Dr. Sarah Mitchell
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Pacifiers: When, Why and How to Wean

Pacifiers, also known as soothers, binkies, dummy, button, and my personal favourite the fussbug, can be a contentious topic in parenting. ? Do they cause nipple confusion? Deform your teeth? Spread germs? Or perpetuate sleep challenges?  How to wean pacifiers when the time comes?  In this post let’s talk about Pacifiers: When, Why and How to Wean.

Just like everything else in parenting, there is no black and white answer, only shades of grey and a personal decision.

Whether or not you choose to use one can depend on your baby’s age and circumstance.

Let’s discuss the yay vs nay aspects of pacifiers.

The “Yay’s” for newborn pacifier use

  1. According to the National Sleep Foundation, pacifier use is associated with a decreased incidence of SIDS which peaks at 2-3 months.
  2. Keeping your child alive is always a good thing.
  3. Sucking happens in utero, it is natural and biological and undoubtedly soothing to a small baby.
  4. Physiologically, sucking on a pacifier can help peristalsis, the action of moving food through the intestine, which makes them a helpful tool in your toolbox if you have a baby with a sensitive tummy.
  5. Some sources say you shouldn’t offer a pacifier until 4 weeks when breastfeeding is well established. This one has been debated for a while but this latest research from doctors at the University of Chicago has shown that pacifiers have no negative effects on breastfeeding.
  6. There is a big difference between nutritive sucking, ie breastfeeding and non-nutritive sucking, aka using a paci.
  7. Our son took a pacifier in the hospital. He was exclusively breastfed and weighed 20 lbs at 4 months.  Anecdotally having a pacifier didn’t impact his breastfeeding.

The “NAYs” start to kick in when we’re looking at long-term use.

  1. Pacifier use shows a higher incidence of recurrent ear infections. Of note, thumb sucking did not show a higher incidence.
  2. Dental malocclusion, your teeth not fitting together properly, can be caused by long-term pacifier use and thumb sucking. But there’s always braces down the road.
  3. While that binky may help your child fall asleep, she may need your help reinserting it at night making you do the zombie paci walk over and over into your child’s room at night. To me,e this is the biggest NAY. Interrupted nighttime sleep and maternal fatigue leading to a greater risk of postpartum depression.

Things to consider with pacifier use:

How to ditch the pacifier:

Two different approaches to losing the pacifier depending on your child’s age.

#1 – FADING

Fading – there are recommendations to fade the pacifier, allow its use only during certain times of the day.

I recommend the “fading” method in the newborn phase.  You can offer the pacifier and then start pulling it out just before your child is asleep. It makes her drowsy but gets used to falling asleep without anything in her mouth. The idea here is when she uses it to calm herself but she’s not fully falling asleep with it in her mouth.  When she wakes in the night she’s not surprised that it isn’t in her mouth.

For toddlers, fading would refer to decreasing the use gradually. For example, allowing your child to use the pacifier for naps and nighttime sleep but not during the day around the house. Then decreasing use further to only night time.

In my experience, fading takes much parental patience and a long time to work. If you have that kind of time and patience, then this might be the route for you. However, I’m not sure how fair it is for your child.

Isn’t it confusing that she gets it sometimes and not others? If you were trying to quit smoking would it be easier to only have 1-2 per day and but not other times you crave it? You have strong reasoning skills but your 8-month-old or 1.5-year-old does not.

#2 – COLD TURKEY – RIPPING THE BAND AID OFF

If you decide that you need to do some sleep training so your child can fall asleep without a pacifier or other help, then I recommend option #2 which is Going cold turkey and ripping the band-aid off.

I think it is easier on the human psyche to not have it be an option rather than it is sometimes available.

With my sleep training clients, this recommendation to rip off the band-aid and lost the pacifier almost always makes parents very nervous.

Parents often say well I can’t go grocery shopping without the pacifier because he’s so fussy in the store.

Here’s the thing if you are ditching the pacifier to create an independent more well-rested sleeper, your child won’t need the pacifier in the same way during the day.

Once you’ve worked on your child’s self-soothing skills, getting more sleep overall and longer stretches of sleep, your child will be that much more content during the day and not need the pacifier.  Essentially – this is sleep training, scroll to the bottom of this post to learn more about how I can help you with this with step-bys-step support.

Once out of the newborn stage, if your child needs a pacifier during the day it is likely masking her true need. She’s either tired or hungry and do you really want to use something to cover those needs up or would you rather meet those needs?

In preschool-aged children who have reasoning abilities, it may be more gentle to do a fading approach but one could also consider the method to be painfully prolonging the inevitable. You can see which side I’m on here about this

Methods to ditch the pacifier in the toddler years that are a little more gentle than cold turkey:

  • Start cutting a little hole in the end of the paci. The pleasure of the paci comes from the suction, and if there’s a whole suction does not exist. Not nearly as satisfying.
  • Have the paci fairy come and take it away and leave something else.
Other things to consider
  • Your child’s temperament will be the biggest influencer on how your child deals with the loss of the pacifier. Also consider that when you take the pacifier away, your baby or toddler will have to develop self-soothing skills and may need some help with that. You’ll need a sleep training to plan to help guide you through how you respond to your toddler’s cries.
  • Expect the unexpected. Often times we think we know our child’s temperament until we have a challenging situation. For example, I have had parents claim their child would cry for hours without having a pacifier at bedtime, and yet once we implement our sleep plan the child cried for 20 minutes and fell asleep and continued to improve from there.

I also covered “How to Wean Pacifier” in a video on my Youtube channel.

When, Why and How to Wean Pacifier

My 3.5 year old decided she was done sucking her thumb, got some Troll band-aids and never looked back. Pretty much in one night. On the contrary, my older son has a thumb sucking addiction that will require more level of intervention. You never know what will happen.

If you’ve got a baby less than 24 months with a pacifier addiction, then you’re going to do some “sleep training” to when you take that external sleep crutch away.  She’ll be confused on how to fall asleep without it.  In my online class, I teach you everything you need to know about removing the pacifier or learn how to wean pacifier and to help your child develop self-soothing skills and become an independent sleeper.

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Online Sleep Class for ages 4-24 months

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