Oh, pacifiers! I think most moms hate to love them…and they can be one of those oddly ‘controversial’ things in motherhood. While they are a personal preference of both baby and parent (some babies will never take a pacifier!) – the American Academy of Pediatrics is now suggesting the use of them for the first 6 months to reduce the risk of SIDS. I personally was always in the ‘no pacifier’ camp before I was a mom. Then I had a baby who loved to suck and the pacifier became a godsend! While we only used them for sleep and easily ditched Piper’s beloved pippy before she turned one – it’s proven to be much more difficult with Flora (who also loves pacifiers). So today I’m chatting with a pediatric dentist on how and when to wean from the pacifier!
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The American Academy of Pediatric Dentistry (AAPD) recommends children stop nonnutritive sucking habits by age 36 months or younger. The American Dental Association (ADA) recommends children should stop using the pacifier by age 2. If the habit can be stopped by 2 to 2.5 years old that would be best. The American Academy of Pediatrics (AAP) recommends pacifier use up to 6 months at sleep times to help reduce the risk of SIDS, but after 1 they don’t encourage it since it has shown some correlation with middle ear infections. They recommend weaning from the pacifier during the second six months of life to prevent complications from prolonged use such as negative effects on breastfeeding, dental malocclusion and otitis media.
From a dental standpoint, decreasing use of the pacifier after age 1 is best so as not to impede correct swallowing pattern and tongue position which guides the growth of the upper and lower jaws. Some kids who use pacifiers with more forceful sucking can start to develop crossbites or an open bite as early as age 2-2.5. Usually crossbites or open bites can’t be fully corrected until the adult teeth begin to erupt, around the age of 6, and with the use of braces or palatal expanders and/or habit appliances if they also developed a tongue thrust.
Prevention is key, so decreasing use and hopefully full cessation by 2 years would definitely be best!!
Unfortunately there is not one trick that works for all kids. Best thing to remember is always use positive encouragement when trying to break the habit. Instead of scolding your child for using the pacifier (or sucking their fingers/thumb), praise them for not sucking. Some kids respond just fine if you take it away completely. Other’s need more time to process and cope. One tip I recommend to families is modifying the nipple of the pacifier. Gradually trim it down over a couple of weeks. Trim off just a tiny sliver for the first week, then each week following take off a little bit more. Over time it will stop providing comfort so they won’t want to keep using it. This may be particularly helpful for younger kids that might not understand reasoning for taking the pacifier away. It doesn’t work for all kiddos but I’ve received lots of great feedback from parents who had success with this method!
1) Replace pacifier with a new blanket or stuffed animal they are really excited about.
2) Get a fun calendar and stickers. Every time they go to sleep without the pacifier, they can place a sticker on the calendar. Have a goal set for # of stickers for the week. Count them up and if they meet or exceed the goal then have a fun reward or activity planned. Work up to 4-6 weeks and then the habit should be broken. This works better for kids who are a little older and able to reason.
3) Have a going away party for all the pacifiers. Talk about it with them so they have time to prepare. Set a day when they will all go in a box. Some parents have buried the box, others have told their child they will donate the pacifiers to another baby who needs them. Not many places will take actual donations of used pacifiers. But you can always check with local women’s shelters or non-profits that may be collecting newborn and infant supplies for a mission trip.
Interview with: Moira Gini Groh, DDS | Linkedin Pediatric Dental Specialist