Put Away the Pacifier

Pacifier use provides many benefits for infants including:

-Lowering the risk of SIDS

-Satisfying the suck reflex

-Encouraging self-soothing

However, prolonged pacifier use can have many adverse effects on your child's teeth, speech production, language, hearing and feeding.

Teeth: The most common negative effect in the mouth is an open bite (see photo above), which is an obvious gap between the upper and lower front teeth when the jaw is closed. Another negative effect is a cross bite, which is when the top back teeth are tucked inside the lower back teeth. Prolonged pacifier use can also delay baby teeth from falling out, which affects the emergence of adult teeth.

Speech: Pacifiers promote forward tongue carriage, which can cause decreased clarity of speech. Forward tongue carriage makes it more likely that children will produce certain speech sounds pushing against their front teeth, or with the tongue through the front teeth (such as a lisp for the "s" sound).

Language: When children constantly have pacifiers in their mouths, their opportunities to use language are limited.

Hearing: Prolonged and frequent pacifier use is a risk factor in the development of ear infections. Repeated ear infections can cause difficulty with speech development, and increase the risk of hearing loss.

Feeding: Pacifier use promotes an immature sucking pattern, which can affect a child’s feeding and swallowing development. If children develop an open bite from pacifier use, they are unable to bite foods from the center of their teeth.

When should the pacifier be eliminated?

Most research shows that pacifiers should be taken away by age 2. However, many doctors and speech-language pathologists believe they should be eliminated around 1 year. Why do we advise taking it away at age 1? It is usually easier, for both parents and baby. By age 2, most children have become very emotionally attached to their pacifiers, often using them as transitional objects.

How can the pacifier be replaced?

Start using a small blanket or stuffed animal as a transitional object, such as a lovey.

Take your child to Build-a-Bear and drop the pacifier in the bear before it is sewn together, and then your child can use the bear as a transitional object.

References

Barbosa, C., Vasquez, S., Parada, M. A., Gonzalez, J. C., Jackson, C., Yanex, N. D., Gelave, B., Fitzpatrick, A. L. (2009). The relationship of bottle feeding and other sucking behaviors with speech disorder in Patagonian preschoolers. BMC Pediatrics, 9(66).

Bashara, S., Warren, J., Broffitt, B., Levy, S. (2006). Changes in the prevalence of nonnutritive sucking patterns in the first 8 years of life. American Journal of Orthodontics and Dentofacial Orthopedics, 130(1), 31-36.

Zardetto, C. & Rodrigues, C. (2002). Effects of different pacifiers on the primary dentition and oromyofunctional structures of preschool children. Journal of Pediatric Dentistry, 24(6).

Hanafin, F. & Griffiths, P. (2002). Does pacifier use cause ear infections in young children? British Journal of Community Nursing, 7(4):206, 208-11.

Jacoby, R. (2013). Why and when you should wean your child off pacifiers. New York Family.

Peck, P. (200). Continuous pacifier use linked to ear infections. WebMD.

Sexton, S. & Natale. (2009). Risks and Benefits of Pacifiers. Am Fam Physician, 79(8):681-685.

Shotts, L. L., McDaniel, D. M., & Neeley, R. A. (2008). The Impact of Prolonged Pacifier Use on Speech Articulation: A Preliminary Investigation. Contemporary Issues in Communication Science and Disorders, 35(Spring), 72-75.

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