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Therapy Tips

Pacifiers – Use Them, Then Lose Them

Professionals warn against prolonged use of soothers Whether it’s your first child or your third child, a newborn brings complete joy as well as an onslaught of emotion and responsibility.   Most likely you did some homework, reading up on the care of this precious little bundle.  A pacifier or two is probably stuffed into the diaper bag along with all the other necessities.  Not all infants take to the pacifier, some preferring their own thumbs, or the fingers of a parent, while others have no particular need for anything.

Reasons to Use a Pacifier in Early Months

  1. Studies have shown use reduces the risk of sudden infant death syndrome (SIDS). 
  2. Pacifiers can help babies soothe themselves, and they satisfy the suck reflex.  
  3. When you are ready to wean the child, it’s easier to wean from a pacifier than his or her own thumb. 
However, limits in the usage and length of time used must be kept in mind.  Here’s what the experts are saying. 

The Pediatrician

PediatricianThe American Academy of Pediatrics suggests children begin to be weaned from the pacifier a few months before their first birthday. Parents must take care that their children not overuse or have over-dependence on pacifiers.  The soother should satisfy the intense need to suck, not to replace or delay nurturing. No studies show benefits of prolonged use of a pacifier and/or bottle. Babies should be able to find comfort from interaction with others, within themselves or from external sources (blanket, favorite stuffed animal, etc.). Parents should help their children develop the ability to fall asleep on their own without pacifiers as they grow.

Ear Infections and Effects on Perception of Auditory Information

In addition, studies have linked pacifier use with a three-times-higher risk for ear infections.  One study showed that children who did not use pacifiers had 33% fewer middle-ear infections.  More than two ear infections within a year before the age of 2 can have significant effects on adequate speech development and perception of auditory information. Continuous sucking on a pacifier causes the auditory tubes to become abnormally open, which allows secretions from the throat to seep into the middle ear. This transmission of bacteria in the secretions may lead to middle ear infections.

The Speech-Language Pathologist

Speech and language therapyIt is the position of the American Speech-Language-Hearing Association (ASHA) that the overuse of a pacifier can interfere with speech development.  It frequently causes the tongue to push forward between the teeth and can cause the upper teeth to tip forward toward the lip, or the formation of a high narrow palate. Pacifiers can interfere with development of tongue-tip movement needed for some sound productions. Overuse of the pacifier may negatively affect the speech skills of children if used longer than recommended.

Delay in Appropriate Verbalizations

If the child’s mouth is always occupied with a pacifier, there can be a delay in appropriate verbalizations (babbling and imitation of sounds) and expressive language development. Talking with a pacifier in the mouth impacts normal speech sound motor movement.  Children can choose to keep the pacifier in and point to have their needs and wants met instead of making the attempts to use sounds and words, leading to better communicative development.

The Dentist

DentistThe American Dental Association (ADA) states that if pacifiers are used after age 2, there is an increased risk of developing protruding front teeth and improper bite, which also affects speech production.  Prolonged use can affect the alignment of the teeth and changes in the shape of the roof of the mouth.

Effects on Speech Development and Regulation

Your infant is a tiny being who requires a huge amount of care and attention, and in many situations there is a legitimate use for the pacifier.  However, parents must consider when, where, and why the pacifier is being used.  Allowing pacifier use as a habitual part of the child’s day will likely increase dependence and negatively affect important things like speech development, regulation and dentition, and may lead to an increase in ear infections. The more the child becomes dependent on the pacifier, the harder the struggle will be to wean the child before their first birthday. Keep in mind that what you are doing now will determine how easy or difficult it will be for you and your child when the pacifier needs to become a part of the past.

WRITTEN ON November 08, 2013 BY:


Marla Zerbib, M.A., CCC/SLP is a Speech Language Pathologist at the Kafuman Children’s Center for Speech, Language, Sensory-Motor & Social Connections, Inc.

Marla has an undergrad degree from the University of Windsor and earned her master’s in speech and language pathology from Wayne State University. She has worked with children for over 14 years, in both private practice and school settings.