There seems to be a new challenge with our kids every few weeks. For me and my husband, the latest was to wean our youngest from his binkie. Much like a smoker needs to set a quit date before actually quitting, we set a binkie wean date. This was mainly to mentally prepare us (the parents) for the potential withdrawal and anticipate alternate comfort activities to soothe our son. So we set our date for a Friday. Well, I should say I set the date. It gave me comfort to know that the potential hardship of life without the binkie would be shared together with my husband over a weekend for those first crucial days. Not romantic, but practical.
With our first child, the binkie wean came when she started a toddler school program. On her second day there, I witnessed a playmate calmly and assertively remove my daughter’s binkie from her mouth and place it in her own. When she was done, she thoughtfully returned the binkie…into my daughter’s mouth. I couldn’t bear the thought that this would likely be happening multiple times a day with multiple schoolmates. Hello germ overload! So the binkie was gone, no weaning ritual or plan, just gone. Thankfully, it wasn’t a problem. After a few weeks, the same has held for our son.
Now I understand there are many camps on this topic. One camp, that a dear relative of mine would fit into well, could be described as the “you don’t need to use that” camp. The phrase was used when she saw me put the binkie into my older child’s mouth when she was a baby. This camp is made up of those that believe that the pacifier, or “paci” as we call it in our family, is a crutch, and an unnecessary one that shouldn’t be around in the first place. The other camp is made up of the mindset: “This comfort measure is a miracle invention… Let the child use as needed: refills unlimited.” Other camps, including the medical community, are somewhere in the middle.
A wonderful article in the April 15th, 2009 American Family Physician reviews the risks and benefits of pacifiers and references the latest medical literature on the subject. Here is a review of some of its major points:
A number of benefits of pacifier use have been found:
1. Beyond fulfilling a natural sucking reflex in fetuses and newborns, pacifier use has been found to decrease a newborn’s sense of pain. Studies have shown they help relieve the pain during procedures such as catheterizations, heel sticks, venipunctures, circumcisions and immunizations.
2. Preterm infants that use pacifiers also appear to have shorter hospital stays.
3. There is a strong association between pacifier use and a reduction in the risk of sudden infant death syndrome or SIDS. We aren’t yet sure why this association exists, but there are a number of possible reasons that include that using pacifiers may increase the openness of the baby’s airway, keep her more aroused, prevent her from rolling onto her belly and face, or decrease reflux of stomach acid toward the mouth. Because of this finding, the American Academy of Pediatrics recommends starting pacifiers at the onset of sleep at about age one month or after breastfeeding has been well established. Though, an infant should not be forced to use a pacifier. And, you do not need to reinsert a pacifier if a sleeping baby has spit it out.
Pacifier use can have complications. But, by knowing what these are, you can learn how to avoid them.
1. If introduced before 1 month of age or before breastfeeding habits are solidly in place, pacifier use can interfere with the establishment of breastfeeding. (Note that this doesn’t apply to premature infants who may benefit from pacifier use for oral training.)
2. If your child uses a pacifier beyond the age of 2 yeats and especially beyond the age of 4, she has an increased risk of dental malocclusion. There does not appear to be any major difference in this risk when comparing orthodontic and conventional pacifiers.
3. After 6 months of age, there is an increased risk of middle ear infections associated with pacifier use. Because of this, the American Academy of Pediatrics recommends weaning pacifier use in the second 6 months of life. Several studies have shown that a significant proportion of pacifiers are colonized with microorganisms, but none of these organisms have been found to be those known to cause middle ear infections. So, a direct association of colonization of pacifiers with microorganisms as a cause of infection has not been shown
Please also keep in mind these general recommendations:
1. Don’t place sweet substances on pacifiers.
2. Replace and clean pacifiers regularly. Having back ups can also be a nice convenience.
3. After 6 months of age, pacifiers become a security object, as opposed to a way of nonnutritive sucking. When avoiding or weaning pacifiers, remember that other things can help comfort our babies: swaddling, rocking, soft music, singing, infant massage, and distractions with other objects or toys.
Visit this American Academy of Pediatrics website for more recommendations on pacifier use and links to the medical literature.
