A blog by Dr Lin Day

Pacifier – Good or Bad?

Pacifier – Good or Bad?

David Beckham hits back at criticism over 4 year-old Harper’s pacifier.

Experts claimed that the pacifier risked stunting her speech and put her teeth at risk of damage. Beckham blasted back saying:

Everybody who has children knows that when they aren’t feeling well or have a fever, you do what comforts them best and most of the time it’s a pacifier. So, those who criticize, think twice about what you say about other people’s children because actually you have no right to criticize me as a parent.”

So should a 4 year-old be using a pacifier? At present, there are mixed opinions as to whether a pacifier in the pre-school years is good or bad. From the child’s viewpoint, the pacifier offers comfort and contentment at a time of need. From the parent’s viewpoint, pacifier use is up to them.

Health professionals argue that prolonged pacifier use may lead to speech delays and dental problems in some, but not all children, if continued after 4 years of age. Problems, if any, depend on the frequency of sucking (how often), duration (how long) and intensity (can you hear it across the room?). However, if the pacifier is taken away too soon, the child will find the fingers or thumb to suck on, which is a much harder habit to break. About 12% of adults still suck their fingers or thumbs.

There isn’t a gold standard in the literature about an ideal age to eliminate pacifier use. Expert opinions also vary greatly (visit:http://www.asha.org/About/news/Press-Releases/2010/pacifier-speech-skills.htm).

Removing the pacifier before your child is ready can create a great source of anxiety. Most children give up their pacifiers on their own, and when they are ready, before they go to school.


 Babies have an innate desire for non-nutritive sucking, but the need for continued sucking can linger for years because it provides the following benefits:

Gives rise to feelings of well-being and contentment.

  • Offers emotional security during periods of isolation or separation from the parent (e.g. during naps and at bedtime).
  • Provides comfort when unwell or distressed.
  • Triggers the calming reflex, which induces sleep.
  • Provides temporary distraction in stressful situations.
  • Prevents finger or thumb sucking.

Sucking on a pacifier is a much healthier means of seeking comfort than eating a packet of crisps! However, pacifiers also have pitfalls. The drawbacks may include:

  • Interference with breastfeeding and milk production in the first 3 to 4 weeks after birth.
  • Night-time crying when the pacifier falls out of the child’s mouth.
  • Increased risk of middle ear infections after 6 months-old (continuous sucking allows secretions from the throat to seep into the middle ear).
  • Skin irritation from excess saliva that may collect behind the base.
  • Contamination by bacteria if not washed or sterilised frequently – latex pacifiers are more significantly colonized with Candida andStaphylococcus than silicone pacifiers.
  • Possible teeth misalignment and/or speech delays from consistent or prolonged use.
  • Dependency on the pacifier.
  • Difficulty in breaking the habit.

In 2006, the International Journal of Orthodontics, and the American Speech-Language-Hearing Association, argued that prolonged use of a pacifier could negatively affect speech skills by interfering with the development of tongue tip movement needed for the production of certain sounds. Instead of making an attempt to use sounds and words, the child may point to objects to have their needs and wants met.

Pacifier use after 4 years-old has been associated with a higher incidence of dental problems (http://www.aafp.org/afp/2009/0415/p681.html). However, thumb or finger-sucking can also alter tongue and teeth positioning. Even slight alterations can affect speech production.

Currently, about 75% of pre-school children in Western countries use a pacifier. Therefore, you can take comfort from the fact that you are not alone. You may wish to consider an orthodontic pacifier, which can help reduce dental problems than a traditional round one (for more information, visit: http://www.aapd.org/assets/1/25/Adair-14-01.pdf).

If you do have concerns, seek the advice of a dental specialist, who will recommend techniques to help your child break the habit. Early orthodontic management may prevent more extensive treatment later on.

Breaking the habit

Methods may include distraction with activities, toys and other objects of affection, putting unpalatable substances on the pacifier, cutting it short to reduce sucking satisfaction, restricting use to bedtime only or stopping the habit abruptly. Social pressure when the child goes to school can also put a stop to the habit. However, the pacifier may be replaced by the fingers or thumb.

Some parents find that agreeing with the child to donate the pacifier to the dummy fairy or to the Christmas elves works best. They will be sure to find a good home with a child who really needs it.


By Dr. Lin Day: www.babysensory.com

Baby Foundations classes cover everything you need to know about your baby before and after the birth including pacifier use and alternative techniques to soothe and comfort your newborn baby.

Visit: www.babysensory.com/en/babyfoundations