Pacifiers (pacis, dummies, binkies or whatever you may call them) may be your best friend or worst enemy depending on the season you are going through. It feels like it might be your only chance to go to sleep or the reason you are up all night to pop it back in as it pops out of your babe’s mouth like a jack in the box. So the question is then, should you offer your baby a pacifier to begin with? As with many things I present on this blog platform, the answer really depends on you and your baby. If offering a paci is important to you, do it. If not, then there is no need. And your baby will also have an opinion regarding the topic so listen to them as well. Having said that, here are a few points to consider when making the choice.
What are the benefits of pacifiers?
Babies are born with a sucking need. Most of that is satisfied by breastfeeding or bottle feeding but for some babies, they need to continue sucking beyond that. The pacifier can be very handy in this situation as it can help satisfy the extra need for sucking and we call this non-nutritive sucking.
This non-nutritive sucking in turn helps babies recall or trigger their calming reflex. This reflex is helpful in soothing a particularly fussy baby. If your babe experiences fussy periods in the day (example purple crying period), try offering them a pacifier to help them find some calm.
In addition, research has shown that the use of a pacifier at the onset of sleep is a protective measure agains SIDS. This means that it can reduce the incidence of SIDS, even if the pacifier is not propped back in in the middle of the night.
What Pitfalls should I be on the lookout for?
While the pacifier has many advantages, it also has some pitfalls that you should be aware of. For starters, if baby comes to rely on it to fall asleep, it can interrupt night sleep if it falls out. This is especially true for infants as they are unable to place it back in their mouths independently and will then need to signal to parents to come place it back.
Each baby is different and while opinions vary on the topic, some breastfed babies have been known to experience nipple confusion after using a pacifier. If this is something you are concerned with, you may want to wait until you stabilize your breastfeeding before you introduce a pacifier.
Though rare, pacifiers have been linked to repeated incidences of ear infections. Check with your pediatrician if your baby is experiencing recurrent ear infections, you may need to drop the pacifier before you intended to.
Most children will have dropped the pacifier by the time they are 4 years old. Prolonged pacifier use can have dental implications such as teeth misalignment.
When should I introduce a pacifier?
The American Academy of Pediatrics recommends introducing the pacifier when baby is around 3 or 4 weeks old. This gives you time to stabilize breastfeeding and prevent any nipple confusion.
What if my baby hates the pacifier?
Even your best plans to use the pacifier may be foiled by your little one. They may just not like it. If this is something that's important to you, you can persist without necessarily forcing it upon your little one. Remember that babies are born with a thrust reflex which might cause them to push the pacifier away when you put it in their mouth. But they also have a sucking reflex which helps them hold on to the nipple (human or bottle/paci) and squeeze it between the roof of their mouth and tongue. Many researchers believe these two reflexes are linked, but I digress here. What I’m trying to say is that Dr. Harvey Karp (author of the Happiest Baby on the Block) recommends that you gently tug the pacifier once you place it in your baby’s mouth to activate their sucking reflex and stop their thrust reflex.
When to drop the pacifier?
I have found that there are a couple of places in baby’s early life where it is easiest to drop the pacifier. Don’t get me wrong, removing the pacifier from baby’s routine is not easy but these times are relatively easier compared to others. The first one is around 4 months of age, when baby’s circadian rhythms are developed. Baby at this age hasn't formed too many habits that are hard to change and is young enough to quickly adjust to life without the paci. This also helps in preventing the pacifier from becoming a sleep crutch/association. If you keep the pacifier beyond this point, the next easiest place to drop it is when baby is between 2 and 4 years old.
How do I go about dropping the pacifier at 4 months?
1- Cold Turkey: Drop the pacifier overnight and replace it with another way to soothe your baby to sleep such as rocking or patting. Or better yet, use this time to teach your baby to self settle and become an independent little sleeper!
2- Gradual: Slowly and over a few weeks, reduce your babe’s use of the pacifier. You can start by not offering it during the day. Then offer it only at the onset of sleep and then finally dropping it altogether.
What if I decide not to drop it at 4 months, how can I reduce the Jack in the Box effect?
If you don’t drop the pacifier when your babe is around 4 months, there will most likely be a period where you will have to replace baby’s pacifier in the middle of the night if it falls out. In this case, encourage your baby’s independence by teaching them to replace it themselves. Instead of putting it directly in their mouth, place it in their hand and then gently guide them to their mouth. Over time, you can slowly reduce your intervention and babe will be able to just place it themselves. To help them out in the middle of the night, place multiple pacis in the crib. You can also use daytime play to show baby how to grab the pacifier and put it in their mouth.
How do I drop the pacifier later (between 2 and 4 years of age)?
1- Cold Turkey: Mentally prepare baby that when they reach 3 years old for example (or any other milestone you choose), you will plant the pacifier or the pacifier fairy will come get it or we will donate the pacifier to other younger babies. But be prepared, once the fairy comes, it can’t bring it back. Consistency is your friend here.
2- Gradual: You can also do it gradually as described for younger babes. Explain to your child that at such and such age, we can only use the paci when its dark and be consistent about your decision. Then choose another change and stick with it for a few days until your baby no longer needs it.
The Paci Weaning System by Frida is also a good option to explore as it helps wean the pacifier gradually.
As you can see, there are good reasons why opinions are divided regarding the pacifier. But if what you are doing is working for you, then it is the right decision for your family!