Binkies, Bo-Bo’s and Dummies: Weighing in on Pacifiers

Sooky, Goo-gee, Suce, Plug, Chewy or Pacifier – no matter what you call it, there’s no getting around the issue.  At some point as a parent, you will have to decide what to do about the Pacifier.  Here’s the “quick and dirty” on pros and cons of Pacifier use, guidelines for using a Pacifier, and what to do if you are constantly re-plugging it through the night.

Pros of Pacifiers

Oral input is powerful.  Your baby uses her mouth to explore her world.  It is also one of the primary ways that she uses to calm and regulate herself when she is “off kilter”.  Some babies need sucking to soothe more than others.

SIDS risk is reduced.  While research has not established a cause-effect relationship, we now know that the use of a Pacifier up to 12 months of age is associated with decreased incidence of SIDS.  Use of a Pacifier may keep baby in a lighter sleep state, or it may open up air space around her mouth and nose.  This is the primary reason that the American Academy of Pediatrics suggests offering a Pacifier in baby’s first year of life once breastfeeding is established.

Sucking is one of the 5 S’s.  Dr. Harvey Karp promotes use of the 5 S’s that mimic life in the womb and help your young baby calm:

  • Swaddling (I recommend using a swaddle sack with secure Velcro closures rather than a receiving blanket)
  • Side or stomach position when held in parent’s arms
  • Shushing close to baby’s ear
  • Swinging (which looks more like a fast “jiggle”)
  • Sucking

Watch Dr. Harvey Karp in action:

Pacifiers are easier to wean.  It is easier to wean your little one from the Pacifier than her thumb.  I recommend weaning the Pacifier by 12 months of age, before behavior patterns become more entrenched.  Pacifier use is not recommended past 2 years of age because it begins to impact dental health and interferes with speech.  Watch for my upcoming blog post on weaning Pacifiers with both older and younger children.

Pacifiers support weight gain in pre-term babies.  Studies show that Pacifier use in premature babies is associated with quicker weight gain, likely because sucking builds strength and development of the muscles around the mouth.

Cons of Soothers

Plugging is too easy.  Parents may default too quickly to popping a Pacifier in their baby’s mouth, rather than taking the time to watch her cues and discover why she is upset.

Paci’s are habit-forming.  Your baby may grow to love her Pacifier and it can be hard to wean as she gets past 12 months of age.  If she is only happy when she has something in her mouth, she will not expand and develop other self-soothing strategies as readily.

She needs your help.  Your little one may not re-plug her own Pacifier until she is 7 – 8 months of age.  Until then, you will need to do the work for her in the middle of the night.

Paci use leads to health issues.  Pacifier use past 6 months of age can trigger fluid collection in the ears and lead to recurrent ear infections.  Sucking on a Pacifier (or fingers or thumb, for that matter) past the 2 year mark is linked to changes to the shape of your child’s palate (roof of her mouth) and misaligned teeth.

Do Pacifiers interfere with breastfeeding?  According to several recent studies, Pacifiers are not likely to blame for early weaning from breastfeeding.  Conservative advice would suggest holding off on Pacifier use until breastfeeding is well established and baby is gaining weight steadily at about the 4 – 6 week mark.

Guidelines for Pacifier Use

If you do decide that the pros outweigh the cons and decide to go ahead and introduce a soother, here are a few things to keep in mind.

Which Pacifier should you use?  Pacifiers are made from either latex or silicone.  The latex soothers are softer but will deteriorate more quickly.  You will need to clean latex Pacifiers by hand with hot soap and water.  As with adults, some babies have a sensitivity to latex as well.  Silicone Pacifiers are sturdier and will last longer.  They can also be cleaned and sterilized in the upper rack of your dishwasher.  Pacifiers come in several shapes: standard (long with a rounded tip), orthodontic (curved on the top and flat on the bottom) and cherry-shaped (narrow stem with rounded tip).  Some Pacifiers are all one piece, but most come with a plastic mouth shield to prevent choking.  Some have knobs that babies can hold onto easily, while others have rings for use with a Pacifier clip.  The bottom line:  start with an orthodontic, latex Pacifier, but be prepared to trial several others.  Your baby will tell you which one she prefers.

Introducing a Pacifier:  If you have chosen to breastfeed your baby, hold off on regular Pacifier use until your milk supply and breastfeeding are well established and your baby is steadily gaining weight (usually around 4 – 6 weeks).   When your newborn baby is upset and you have checked out obvious causes for her distress (being cold/hot, wet/ poopy or hungry) then use other comforts as first-line strategies to help her calm.  Here’s where using the 5 S’s can be instrumental.  Start with swaddling and add in side/ face down cuddling in your arms, shushing and gentle swinging/ jiggling motion as needed.  If she still requires support, then add in sucking on your finger or Pacifier.

Never force your baby to take a Pacifier – respect her decision if she rejects it.

Watch your little one’s cues and listen to what she is saying to you.  If she is hungry, do not use the Pacifier to try and delay feeding her.  She experiences hunger as pain.  In the early weeks and months, it is especially important that you respond quickly to her needs to build that secure attachment bond of love and trust.

Building Pacifier Independence:  Go ahead and offer a Pacifier at the start of sleep time if it is helpful for your baby.  Avoid the temptation to re-plug her Pacifier when it falls out after she is asleep.  When she wakes and looks for the Pacifier to go back to sleep (and you have decided that you want to hang onto the Pacifier for a while), then work towards Pacifier independence.  Do less and less of the work of re-plugging.  Put the Pacifier in her hand and guide it to her mouth.  When your little one is able to get it in her mouth when you put the Pacifier in her hand, then take it up a notch.  Say, “Find your Pacifier” and tickle her fingers with the Pacifier so she reaches for it and puts it in her mouth.  When she has mastered that skill, then tickle her fingers with it and move it away a little bit so you teach her to “sweep” the crib to look for her Pacifier.

Scatter several Pacifiers in the crib so baby can “sweep” the crib and find one in the middle of the night more successfully.  You can also place the Pacifiers in the same spot in the crib so she knows where to find them.

If the Pacifier(s) fall out of the crib, some parents choose to install a mesh bumper to help retain the Pacifiers (and keep arms and legs of an older mobile baby from “catching” in the rails of the crib).

Consider using a WubbaNub or similar invention to keep the Pacifier close to baby through the night. The attached little stuffie often becomes her “lovey”, too.
Pacifier Safety

  • Clean Pacifiers regularly with soap and water (latex) or in the upper rack of your dishwasher (silicone). Cleaning is especially important in the first 6 months when your baby’s immune system is still maturing.
  • Don’t “clean” her Pacifier by putting it in your mouth. Your saliva contains bacteria that can impact your baby’s health.
  • Use Pacifier clips that are 6”/ 15 cm. or less and attach to baby’s clothing. Don’t attach a Pacifier to the crib, stroller, infant seat or play gym.
  • Never use a Pacifier with attached parts that could come off (such as a plastic “moustache”).
  • Don’t dip the Pacifier in sugar or honey. Besides introducing unnecessary sugars in her system, her developing teeth will be prone to cavities.
  • Watch her Pacifiers for signs of wear and replace regularly.

Your decision about introducing the Pacifier or not with your baby will be based on many factors, including your little one’s temperament and preference for oral soothing.  Both options can work well.  Consider the pros and cons, factor in your baby’s individuality and reflect on your own parenting philosophy.  And if you have a child who is attached to the Pacifier and you are ready to move onto Life-Beyond-the-Binky, then be sure and watch for next month’s post on weaning the Pacifier!
Margot Byer
Sleephaven Sleep Consultation
Helping Tired Families Sleep
… in Edmonton, Alberta and Beyond