In Favor of the Pacifier

Pacifier PrinciplesIn Favor of the Pacifier

Most parents wonder whether or not they should use a pacifier with their baby. Some object because they are breastfeeding, while others have images of five year old kids that are addicted to their pacifier burned in their minds, believing that it is too habit forming and hard to break. Some believe that if a baby has a pacifier, she won’t learn how to suck her own thumb (which many, like I, want). Some are afraid that a pacifier will mean braces will be needed, and others simply fear a baby will not be able to self-soothe without it.

But, pacifiers have been around since babies have been, so there must be good reason for them! Archaeologists have found prehistoric pacifiers, Ancient Egyptian drawings of babies with pacifiers and different forms of pacifiers have been used throughout the centuries. If you follow basic pacifying principles and use them properly, they will prove to be valuable on many levels for baby and you.

Newborns Need to Suckle

A newborn has very little control over her body, but she does have control over her mouth.  She has an actual need to suckle separate from feeding, which satisfies the oral stimulation she needs. A newborn may have the need to suckle for several hours throughout the day! Remember, though, that vigorous sucking does make your newborn tired. This is the type of sucking that should be happening during feeding, while pacifiers should be suckled (a very clear difference in the type of suck). If your baby is sucking aggressively, she is probably hungry. Don’t let a newborn suck vigorously at a pacifier when it close to feeding time. You don’t want her to waste her energy on the pacifier and not have enough to get in a full feed.

Reducing the Chance of SIDS

Several studies have shown a major decrease of SIDS deaths among babies who use a pacifier. The American Academy of Pediatrics goes as far as recommending pacifier use! In a report published in 2005, they concluded:

“Published case-control studies demonstrate a significant reduced risk of SIDS with pacifier use, particularly when placed for sleep. Encouraging pacifier use is likely to be beneficial on a population-wide basis: 1 SIDS death could be prevented for every 2733 (95% CI: 2416–3334) infants who use a pacifier when placed for sleep (number needed to treat), based on the US SIDS rate and the last-sleep multivariate SOR resulting from this analysis. Therefore, we recommend that pacifiers be offered to infants as a potential method to reduce the risk of SIDS. The pacifier should be offered to the infant when being placed for all sleep episodes, including daytime naps and nighttime sleeps. This is a US Preventive Services Task Force level B strength of recommendation based on the consistency of findings and the likelihood that the beneficial effects will outweigh any potential negative effects. In consideration of potential adverse effects, we recommend pacifier use for infants up to 1 year of age, which includes the peak ages for SIDS risk and the period in which the infant’s need for sucking is highest. For breastfed infants, pacifiers should be introduced after breastfeeding has been well established.”

For Breastfed Babies

Opinions are all over the place on what parents should do about pacifiers for the breastfed baby. Some resources suggest waiting 3-4 weeks, others recommend waiting up to 6 weeks, while some say it’s ok to start with them right away. There is no right or wrong time to introduce a pacifier to breastfed babies. Ultimately, you have to do what is right for you and your baby. The main concerns with pacifiers and breastfeeding are nipple confusion and mom’s milk supply getting established, so keep these things in mind:

  • If your baby is having a hard time figuring out how to breastfeed, latch on or suck, you should probably hold off on the pacifier.
  • If your baby is not being super fussy and is not needing to suck all the time for comfort, you don’t need to give her a pacifier right away.
  • Don’t ever substitute a pacify for feeding your baby or to hold her off. Newborns need to eat very frequently and should not be encouraged to wait longer between feeds until she is much older. Your newborn baby needs to be eating 8-12 times a day.
  • If your baby is having problems gaining weight, she should be at the breast as often as possible and a pacifier should not be used until weight gain is adequate.
  • If mom is having problems with her milk supply, a pacifier should not be used until the supply is established. The more a baby sucks at the breast, the more of a demand for milk there is.
  • If your baby is spending an hour or more at the breast for a feeding, she is probably spending some time just suckling. A pacifier may help satisfy her desire to suck between feeds. Just be sure that you know your baby is not hungry.
  • Studies show that babies that have a pacifier wean earlier than those that do not. This is probably because as a baby gets older and is established on solid food, his desire to suck keeps him on the breast. Babies who use pacifiers are getting that need to suck met with the pacifier instead of the breast, so they may decide to give up breastfeeding sooner than if they did not take a pacifier. To avoid this, limit pacifier use for babies older than three months.

How Long to Use a Pacifier?

The AAP recommends pacifier use up to one year. The most important time is during those first three months when a baby’s need to suckle is the strongest and he is unable to control his limbs and find his thumb to suck on. The pacifier will help calm him before sleep and soothe him when he is upset. Many children (including some toddlers) use a pacifier as a transitional object, something that relieves stress and helps your child adjust to new or challenging situations. Once you are past the first few months, limit pacifier use so it does not become a habit that is difficult to break and causes developmental delays. If your child is learning to speak or is having speech delays, the pacifier can be a problem.

It is best to set an absolute timeline for your baby’s pacifier use, so you have a plan on when you will get rid of it as soon as you get started. This way time won’t get away from you and you won’t have a five year old walking around with a pacifier in his mouth all day long. The longest your baby should probably go using a pacifier is 18 months, although this is a personal decision. Whatever time you decide to get rid of the pacifier is best, stick with it and don’t let your child change your mind!

Pacifier Principles

  1. Don’t use a pacifier to replace feeding a hungry baby. If your baby is hungry it is important to feed him. If you need to keep baby quiet while you prepare to feed him or if you are trying to hold him off for a few minutes using a pacifier is ok. Just be sure that you are keeping track of your baby’s feeding schedule and you are determining why he is crying before offering the pacifier.
  2. Don’t use a pacifier at all times of the day, as your baby gets older. When your baby is a newborn and for the first three months your baby will want and need to suck more than any other time. But, as your baby enters his fourth month consider reducing use to sleeping times only. A child does not need a pacifier when he is happy and playing.
  3. If your newborn doesn’t take to a pacifier right away, keep trying. This doesn’t mean that he won’t like a pacifier or doesn’t have a need for one. Some babies just take a while to get used to one. Also, sometimes when a baby is figuring out how to suck a pacifier it pops right back out. This is not always intentional and could be result of the way you are offering it. As you put the pacifier in your baby’s mouth, try lightly stroking just to the side of his mouth and gently hold the pacifier in his mouth for a moment as he starts sucking.
  4. Find a pacifier that your baby likes. There are many different types of pacifiers available and babies do not find them one in the same. Try to find one that matches your nipple (or the nipple on the bottle you use) the closest. IF your baby doesn’t seem to be taking to one, try another kind until you find one he likes.

To read all about Tracy Hogg’s Sleep Methods and to hear many case studies, check out her incredible books: Secrets of the Baby Whisperer and The Baby Whisperer Solves All Your Problems.

Recommended Reading

To read more about pacifier use or problems, we recommend Tracy Hogg’s books, Secrets of the Baby Whisperer and The Baby Whisperer Solves All Your Problems

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