething or any other tricky time, pacifiers are a handy way to calm a baby. Children are born with a primitive sucking instinct separate from their need to feed. Sucking is a powerful way to soothe a baby whose nervous system may not be quite up to the task of self-soothing just yet.

  • Pacifiers have been also shown to decrease pain in infants, often making them a go-to when it comes to shots, medical examinations and the like. Sucking also induces swallowing, which can help reduce ear pressure while traveling.

  • Boost growth and development in premature babies

  • Babies born premature, before 37 gestational weeks, may not have fully developed sucking abilities, which causes feeding problems that can result in poor nutrition and weight gain. Sucking on a pacifier gives preemies a way to practice and strengthen the skill they need in order to feed and grow properly.

  • Can encourage infant-parent bonding

  • New mothers with post-partum depression or mood disorders have higher rates of breastfeeding when baby uses a pacifier. The reason for this is because for an exhausted mother who is struggling to take care of a needy infant, having a way to soothe her baby lends more calm to the entire situation. When baby isn’t constantly crying or needing a lot of hands on help from a caregiver to quiet, Mom has a chance to rest and regain some of the equilibrium necessary to give breastfeeding a chance. This applies to all new parents; having a means to calm your baby brings you back from the edge and gives you the ability to enjoy your new baby.

Cons to pacifier use:

  • Can cause dental problems

  • No baby is going to suffer dental problems from using a pacifier but with prolonged use, you may run into tooth trouble during the toddler and preschool years. The American Dental Association notes that most children stop using pacifiers on their own by age 4 and that if a child hasn’t by that time, parents should assist in breaking the habit. However, dental problems caused by sucking are oftentimes related to unique variables such as how active and frequent the sucking is as well as a genetics. For that reason, many pediatric dentists suggest getting rid of the pacifier by age 2 or 3.

  • May increase incidence of ear infections

  • Studies show that in small children, recurring ear infections may be caused by pacifier use.

  • Can become a disruptive sleep crutch

  • If you find yourself replugging a pacifier all night or your toddler screams without one, you may have a non-functional sleep situation on your hands. Having a sleep association becomes an issue when it’s not independent and is disturbing your child’s sleep as well as yours. Even if a child is using the pacifier independently, the time will eventually come to transition out of it and learn a new way to fall asleep.

  • Require some care and hygiene

  • If you're not up to the task of washing your pacifiers, they can easily become a nice little source of germs, especially if they aren't restricted to the crib or bed. Pacifiers should be washed occasionally, as well as boiled before first use and after illness, tested periodically to make sure they're not ripped or torn and haven't accumulated any yucky grime or mold on in inner part.

Whether it’s your binky, dummy or soother, pacifiers have got their good points and their bad. Your choice as a parent is not only whether to use one but also when and for how long. As a sleep consultant, I recommend keeping a pacifier for bedtime and nap time only, perhaps with the exception of long car rides and visits to the doctor. If you’re letting your child use a pacifier, I suggest you teach him to use it on his own as much as possible. That means, putting it in your child’s hand instead of his mouth, leaving a few in the crib within easy reach or, for an older child, give him a special container where he can find an extra pacifier, should he need it in the middle of the night. Keep in mind that our goal, as always, is to encourage calm, peaceful sleep for the whole family.