Pacifier Addiction

Dear Mr. Dad: My son loves his pacifier, but he’s almost three and my wife says it’s time for him to give it up. But when I try to take it away he doesn’t sleep and cries hysterically. What’s wrong with a pacifier?

A: The day-to-day life of a toddler can be a lot more stressful than we realize. New activities all the time, constant field trips and errands, new friends, a transition to preschool—and then someone comes along and tries to take away the one thing in life he can always count on: the binky. It sounds like your son’s pacifiers have become “transitional objects”—something (as opposed to some person) he uses to soothe himself and relieve stress. If so, it might be wise to let him keep using it until he develops other coping mechanisms.

Besides relieving a child’s stress and giving him a sense of comfort and security, there are other benefits associated with pacifier use. One of the biggest is that pacifier use seems to reduce the risk of Sudden Infant Death Syndrome (SIDS). The connection is so strong that the American Academy of Pediatrics actually endorses pacifier use. According to the AAP, most children break the pacifier habit on their own between ages 2 and 4. In addition, some parents (and researchers) believe that taking away the pacifier too soon may forcethe child to find a different comfort measure, like sucking her thumb or shirt sleeves, pulling her own hair, or carrying around a blankie.

That said, there are plenty of folks who believe that pacifiers shouldn’t be used after a baby’s first birthday. There’s a lot of disagreement about this, but in fairness, here are some of their reasons:

  • With a pacifier in his mouth, your son may talk less and may have problems with pronunciation. Taken to an extreme level, binky use could damage his tongue and lip muscles, which in turn could delay his language development and might even cause a lisp.
  • For young babies, dependence on a pacifier for sleep means they’ll wake up and need your help finding it if the thing falls out of their mouth at night.
  • Newborns may have trouble learning to breastfeed properly if they get a pacifier before breastfeeding is well established.
  • Although no one can say exactly why, some studies link pacifiers to increased risk of ear infections.
  • Prolonged pacifier use might cause buck teeth. This isn’t an issue for baby teeth—they move back into position after a few pacifier-free months—but it could be a problem with adult teeth, which typically appear around 4-6 years. The American Dental Association and the American Academy of Pediatric Dentistry discourage pacifiers after age four.

The best way to settle this is to ask your son’s pediatrician and dentist (if he’s doesn’t have one, he should). If you decide to give up the pacifier, here are some strategies to try:

  • Give them away (tell your son he’s giving them to babies who need pacifiers, or have him leave them under his pillow for the pacifier fairy).
  • Exchange them for a toy.
  • Cold turkey—just throw them away (for example, after his 3rd birthday when he’s officially a “big boy”).
  • Ease the transition away from the pacifier habit by offering a reward for achieving a specified number of pacifier-free days or for giving it up completely.
  • Rely on peer pressure. Surround your son with other (pacifier-free) children and he may decide he doesn’t want to be the only “baby” using a pacifier.