Babies are born wanting to suck. Some even suck their thumb or fingers before they are born. This is a natural behaviour that allows them to feed and grow. It is also comforting and helps them settle.

A pacifier (or soother) can be used to satisfy a baby’s need to suck. However, it should never be used instead of feeding, and it should never be used without the extra comfort and cuddling a parent can provide.

If your baby seems to want to suck in between feedings, a pacifier can help.

• Sucking on a pacifier is better than a thumb or finger because it causes fewer problems with future tooth development.

• A parent can control the use of a pacifier but it’s harder to control thumb sucking. When it’s time to stop using a pacifier, you can throw it away. You can’t throw away a thumb!

• Also, the latest medical research finds that using a pacifier may decrease the risk of sudden infant death syndrome (SIDS) or crib death.

• Not using a pacifier properly can lead to problems with breastfeeding, teeth (cavities and overbite), and possibly, ear infections.

• Homemade pacifiers, sweetened pacifiers or pacifiers tied around a baby’s neck are not safe and could lead to injury or death. If you choose to use a pacifier for your baby, use it wisely and safely.

• Never start using a pacifier until breastfeeding is fully established. Talk to your doctor or lactation specialist if you feel your baby needs to use one at this early stage. An exception is for premature or sick babies in the hospital. They may use one for comfort.

• Never give your baby a pacifier instead of feeding.

• Always see if your baby is hungry, tired or bored before giving him the pacifier. Try solving these things first.

• Always sterilize the pacifier by putting it in boiling water for 5 min before the first use. Make sure it’s completely cooled down before giving it to your baby. Then, keep it clean by washing it with hot, soapy water after each use.

• Always check for cracks or tears before giving a pacifier to your baby. Sometimes, parents give their baby a pacifier right after giving a medicine (like a pain reliever, antibiotics or vitamins); some of these medicines can cause the material in the pacifier to break down. If there are cracks or tears, throw it out. Replace the pacifier every two months, before damage occurs.

• Never dip the pacifier in sugar or honey. This will damage the teeth. Honey can lead to botulism, which is a type of food poisoning.

• Never tie a pacifier around a baby’s neck. This can cause strangulation and death. Instead, you can use clips with short ribbons attached to them. These are available where you buy pacifiers and are safe to use.

• Never make your own pacifier out of bottle nipples, caps or other materials. These can cause choking and death.

• Never let your older child crawl or walk around with a pacifier all day long. This may interfere with speech development and may cause problems with their teeth.

• Never let your baby or child chew on a pacifier. It could break down and cause choking and death.

• Limit the time you allow your child to use a pacifier. Use it only for sleep time and comfort until about 12 months old and then plan to give it up.

• Never use punishment or humiliation to force your child to give up using a pacifier.

• Involve your child in the decision to stop using it by giving him the choice of throwing it away, putting it away or leaving it under the pillow for the ‘tooth fairy’.

• Start a reward chart to mark your child’s progress.

• Praise your child when your child has given up the pacifier and tell her you are proud that she is growing up.

• Allow your child to express his feelings and if your child is upset or angry, give him special cuddles to help him cope.

• If your child asks for the pacifier again (and she probably will), don’t give in. Remind her that the pacifier is gone and that she is grown up now.

Summary

• Most children stop sucking habits between the ages of two and four.
• Dummy sucking is not a problem for oral health in the very early years but can cause changes to the teeth and jaws if it continues.
• Never put anything sweet on a dummy.

Sucking a dummy can help relax and settle babies but many parents are concerned about the effect of a dummy on their child’s teeth and mouth.

Problems caused by dummies

For many children, sucking a dummy, thumb or finger can cause changes to the teeth and jaws. The younger a child stops sucking a dummy, the more likely their teeth and jaws will correct the growth problems naturally.

Long-term dummy use may lead to:

• incorrect positioning of teeth – upper teeth may be pushed further forward than is ideal, or the top and bottom front teeth may not touch. This can change the way the teeth meet when the child bites and can also affect speech development, especially s and z sounds.
• mouth breathing – the upper airway can be narrowed leading to mouth breathing causing the mouth to dry out which increases the risk of tooth decay. Narrow airways can also lead to issues with quality of sleep.
• speech and language problems – having a dummy in the mouth may delay children using sounds to communicate, and prevent them from exploring the full range of tongue movements required to make all the speech sounds.
• tooth decay (especially the front teeth) – if the dummy is dipped in sugary substances such as honey or jam.

Stopping dummy use

Give your child the chance to stop their dummy habit when they are ready. Most children stop sucking habits between the ages of two and four, but you can start the process from around one year of age. If left too long the child can become more attached and it may be harder to stop.

Avoid trying to stop dummy use suddenly, as it can lead to other oral habits such as thumb or finger sucking.

You might start by limiting the use of the dummy, for example only using it at sleep times or at night time. Give plenty of encouragement and persist gently but firmly. It may take several attempts before the habit is completely broken. Try to be patient. The first few days without a dummy are likely to be the most difficult.
If the habit continues into primary school years, seek advice from your oral health professional.

Dummy sucking versus thumb or finger sucking

Studies of children who suck their thumb or finger shows they have more difficulty breaking their habit than children who suck a dummy. One advantage of the dummy over finger sucking is that the dummy can be gently taken away when the child goes to sleep. This helps form the habit of sleeping without dummy sucking.

Keeping dummies safe

Never dip dummies in sweet things such as honey, jams or syrups; this can cause severe tooth decay very quickly.

Follow good hygiene procedures. Dummies may cause infection if they are shared with other children or picked up from the floor.

Check that dummies are in good condition and meet Australian safety approval ratings.