Thursday, July 9, 2009

Pacifiers: The basics

Reviewed by the BabyCenter Medical Advisory Board
Last updated: April 2008

Should I give my baby a pacifier?

As a new parent, comforting your baby is one of your highest priorities, and you may find a pacifier very helpful. While some babies find activities like rocking and cuddling to be perfectly soothing and are content to suck during feedings, others just can't seem to get enough of sucking, even when they're not hungry. If your baby wants to suck even after she's had her fill of formula or breast milk, a pacifier may be just the thing.

A pacifier isn't a substitute for nurturing or feeding, of course, but if you've fed, burped, cuddled, rocked, and played with your baby and she's still fussy, you might want to see if a pacifier will satisfy her.

There's another benefit to using a pacifier, too. Some studies have shown that babies who use pacifiers at bedtime and naptime have a reduced risk of sudden infant death syndrome (SIDS). These studies don't show that the pacifier itself prevents SIDS, just that there's a strong association between pacifier use and a reduced incidence of SIDS.

Are there any disadvantages?

Pacifier use may increase the risk of middle ear infections in babies and young children. In one study, the incidence of ear infections was 33 percent lower in babies who didn't use pacifiers.

Since the risk of these infections is generally lower in young babies, you may find that using a pacifier until your baby's half-birthday (when her need to suck is greatest) and weaning her from it soon afterward — especially if she seems prone to ear infections — works just fine.

If you're breastfeeding your baby, you'll want to delay offering a pacifier until she's a proficient nurser. That's because sucking on a pacifier and sucking on a breast are different actions, and babies who are offered a pacifier before they become adept at nursing sometimes experience nipple confusion, which can interfere with successful breastfeeding.

For this reason, the American Academy of Pediatrics (AAP) suggests that you wait until your baby has learned to latch on and suck well and your milk supply is well established. Her 1-month birthday should be about right.

Because sucking on a pacifier can easily become a habit, many parents don't introduce one because they don't want to have to deal with having to take it away down the road, or because they don't like the thought of having their 3-year-old walking around with a binky in her mouth.

Taking care not to overuse the pacifier should help avoid overdependence. And a pacifier habit is easier to break than a thumb-sucking habit. After all, you can dispose of a binky! (For help, here are ten ways to help your child give up the pacifier.)

Pacifier guidelines

If you decide to introduce a pacifier, keep these guidelines in mind:

• Let your baby guide your decision. If she seems to love the binky right off the bat, fine. But if she resists, don't force it. You can try again another time if you like or just respect her preference and let it go.

• Whenever possible, don't use a pacifier to delay your baby's feedings or as a substitute for your attention. Offer the pacifier between feedings, when you know she's not hungry. When she's fussy, try to comfort your baby in other ways first, such as cuddling, rocking, or singing.

That being said, sometimes your baby does have to wait to feed or be comforted by you (in the checkout line at the grocery store, for example, or in her car seat five blocks from home). In these instances, a pacifier can be a godsend.

• Never tie a pacifier around your baby's neck or to her crib. She could strangle in the cord or ribbon. It's safe to attach the pacifier to her clothes with a diaper pin or a clip made especially for the job.

Take care of the pacifier. Choose a pacifier that's safe and appropriate for your baby and keep it clean. Replace it as soon as it shows any signs of wear.

Are there times when a baby definitely should not be given a pacifier?

A baby who is having problems gaining weight shouldn't be given a pacifier. If your baby is breastfeeding and having any difficulty nursing — or if you're having trouble maintaining your milk supply — you'll want to do without a pacifier, at least for now. You'll also want to consider having your baby go without a pacifier if she's had repeated ear infections.

If you don't want your newborn to have a pacifier at the hospital, alert the staff in advance — particularly if you intend to breastfeed. Although a day or two of pacifier use in the hospital won't hook your baby on binkies, it simply makes sense not to introduce something you aren't going to use at home.

Will a pacifier interfere with the development of my child's teeth?

Sucking on a pacifier well into the childhood years might threaten proper dental development, but it's unlikely that your child will be at it for that long.

During the years when your child is likely to be using a pacifier, she has only her baby teeth. (Permanent teeth generally start appearing by age 4 to 6.) If you ever become concerned about this, ask your baby's doctor or dentist to check that your child's jaw and teeth are doing fine.

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