LET’S TALK ABOUT PACIFIERS!

Let’s talk about pacifiers! As speech-language pathologists, we’re frequently asked about pacifiers and their impact on speech development. The internet can be a helpful, but overwhelming, place full of information when making choices about your child’s care. Here at OWLS Therapy, we aim to provide education and ways to support both you and your child so you can achieve success.

Because of the amount of information covered on this topic, we’re separating it into two individual blog posts. Today, we’re answering the most frequently asked questions about pacifiers and sharing all the information- the benefits, the risks, you name it!

Are there benefits to pacifiers?

Yes! We want to start out by saying that pacifiers can have many benefits for babies. Research has shown that until the child is 6 months old, benefits for pacifiers can include:

• lower the risk of SIDS

• Support sleep

• encourage self-soothing behaviors and overall regulation

• Reduce reflux

• assist with pain management

Up until 6 months of age, as long as they are not overused, they’re more helpful than anything else!

What pacifiers would you recommend?

When searching for a pacifier, we recommend pacifiers with straight nipples and a rounded shape. This shape helps promote the front to back tongue reflex. It can also help encourage tongue elevation and cupping around the nipple of the pacifier. Two pacifiers we recommend include the Philips Avent Soothie and the Ninni Co. Pacifier. We do not recommend pacifiers with plush animals, or “lovies”, located on the ends of them. All of that extra weight just pulls everything down. Remember- we want to encourage tongue cupping and elevation- not a low tongue resting position!

When should pacifiers be weaned? 

A pacifier should be weaned around 12 months of age (after 6 months but before 18 months).

Your baby will start saying their first word by 12 months. What an exciting time! As your child is learning to communicate, a pacifier may limit their opportunities to make sounds and produce speech. We want to maximize your baby’s opportunities to babble and move their tongue, lips and jaw as it ultimately helps them learn speech and language skills!

It’s also important to consider that by around 12 months your baby’s oral development is changing rapidly and they may begin to develop some teeth. We want their teeth, tongue, lips, palate and swallow pattern to develop appropriately and not be disrupted by any foreign objects in the mouth. It is important to understand that the more time a pacifier is in a baby’s mouth the less time their oral structures have to develop normally without any disruptions.

Check out our recommended timeline of pacifier usage and weaning below:

0-6 Months: Absolutely go for it! Pacifiers have proven benefits during this time of a baby’s development.

6-12 Months: Keep the pacifier in your baby’s crib and attempt to use it for sleep only. This helps begin the weaning process. The pacifier is not ingrained as a sleep association yet! 

12-18 Months: Wean the pacifier in total. To begin this process, skip the pacifier during naps and use it for nighttime sleep only. Another weaning tip is to remove the pacifier from the crib right after your baby falls asleep. 

By 18 months, pacifier and bottle usage should be extinguished. 

Weaning your child from the pacifier earlier may be easier for all involved, as you do not need to provide a rationale for your baby. Toddler’s are concrete thinkers, so removing a pacifier may be more difficult and an explanation may need to be provided! Also, it’s important to consider that the longer the pacifier is used, the habit is more established. This may make weaning more of a challenge the older a child is.

What do other disciplines say about pacifier usage? 

The American Academy of Pediatrics (AAP) no longer encourages the use of pacifiers after age 1. Most dentists recommended weaning should begin by two years of age, if not sooner.

What are the impacts of prolonged pacifier use? 

There are several areas of development that can be impacted by prolonged pacifier use. These include:

• Dental Impacts: Because the mouth is attempting to accommodate a foreign object, prolonged pacifier use can impact a child’s bite, gum, and dental development. By possibly interfering with eruption and alignment of teeth, malocclusions (misaligned jaw/teeth) can occur, which may cause differences in a child’s production of speech sounds.

• Middle Ear Impacts: During pacifier use, continuous sucking can cause the auditory tubes to become abnormally open. With the auditory tubes opened, secretions from the throat can seep into the middle ear. This transmits bacteria and may lead to middle ear infections, which can cause temporary hearing loss due to the build up in the ear. Research has shown that pacifier usage is linked to three-times-higher risk for ear infections. When considering this critical time in a child’s development, reduced hearing abilities can impact their speech and language skills.

• Oral and Nasal Cavity Impacts: In typical development, the tongue rests on the hard palate, which creates the appropriate amount of room in the oral and nasal cavities. Having enough room in these cavities is important, as the space helps achieve appropriate tongue resting posture and nasal breathing. Prolonged pacifier may cause a raised or indented palate and/or smaller nasal cavity, which can lead to low tongue resting posture, increased congestion, mouth breathing, and/or sleep difficulties. Ultimately, not having enough space in a child’s mouth may impact how they produce certain speech sounds.

• Oral Habit Impacts: A tongue thrust may develop from prolonged pacifier usage, as the pacifier encourages the tongue to push forward between the teeth. A tongue thrust can occur while swallowing (also known as an infantile swallow pattern) and/or producing certain speech sounds (such as /s/ and /z/ sounds). This oral habit impacts oral, feeding and speech development.

Ultimately, pacifiers can be a positive tool in a child’s development! With knowing both the positive benefits and possible risks, we want to be sure they are used appropriately. If overused or used for too long of time, research has shown known the impacts on a child’s health development. If you are concerned about your child’s oral, feeding, speech, and/or language development, contact us! Our team can assist you and your child in their individual needs.

Be sure to stay tuned for Part 2 where we will discuss tips and tricks for weaning!