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The Great Pacifier Debate

To suck or not to suck: That is the question for many parents regarding a baby's "binky." The answer may not be so black and white.
WebMD Feature

You'd think something as small as a pacifier wouldn't cause such a big ruckus. But it seems that moms and dads either rave over them or revile them. But who's right? Pediatricians, parents, therapists, and dentists weigh in on the pros and cons of baby pacifiers.

A Few Reasons to Use a Pacifier

There are lots of good reasons to use pacifiers -- just ask any parent who's gotten a moment of quiet with the judicious use of one. But a bit of peace isn't the only good thing that comes from using a pacifier.

  • Protection against SIDS. The American Academy of Pediatrics recommends parents consider letting their child fall asleep or nap with a pacifier for their first year. Doing so has a protective effect against sudden infant death syndrome (SIDS). Use the pacifier when putting baby down to sleep, but don't put it back in baby's mouth once he's already asleep.
  • Helping babies pacify themselves. Infants need ways to soothe themselves, says pediatrician Jennifer Shu, co-author of Heading Home with Your Newborn: From Birth to Reality. A pacifier can be a source of comfort for a crying or colicky baby.
  • It satisfies the suck reflex. Pediatrician Laura Jana, co-author with Shu of Heading Home with Your Newborn, says some babies have a need to suck that exceeds the time they get on the bottle or breast. For these infants, a pacifier can meet this very real need.
  • Easier weaning. When you're ready for a child to stop, it's much easier to wean him from a pacifier than from his own thumb, Shu says.


Reasons to Avoid a Pacifier

While some parents hope to avoid pacifiers all together, Jana doesn't think that's necessary. Yet there are a few issues to watch for when using a pacifier:

  • According to a study reported in Pediatrics, pacifiers may lead to 40% more ear infections (called acute otitis media). Though researchers aren't sure why this happens, they suspect it may be due to a change in pressure between the middle ear and upper throat. One study showed that "children who stopped using pacifiers regularly after the age of six months had more than a third fewer middle ear infections than children who use them," Rod Moser, PA, PhD, writes in his WebMD blog "All Ears."
  • If a pacifier is introduced too early, there's the risk of nipple confusion for a baby who's just learning to nurse, Shu says. If you want to give your baby a pacifier, wait until breastfeeding is well established before starting (usually a few weeks).
  • Parents can mistakenly offer a pacifier when baby really needs nutrition-based sucking, such as on a breast or bottle.
  • Babies who are overzealous suckers may change their tooth alignment or delay speech. This especially becomes important when the child becomes a toddler and does not give up the pacifier. Sucking a pacifier at this stage can lock the mouth into an unnatural position and cause dental problems later on. Additionally, talking around a pacifier may delay speech development.

If you decide your baby should have a pacifier, make sure to buy one that states the same age on the label as your child's age. Buying pacifiers that are meant for younger infants could pose a choking hazard. Lastly, you may want to get a bisphenol A-free plastic pacifier as there have been studies showing that endocrine-disrupting hormones found in some plastics can be harmful to infants.

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