On the East Coast it’s a binky. Southerners call it a paci. British babies use a dummy. Some folks even call it a plug. But no matter what you call a pacifier, you’ve undoubtedly heard an earful of conflicting information about using one. Many experts recommend using them to calm colicky babies while others insist they only serve to harbor bacteria and misalign teeth.
How can a little plastic and rubber device soothe your crying baby while dooming him to braces? Can a pacifier actually cause ear infections and prevent SIDS at the same time? Your mother-in-law says it’s a crutch, but all your friends say it’s a lifesaver. Pacifiers: Should your baby use them?
Satisfying Baby’s Need to Suck
The one thing everyone can agree upon is the newborn’s need to suck. “Infants are hardwired to need and enjoy sucking as a separate experience from feeding,” says Dr. Alan Greene, MD, FAAP. This sucking instinct is so hardwired that babies are often seen sucking their thumbs in the womb during routine ultrasounds. Why they enjoy sucking so much is unknown, but any mother who has experienced a 45-minute breastfeeding marathon or any dad who’s had the pad of his pinky rubbed raw by the vacuum power of a two-week-old baby knows that nothing delights an infant more than something in his mouth.
Our ancestors knew it too. Archeologists have unearthed prehistoric pacifiers made of bone, wood and smooth stone. Ancient Egyptian drawings appear to show babies using pacifiers. And the Athabascan women of Alaska, relatives of modern day Inuits, used to poke a stick through a piece of animal fat and place it parallel to the baby’s face so the child could enjoy the sensation of sucking without swallowing the fat. It’s a fact; where there are babies, there are binkies.
SIDS and Pacifiers
While it’s obvious that oral gratification can help keep babies and parents on an even keel, there are other benefits to letting your infant “plug in.” Several studies have shown a two- to threefold decrease of SIDS deaths among babies who use a pacifier. As explained in a recent article in Pediatrics magazine, “The hypothesis is that a pacifier protects the upper airway from becoming obstructed by the tongue.”
Some scientists speculate that a pacifier keeps a baby’s nose free of bedding in order to breathe or that pacifiers keep restless babies quiet, so they are less likely to thrash around in the crib and end up underneath the bedding. The American Academy of Pediatrics even created a task force to study this phenomenon and released a report in March 2000 stating, “Four recent studies have reported a substantially lower SIDS incidence among infants who used pacifiers than among infants who do not.”
Increase in Ear Infections?
On the other hand, there are also studies linking pacifiers to ear infections. For example, in a study published in Pediatrics, researchers found a 33 percent increase in ear infections in 6- to 10-month-old infants with unlimited use of a pacifier compared with those who only used one at bedtime. Doctors suspect that when a baby has a stuffy nose and sucks on a pacifier, it creates harmful pressure in the tube between the nose and the ear, increasing the likelihood of an infection.
There are also conflicting studies concerning binkies and breastfeeding. Some studies link early (before four weeks of age) pacifier use to decreased breastfeeding when mothers mistakenly substitute a pacifier for the breast, while other research indicates that babies who use pacifiers exhibit less breastfeeding problems overall, perhaps because they get extra sucking practice.
Effects on Teeth
While SIDS, breastfeeding, and ear infections are important issues to consider, the big pacifier debate has historically been about teeth. Dentists and orthodontists warn that pacifiers and thumb sucking keep them in business fixing buck teeth and misshapen jaw lines while legions of mothers claim that their children were addicted to pacifiers with no ill effects. Why the disparity?
“Every child is affected differently by pacifier usage. The effects depend on three factors: how intensely the child sucks, how long the child sucks, and how often the child sucks,” explains pediatric dentist Dr. David Snodgrass, DDS. But he goes on to warn, “Pacifiers can be extremely detrimental to a growing face, causing the underlying skeletal structures (bones and cartilage) to grow asymmetrically. They cause the upper front teeth to intrude and protrude which can interfere with proper speech and development and can lead to a tongue thrust.”
Dr. Snodgrass also dispels the common myth that pacifiers only affect baby teeth, so if your child is weaned from his binky before his permanent teeth come in, there shouldn’t be a problem. He says, “Pacifiers can harm a child’s normal growth and development causing the upper arch to be too narrow and the lower jaw joint to develop incorrectly.” With a mouth malformed as a baby, adult teeth will come in improperly too. And the cost of correcting these malformations? Anywhere from $650 to $950 for a device to correct problems in young children and possibly around $5,000 for braces later on.
Breaking up with Binky
The silver lining in this cloud is that unlike a thumb, children can be weaned from a pacifier. And the sooner you do it, the better. According to the American Dental Association, “Children who continue to use pacifiers past the age of three show a higher prevalence of altered dental arches and abnormal lip and cheek mobility compared to those who never used a pacifier.”
After 18 years of pediatric dentistry, Dr. Snodgrass recommends ditching the binky between 14 and 16 months of age. “We’ve found that the best way to get the children off the pacifier is to simply place every one of them in the house in a plastic freezer bag, shake them in front of the child, and tell them they are going to take them to their pediatrician (or Dr. Snodgrass) so he can give them to the little babies at the hospital. The next time the child asks for them, blame it on me. Another way is to simply gradually cut back on the nipple size by cutting a little off each week.” (This “snipping the tip” technique worked like a charm for the author and her 22-month-old daughter.)
Take these precautions when using a pacifier:
- Never tie a pacifier around a baby’s neck. No matter how many times baby drops it, never put the binky on a string. It could strangle your baby in seconds.
- Inspect pacifiers for wear and replace them often. A baby can choke on a tiny bit of rubber sucked loose from an old binky.
- Don’t make homemade pacifiers out of bottle nipples. They don’t have a wide enough base to prevent inhalation and choking. They also have a hole in the end that causes your baby to suck in air, creating gas and hiccups.
- You wouldn’t use the same dirty fork meal after meal and day after day, so wash your baby’s pacifiers often to avoid bacteria build-up.
- Disregard the “three second rule” when the binky hits the floor. As clean as your floor may appear, it can harbor traces of animal feces, tar, garbage and other nasties tracked in by pets and shoes.
- Never dip a pacifier in honey. Honey eaten by babies under one year can cause infant botulism—a sometimes fatal disease.