Q: What Should I Tell Families About Pacifiers?June 9, 2021
Q: I have a parent asking about when and how to wean their child off the pacifier. What should I tell them?
A: The American Academy of Pediatrics recommends that parents consider offering a pacifier at nap time and bedtime in infancy, as studies have reported a protective effect of pacifiers on the incidence of SIDS, even if the pacifier falls out of the infant’s mouth. The American Academy of Family Physicians states that “pacifier use should no longer be actively discouraged and may be especially beneficial in the first six months of life. However, the risks begin to outweigh the benefits around six to 10 months of age and appear to increase after two years of age.”
As children get older, pacifier use has been shown to be a risk factor for otitis media  and associated with higher rates of dental malocclusion . Additionally, pacifier use can prevent spontaneous speech, and affect the development of language skills. Pacifier use can also delay a child’s ability to develop other self-soothing strategies.
As a provider, you can:
- Recommend pacifier use in the first six months of life to help with self-soothing and decrease the risk of SIDS.
- After six months:
- Suggest that families limit the use of pacifiers to the crib or sleep space whenever possible.
- Promote autonomy and self regulation by offering alternative ways that children can calm and soothe themselves, like using a transitional object. A transitional object is an object like a stuffed animal, a favorite book, or a blanket that helps to soothe a child.
- Positively acknowledge attempts children make to manage their stress.