Pacifiers: A primer

Who knew that something as small and simple as a pacifier would come with such a detailed user manual.

There is more to pacifiers than meets the eye, and In today’s post, I will give you all you need to know - the what’s, when’s, how’s and where’s, the good, the bad and the ugly.

So let’s get right into it…

Common pacifier uses:

• The use of pacifiers in the early newborn stage can be very helpful in satisfying a baby’s primitive need to suck. I will elaborate more on this below.

• Pacifiers can be used to delay a feeding if your baby is not necessarily hungry or ‘due’ to eat yet. If your baby recently tae, say within an hour or even two and he starts crying, try offering a pacifier to see if he can go the extra half an hour or so until his next feeding. Perhaps he just needed a change of scenery or something to help soothe him. This is also a great way to help establish a feeding routine. Babies will not be easily soothed if they truly are hungry and ready for a feeding and they will let you know!

• For many babies, pacifiers are the key to contentment between feedings. Consider the advantages: Pacifiers can be used to teach a baby how to stretch their night time sleep. Given that your pediatrician gives you the green light for this, you may begin trying to delay nighttime feedings in order to teach your baby how to fall back asleep in the middle of the night without relying on a feeding in order to go back to sleep. It’s also an effective way of preventing the crying/feeding and feeding/sleeping association.

Pacifier Pros:

1. Pacifiers can help soothe fussy babies.
   If you have a fussy baby, pacifiers can really help calm your baby, especially in the newborn stage. Sucking is one of the most effective and common ways that a baby is soothed. It can also help your baby cope better with pain or discomfort. Sucking sends signals to the brain that release feel-good hormones (like endorphins, serotonin and other hormones) that help reduce stress and help babies feel calm and relaxed.

2. pacifier offers a temporary distraction.
   As mentioned above, a pacifier can be a great distraction for a baby if you’re trying to hold off on a feeding or if your baby is not easily soothed in other ways.  

3. Pacifiers provide non-nutritive sucking.
   Pacifiers help fill a baby’s primitive need to suck and at the same time help babies relax. It’s a natural reflex for an infant and sucking is seen in infants early on in utero. Non-nutritive-sucking is essentially providing comfort to your baby without the need for food.

4. Pacifiers may help reduce the risk of sids.
   The AAP recommends the use of pacifiers to help prevent the risk of SIDS, at least until the first 6 months of life when the risk for SIDS is at its highest. There are a few reasons why Pacifiers are believed to reduce SIDS, one is that pacifier use may result in more control of bodily functions such as breathing and cardiovascular stability, especially while infants are in REM sleep where breathing patterns are naturally irregular. It may also help keep their airway clear and open and keep them breathing properly.

5. Pacifiers can help infants fall asleep.
   Pacifiers can help babies fall asleep more easily. This is such a common way for babies to fall asleep and if it’s not disrupting their sleep…or yours…then go ahead and use a pacifier before naps and bedtime if that’s what’s working for you.

6. Pacifiers are disposable.
   Unlike a thumb, you can get rid of the pacifier whenever you see fit or when you feel your child is ready to say goodbye to it. You can do this at any point with a gentle weaning process or you can go cold turkey with the pacifier and that’s fine, too.

Pacifier Cons:

Of course, pacifiers have pitfalls as well. Consider the following drawbacks:  

1. Babies may become dependent on the pacifier.
   If your baby uses a pacifier to fall sleep, parents may face frequent middle-of-the-night waking and crying when the pacifier falls out of baby's mouth.

2. Pacifier use may increase the risk of middle ear infections.
   Rates of middle ear infections (otitis media) are generally lowest from birth to age 6 months, when the risk of SIDS is the highest and the baby may be most interested in a pacifier. Studies show that babies and toddlers who use pacifiers to sleep are at a higher risk for middle ear infection. Prolonged sucking on the pacifier can cause secretions from the throat to pass into the middle ear where it puddles and can easily collect bacteria and become infectious. The AAP discourages the use of pacifiers past 6 months of life to help prevent middle ear infection from occurring.

3. Prolonged pacifier use may lead to dental problems.
   Normal pacifier use during the first few years of life doesn't cause long-term dental problems, however, If a child continues to use a pacifier persistently, his or her top front teeth may slant out, or the upper and lower jaws may be misaligned. (Mayo Clinic) 

Here are a few tips to help you navigate through pacifier use:

1. Know when to say goodbye to the pacifier. Determine whether or not the pacifier is helping or hindering your baby’s sleep and If a habit starts to form and you are constantly reinserting it, it's probably time to pull the plug.

2. Follow the baby's lead. If he is not interested in the pacifier, try again at a later time and don't force it. Not all babies will take the pacifier.

3. Pacifiers should be replaced often, as they deteriorate over time. A worn or cracked nipple can tear off and pose a choking hazard.

4. Buy extras and keep a few identical backups on hand. Some babies refuse a substitute pacifier.

5. If your baby is not settling or easily soothed with a pacifier, and you’ve tried other distractions, you can begin to rule out whether or not he is hungry or tired and figure out what to do next.

Now that we’ve gone through everything we need to know about the pros, cons and common uses for the pacifier, I thought it would be helpful to provide a list of simple pacifier do’s and don’ts that you can keep handy to refer back to when needed.

Pacifier do’s

Do use a pacifier to…

1. Calm a fussy baby

2. Use as a distraction to stretch the time between feedings

3. Help stretch nighttime sleep

4. Help lengthen a short nap

5. Get by during the witching hour

6. Offer extra comfort for your little one should he need it during the day

Pacifier don’ts

Don’t do this with the pacifier…

1. Don’t cut a hole in the nipple. This is not safe and cause pose a choking hazard

2. Don’t wean your child off of the pacifier if they are sick or teething 

3. Don’t get rid of the pacifier if your little one is going through a big transition

4. Don’t get rid of it While you are traveling or have any upcoming transitions that could make your child feel unsettled and insecure.

Are you worried about your baby becoming dependent on the pacifier? Below I have shared with you some simple and tried and true ways to prevent a pacifier dependency.

how to minimize a pacifier dependency:

• Offer the pacifier to help fussy or restless newborns fall asleep, and just as they start dozing, gently take it out and put it aside. This will encourage independent sleep, as they are practicing falling asleep on their own once the pacifier is taken out.

• If you are going to use pacifiers at the start of naps and bedtime, do your best not to reinsert it if it falls out throughout the night.

• By 12-15 weeks, if your baby has good independent sleep skills, consider eliminating the pacifier altogether.

• Try and limit pacifier use to daytime only, when your baby is in need of extra comfort, perhaps for a few minutes before a nap or bed to help them relax. You can even try replacing it with another comfort item such a blanky or a stuffed animal.

Here are some of my favorite pacifiers:

1. Bibs Pacifiers

2. Philips Avent Soothie Pacifier

3. MAM Original Start Newborn Pacifier

What was your experience with the pacifier?

If you have questions regarding your child’s sleep, reach out and send me a message or book a free discovery call so that I can answer all of your questions.