How can a pacifier be harmful for my baby?
Shari Green
Dental Hygiene

Although benefits exist from pacifier usage, (please see earlier posts) equally, there may be potential issues in a child who sucks a pacifier beyond an acceptable time. The time frame researchers frequently cite is after 24-36 mos. 

Researchers suggest weaning begins at 6 mos. Beyond that, increased incidence of otitis media could become a concern. Pacifier usage into early childhood may decrease opportunities for a child to learn positive strategies to self soothe, or decrease socialization in an older child who continues to suck. May I add potential issues that may relate directly to orofacial myofunctional development/oral muscular behavior patterns of activity?

We know from significant research that increasing the usage of a pacifier decreases time at the breast. Breastfeeding helps develop the proper peristaltic action of the tongue. Proper tongue activity encourages optimum growth and development of the hard palate and facial structures. Thus, extended pacifier usage may have the potential to impact orofacial growth and development in some children. For example, less breastfeeding=decreased potential of proper "tongue action", i.e. the potential to impact tongue behavior patterns.

A pacifier lowers the tongue in the oral cavity as well. A tongue prior to age 4-6 usually does not rest within the hard palate as for example, as the tongue of an adult with normal tongue posture does. The tongue should begin to rest in the roof approx. 4-6 years of age. Extended pacifier usage can interfere with the natural vertical transition of these more vertically based tongue activity patterns, and the tongue maintains this "lowered rest posture" instead of smoothly transitioning to a vertically-based rest posture.

There is much new research in this area being done. For example, newer studies have suggesteded that non-nutritive sucking beyond 24-36 mos. may result in a vertically-based growth pattern tendency of the roof and may impact facial growth patterns in some children, or may sustain a "tongue thrust" pattern of swallowing (thrusting the tongue against the teeth or beyond the dental arch rather than vertically towards the roof away from the teeth), as well. A narrow roof does not "house" the tongue efficiently at rest. Many dental professionals cite that a narrow roof does not allow optimum space for newly erupting teeth. 

Fortunately, this is an opportune time to discuss your child's oral habit with their pediatrician dentist!  

Infants have an innate need to suck and that is why many babies will thumb-suck or use pacifiers.  This sucking act will soothe a crying infant.  The need to suck will start to decrease when the baby is about three or four months old.  A precise age for termination of pacifier use has not been established, but it clearly should be terminated before 4 years of age to prevent subsequent dental problems.  Prolonged use of pacifiers is usually the result of parental reliance on the pacifier to soothe or calm the infant.  The pacifier must be a one piece unit because two piece pacifiers can be a choking hazard.  The pacifier should be wider than your child's mouth and should never be tied to the child's clothing or attached to the crib as this could lead to the risk of strangulation.
Using a pacifier can be harmful to your baby in the following ways:

Early use may interfere with breastfeeding
It is sometimes difficult to identify and understand your baby’s cues with a paci in his mouth, not to mention easier to overlook his hunger cues. Additionally, some infants may get confused since sucking on a pacifier
(or even bottle) involves a slightly different action than for breastfeeding.

• Overuse
Infants quickly get used to the paci to soothe themselves and aid in sleep—a habit that is often hard to break down the road. Older infants who use pacifiers are more prone to picking up colds because they are accustomed to constantly sucking and mouthing objects (the usual entry point for germs). In addition, paci use for longer than a year or two can interfere with tooth alignment and bite (just ask your dentist).

• Increased risk of ear infections
There appears to be an association between pacifier use and increased ear infections. Some experts feel that the constant sucking on the pacifier can push extra fluid into the middle ear, increasing a baby’s chance of developing an ear infection.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.