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Pacifiers are supposed to safely soothe babies — that’s in fact their very purpose. That’s what I thought until I tried weaning my son off them last month only to discover (twice) that they were a choking hazard.
It turns out, there is a lot of confusion over pacifier guidelines — which are safe, for what ages, and when and how to wean — so I did some research.
Pacifiers are recommended by the American Academy of Pediatrics (AAP). See, babies have a strong sucking reflex and the sensation is calming; more importantly, research suggests that pacifier use reduces risk of sudden infant death syndrome (SIDS). So, I encouraged my son to use them. I chose the WubbaNub, in part, because I thought the attached stuffed animal would decrease choking probability since the plush is too big to swallow. My son LOVED his two pacifiers. Nevertheless, he was getting older so the time came to wean.
Both medical and dental experts suggest weaning between age 2 and 4. Dr. Gregory Gordon, an Orlando pediatrician who weaned his own nine children, suggests that using a pacifier beyond age 4 can permanently affect the teeth. While Dr. Laura Jana, an AAP spokesperson and author of The Toddler Brain, admits the wide age range causes parental confusion. “Pediatricians, in general, no longer pinpoint an exact age because it depends on safety, like SIDS in the first year of life, and personal preference depending on the child,” she says.
With my son Finn’s second birthday coming up in August, I sought weaning advice from his pediatrician, medical websites, and my mommy Facebook group. The most suggested technique: cut the tip to eliminate the desired suckling sensation, which causes your baby to reject the broken binky.
Attempting to wean gradually, my husband poked a tiny hole in the tip and progressed to a cut. One particular day, my son showed cold symptoms. So when I heard him “cough” at 2:30 AM, I went into his nursery armed with cough syrup. To my surprise, he was covered in vomit including pacifier pieces. Finn had bitten off a chunk of the nipple, swallowed it, and gagged it back up. I immediately went into panic mode as he vomited again. I called the poison control hotline and his pediatrician. Finn was scared and stunk of puke, but both authorities believed he was not in danger as the silicone nipple was nontoxic.
Experts are divided when it comes to the punctured tip method. Dr. Gordon has tried it; whereas Dr. Jana is not a fan. “I’ve learned about how much goes into the process of product safety, so I don’t like the idea of modifying something,” she cautions. “And, cutting the binky hasn’t been proven as the magic solution.” Both doctors agree that pacifier use should decrease around 12 months as not to impede speech and, eventually, be limited to bedtime.
“Parents should not remind their child about the pacifier — i.e. out-of-sight, out-of-mind — or put it back in when it falls out, but rather redirect with a bedtime routine focused on books or other comforts like a blanket [or lovie],” Dr. Jana suggests for weaning.
After the choke, I decided to take a weaning break and resumed use of an unaltered pacifier. Just days later, Finn bit off the nipple AGAIN! My toddler doesn’t have vampire teeth so I was stunned. And, of course, could have gone without a scary pacifier sequel.
Did I simply chalk it up to an epic #MomFail? Nope! I reviewed the safety page on the WubbaNub site and did not find warnings; however, housed on their FAQ page, they state that the “recommended age is newborns less than six months of age or babies without teeth.”
I was shocked … as were my mommy friends and Drs. Gordon and Jana. “I’m not familiar with restrictions on pacifier age and definitely not at 6 months. I don’t know any doctor that recommends weaning before 6 months,” said Dr. Gordon. And Nancy Cowles, Executive Director for Kids in Danger (KID), a nonprofit organization dedicated to protecting children by improving their product safety, is also in agreement stating, “I’m not aware of that [6 months] age warning on pacifiers, aside from ones labeled newborn for 0-3 months.”
It looks like Finn’s incident wasn’t the only one. In 2015, KID released a report with data from the National Electronic Injury Surveillance System (NEISS), which tracks hospital visits due to unsafe products. They reported that between 2010 and 2014, there were 179 pacifier-related visits to emergency rooms and projected that 7,500 incidents involving pacifiers likely occurred nationwide — the majority involving choking, lip laceration, poisoning hazards, and allergic reactions.
While choking incidents are rare, they do happen and both Drs. Gordon and Jana have encountered them in their careers. Dr. Gordon encourages parents to be vigilant about checking pacifiers because, over time, the material can crack and tear. AAP recommends pacifiers that are one solid piece with short nipples and adherence to age guidelines. Yet the latter is easier said than done. For instance, I’ve seen some listed as an “infant” pacifier on retail sites though the fine print says “newborn.” As I unfortunately learned, marketing verbiage is nothing to cough at. Many brands cap at 18 months, which is before pediatrician weaning is emphasized. While others do sell 18-36 month pacifiers but are two-piece versus the recommended one-piece style.
I can’t tell you which brand is ideal but I can tell you that I remain pro-pacifier but with a new drive to promote pacifier safety. “Parenting is a work in progress and this is just one eye-opening experience that shouldn’t be ‘mom shamed’ but increase awareness that we all need to do a better job of paying attention to safety recommendations — from pacifiers to car seats to toys,” says Dr. Jana.
I still feel #MomGuilt but am thankful that my son is safe and, now, weaned. After the second incident, we successfully went cold turkey with a couple of tearful bedtimes, a lovie, and the WubbaNub plush sans pacifier.
If there’s one piece of advice I can give, it’s to do your research on the pacifier (and then some) — paying special attention to the age recommendation. God speed, Mamas!