After the 5-year-old daughter of an "A list" celebrity
couple was photographed by the paparazzi as she calmly sucked a
pacifier, I was invited to be a guest on a network morning show to
talk about "how old is too old" for a child to use a pacifier. I
realized I have never addressed this issue here.
Babies come into the world wired to suck. Sometimes
parents will get a glimpse of their baby sucking a thumb or a fist
in the womb on a prenatal ultrasound.
The American Academy of Pediatrics has a positive view on
pacifier use because it may improve sleep, helps a baby learn how
to calm himself, and there is evidence that it reduces the risk of
Sudden Infant Death Syndrome. The AAP suggests waiting one month to
introduce a pacifier to a breast-fed infant to ensure that
breastfeeding is firmly established.
Some babies like pacifiers and some don't. A pacifier
should not be forced on a baby and should not be re-inserted once a
baby falls asleep. Parents should not use a string or other device
to attach pacifiers around the baby's neck or to clothing because
of the risk of strangulation.
Between the age of 6 months and 1 year the pacifier can
gradually be removed so that the baby stops using it by the first
birthday. After 1, the risk of ear infections rises among kids who
continue to use pacifiers, compared to those who don't. There's
also a risk of dental problems that increases around 2 and is
definitely present by age 4 among kids who use a
As the parent of three children, I have a lot of personal
experience with pacifiers. Our youngest thought her pacifier was
her best friend. She had them scattered around the house and car.
For her, it became a necessary accessory like a purse or a pair of
shoes. By the time she turned 3 (yes, as a pediatrician I should
know better) my husband and I were willing to do whatever it took
to get rid of the thing. After some brainstorming we decided to
have a "goodbye packy" ceremony. We asked our daughter to gather
all her "packys." During the ceremony she was able to suck each one
and say goodbye. Then we all went out to the garbage can in the
alley and she dumped them in. That night at bedtime she had a
moment of longing, but it quickly passed.
Pacifiers can serve a great purpose and may even save
lives by reducing SIDS. Most kids will lose interest and wean
themselves, but sometimes, like in my family, parents have to
develop clever strategies to help children let go.
Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago.
See more of Dr. Thornton's stories here.
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