Is a Pacifier Worth the Potential Problems?

Though they may be soothing for little ones and helpful for parents, many of the most common oral habits can have a negative effect on a child’s health and create a snowball effect of issues. The main culprit is pacifier use beyond age 6-12 months, but other oral habits include thumb/finger sucking, fingernail biting, clothing sucking/chewing, and hair chewing.

In general, any oral habit can cause the tongue to rest too low and be in a forward position. Over prolonged periods, these positions can have a detrimental effect on facial growth and the formation of the roof of the mouth, and can lead to disordered breathing habits like mouth breathing and snoring. In turn, these breathing habits are associated with sleep disordered breathing and can result in reduced oxygen to a child’s developing brain during sleep.

There are well-known benefits to pacifier use for infants. They reduce the risk of sudden infant death syndrome (SIDS) when introduced at the onset of sleep and can offer pain relief for discomfort, particularly helpful for infants in the NICU or hospital setting. Pacifiers can help in oral motor development and sucking coordination, especially in infants born prematurely or with feeding difficulties.

But things shift at 6 months of age, a timeline that may not even be on the radar for many parents. Beyond the 6-month mark, there are minimal benefits from pacifier use. Although pacifiers continue to offer some protection against SIDS, there is an increased risk of ear infections. Ear infections in children under 12 months old have been directly tied to an increased risk of developing long-term speech and language problems.

Once a baby hits 12 months, there is no evidence-based benefit to continue using a pacifier. Here are the main issues that can develop from pacifier use beyond 6-12 months of age:

• Teeth Development. Pacifier use, as well as thumb/digit sucking, often negatively impact the way a child’s teeth develop and the way the teeth meet when the jaws bite together (called occlusion). Teeth can form in an open bite formation, meaning the front top and bottom teeth don’t meet.

• Tongue thrust swallow. An oral sucking habit prevents the tip of the tongue from reaching its designated position at the roof of the mouth behind the front teeth to initiate a swallow. Instead, the tongue thrusts against the teeth, which pushes the teeth forward and often contributes to an open bite. This atypical swallow pattern does not typically self-resolve and requires treatment to correct.

• Putting Away the Pacifier. As the months go by, it becomes increasingly harder to break the habit and eliminate a pacificer!

Whether you’re awaiting the arrival of your first baby or are a seasoned parent, there are some simpletips and tricks to keep in mind to either decrease or eliminate this oral habit:

• With infants, use a pacifier as intended: as a soother and to help them fall sleep. Once the infant has calmed, remove the pacifier.
• As the infant approaches 6 months of age, begin limiting the pacifier to crib use only and begin keeping the pacifier in the crib as well.
• Offer oral motor and chewing toys to promote healthy orofacial growth and development. Toys that allow the child to explore chewing on their future-molar regions encourages a variety of tongue movements, oral motor coordination, and builds jaw strength.
• Encourage the use of “chewlery” and other chewing aids for older children continuing to struggle with oral habits. You can find chewing pendants for necklaces, chewing bracelets, chewing pencil toppers, and more on websites such as arktherapeutic.com, talktools.com, and even Etsy.

If you feel as though you’ve tried everything, but still can’t seem to eliminate the habit, consider reaching out to your child’s pediatrician for assistance. They may recommend a referral to a Speech Language Pathologist or Orofacial Myologist to help reduce and eliminate the habit. It can be beneficial to have a multi-disciplinary team further assess and rule out any contributing factors, such as disordered breathing, lending to the oral habits.

Megan Davis Dewberry, M.A., CCC-SLP, CLC
Speech Language Pathologist, Certified Lactation Counselor
Baton Rouge General Pediatric Rehabilitation Therapy