Parents of infants and toddlers frequently ask me a mouthful of questions about pacifiers. Let me see if I can pacify everyone’s concerns with a few tips on this interesting habit.

All babies have a need for sucking to quiet and calm themselves when a mother’s breast isn’t available. I don’t recommend introducing a pacifier to quiet your baby until breast-feeding is in full swing. Otherwise, it may confuse a baby who is learning to breastfeed.

If you want your baby to use a pacifier, offer it a naptime and bedtime. Don’t use it to replace or delay meals. And don’t force your baby to take one if he or she doesn’t want it. Never use a pacifier as a substitute for communicating with your baby. Nor should you use it to silence your baby so that he or she cannot communicate with you.

If you use a pacifier, select a sturdy one-piece model with ventilation holes and a base or shield that is 1½ inches across. This will keep your baby from putting it completely into his or her mouth and choking. Do not tie a string or ribbon to the device, since this may get caught around the baby’s neck.

You don’t really need to be concerned about persistent pacifier use until a child’s permanent teeth start to come in. At that time, the pacifier can affect the shape of the mouth and how teeth are lining up. Some parents want their toddler to stop sucking on the pacifier after a year of age. If that’s you, here are some suggestions learned from other parents:

  1. Restrict the use of the pacifier to your child’s room. Consider limiting its use to naps and bedtimes to wean gradually.
  2. Let peer pressure do its work. When your child’s friends aren’t using their pacifiers in public, then neither will your child.
  3. Don’t call attention to the habit, although you can distract your child if you see him or her going for it. On the other hand, feel free to offer praise if your child is getting by without the pacifier.
  4. Consider wrapping up the pacifier and giving it to a friend’s new baby. Have a gift from new baby for your child in exchange.
  5. Finally, never wean from a pacifier at times of increased stress for your child. This could include the arrival of a new sibling or a family move.

Hopefully, tips like these will wean you of your concern that your baby will go to college with the pacifier.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.  You can also catch “First with Kids” weekly on WOKO 98.9FM and MyNBC 5, or visit the “First with Kids” video archives at www.UVMHealth.org/MedCenterFirstWithKids.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.

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