Chicago doctor: Should your child use a pacifier?

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 pacifier.

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.

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