Nursing went smoothly right from the start for Rexann Brew, but she soon noticed that even when her baby wasn't hungry, little Anna still had a strong desire to suckle. Rexann resorted to giving the infant a pacifier.
"We sort of hoped she would be a thumbsucker and comfort herself," says Brew, of Pasadena, Calif., who admits she and her husband awoke at least once a night for more months than she cares to count to replace the pacifier in Anna's mouth so the baby could get back to sleep.
Despite the sleepless nights, the pacifier was a lifesaver. "I nursed her," says Brew, "but I didn't want to become her pacifier."
The Sane Choice
Pacifiers may still carry the stigma of being second-rate next to the old standby -- a baby's own ever-so-handy thumb or fingers. But most experts say that for infants who have a stronger than usual urge to suck and don't really take to fingers or thumbs, pacifiers are fine if used properly.
"I prefer that babies suck their hands," says Dr. Barbara Howard, assistant professor of pediatrics at the Johns Hopkins University School of Medicine in Baltimore. "But if they won't and they have a lot of difficulty regulating themselves, then listen, let's do what works. Pacifiers can save lives, seriously."
Christine Sellai of Takoma Park, Md., agrees. During car trips when baby Grace got hungry or crabby, 6-year-old Frank was entrusted with the all-important pacifier duty until they could race home. She says the temporary fix kept them from going bonkers. "You get stuck in traffic, and there's nothing worse," Sellai says.
Nipple Confusion
The fact is, sucking is instinctive and necessary to healthy development, particularly in the first few months. Most babies satisfy this primal urge by nursing or bottle-feeding, but some babies -- especially those who have trouble managing their moods and calming themselves -- may need extra non-nutritive sucking by using fingers or a pacifier.
Nonetheless, most doctors recommend waiting a few weeks to introduce a pacifier -- until babies and parents get used to feeding routines -- especially if moms are nursing. Not only could a newborn become confused between a pacifier nipple and the real thing -- possibly prompting breast-feeding problems -- parents also may fail to recognize cues that the baby is hungry.
"You put the pacifier in the child's mouth, and it holds her off for 15 or 20 minutes longer than if you had just put the baby right to breast, and over a day you may miss one to three feedings," says Dr. Debra Bogan, assistant professor of pediatrics at Children's Hospital in Pittsburgh. "I suggest restraint for the first three to four weeks."
I Want My Binky
Parents often worry that pacifiers -- or thumbsucking, for that matter -- will interfere with normal tooth growth. But dental studies show that those worries are unfounded as long as the habit is abandoned before adult teeth start coming in, at about age 5. Pacifiers may aggravate chronic ear infections, though, notes Howard.
Children who use pacifiers excessively past the age of 2 may also increase their risk for speech problems, says Dr. Mary Hayes, a pediatric dentist in Chicago and spokesperson for the American Dental Association. Pacifiers encourage a habit of swallowing with the tongue forward, which can affect formation of the "s," "z," "t" and "d" sounds.
Fortunately, a baby's urgent need for sucking usually starts to wane after about 3 or 4 months -- the perfect time for parents to be more selective in offering a pacifier. "If they're not asking for it, put it away. Out of sight may be out of mind," says Bogan.
In fact, it may be easier for children to kick the habit if they're using a pacifier than their fingers. Brew thinks so. "Pacifiers put more control in the parents' court when it comes time to give something up like that," she says. Her Anna is a case in point. At the age of one-and-a-half, she still uses a pacifier, but, with her parents' help, she's already learned to leave it in her crib for nighttime and naptime use only.
