Time to Pass the Paci, Bye Bye to the Binky, Sayonara to the Soother?

You feel ready to wean your child from their pacifier and want your child to also be ready about this new step. But wait a second — there are a few things to consider before you say sayonara to the soother. Your child’s sucking reflex is a very real need. In fact, they began learning this skill when they were in your womb. Don’t be surprised if your child (and you) need some help to drop the habit. Here’s the lowdown on how to make the transition smooth.

Why should we wean?

Pacifier use has been associated with conditions that are considered risk factors for speech and language issues:

• Ear infections: Prolonged and frequent pacifier use appears to be a risk factor in the development of otitis media (ear infection). Repeated middle ear infections can increase the risk of hearing loss – and even cause temporary conductive hearing loss. Children with hearing loss have more difficulty learning speech and language.

• Dental problems: Malocclusions (misaligned or malpositioned jaw/teeth) are associated with prolonged pacifier use. Differences in dental structures can lead to distortions during the articulation of speech sounds. In some cases, frequent pacifier use can cause the tongue to push forward between the teeth which set the stage for the development of a lisp when producing the /s/ and /z/ phonemes.

However, research directly investigating the articulation (speech production) of pacifier users versus non-pacifier users has yielded mixed results:

• One study found no significant differences between the articulation skills of children who had no or minimal history of pacifier use, children who had a history of pacifier use for up to 15 months, and children who had a history of pacifier use that ranged from 18-55 months (Shotts, McDaniel, & Neeley, 2008).

• Results from another study suggested that prolonged sucking outside of breastfeeding may negatively impact speech. More specifically, investigators found that children who used a pacifier or sucked their fingers for 3 years or more were three times more likely to develop a speech disorder (Barbosa et al., 2009).

When to wean? The American Academy of Pediatrics (AAP) suggests offering a pacifier (after breastfeeding is established) as one method of reducing the risk of sudden infant death syndrome (SIDS). Stopping pacifier use before 2 to 4 years is suggested. The American Academy of Pediatric Dentistry (AAPD), agrees non-nutritive sucking is normal for babies and young children and they recommend weaning from the pacifier by age 3.

It’s believed that throwing out that paci before age 3 reduces your child’s risk of dental malocclusions. Weaning at 6 months can reduce your child’s chance of ear infection, according to one review of studies, but the SIDS risk reduction may continue through the first year, so families may want to continue offering the paci until 1 year of age. As we can see, when to wean is not clear-cut. Parents should talk to their pediatrician about what’s best for their child if they’re not sure.

My recommendation to my clients is to eliminate the pacifier use by 12-18 months of age. Many concerned parents have asked me "Do you think the pacifier is inhibiting my child's speech?" My response is a simple question, "Have you ever tried talking with a pacifier in your mouth?" At this age, critical developments in your child’s speech and language learning are occurring rapidly; therefore, maximizing your child’s opportunities to babble and speak optimizes his or her ability to develop speech and language skills. A pacifier may decrease the likelihood of your child babbling or speaking and, if they attempt to babble while sucking a pacifier, your child’s speech will be distorted.

How to wean (baby)

Most research shows there is no harm in pacifier use up to one year of age, and ther are some added benefits. After the first birthday if you plan wean pay attention to when your baby is sucking. Are they sucking for real comfort or are they content, and sucking just because? Try to eliminate the pacifier at times your baby doesn’t really need to suck. Offer some other form of stimulation: a rattle or lovey. If teething seems to be an issue, offer a teething ring.

It’s best to wean gently, when baby is content. Also, it’s worth noting that if you take the pacifier away at an age when the urge to suck for comfort is still strong, your baby may just switch to sucking on something else like their thumb.

How to wean (toddler) If you have waited until they are toddler to wean them off the pacifier it will be more difficult. Simply because the longer we are engaged in a habit (pacifier use) the more difficult it is to break it. Yes, there are tried and true methods to wean your toddler off their pacifier. Basically, there’s the fast way and the slow way. Both of them rely on your child’s developing cognitive abilities.

Like a band-aid!

Explain to your toddler that in 3-4 days’ time, you’ll be taking away their pacifier because they’re old enough and no longer need one. Repeat your message the next day. On the day you decide, take all pacifiers. I suggest you offer your another comfort toy like a stuffed animal, a blanket, or doll. I have heard parents using the story of a paci fairy, who comes to take the pacifiers in the house so that other babies can use them, and leaves something special, and/or fun in its place. Hang in there: Within 2-3 days, the tantrums will be over.

Slow and steady wins the race (sometimes). Talk to your toddler about being big enough to throw out their pacifier. Plant the idea that they can do it by telling them stories about other friends (real or imaginary) who did just that. Let your toddler see you bragging to their favorite teddy that very soon your toddler is going to put down their pacifier. I even told my son my true concerns about prolonged pacifier use. He was on board once I started talking about possible crooked teeth. Use your instincts to figure out when your toddler really needs it and when they can go without. Limit times and places that it's used, such as nap time, bedtime and in their room. Rewards can also be used in conjunction with verbal praise. Your child is venturing out of their comfort zone, and a reward may help keep them on track. Some parents use sticker charts to help their child visualize how many days they’ve made it through without a pacifier. Some children respond better to other rewards such as time at the park, or special 1:1 time. Changing their experience with the pacifier can also help them to wean. Snipping off the end little by little so that it no longer provides the same comfort when sucked can greatly diminish it's appeal.

Whichever pacifier-weaning method you choose, once you’ve made the decision to stop, you must stick to your guns. Brace yourself against the tantrums and the crying, show the empathy that you surely feel, but don't give in. You don’t want to send the message that if they yell for long enough, they’ll get what they want. And you certainly don't want all of that hard work to go down the drain. Just remember that eventually, your child is going to give up their pacifier. After all, no one goes to college with a pacifier!