Pacifiers – allies to use with care

Pacifiers are as rooted in history as they are in controversy. Pacifiers made of clay, gold, pearl or coral, and sugar teats have been used to soothe babies for thousands of years. The use of pacifiers is still widespread in Canada, with an estimated 84 percent of parents using them with their infants at least some of the time. Pacifiers have been accused of causing many problems, so should we still be using them?

Pacifiers are as rooted in history as they are in controversy. Pacifiers made of clay, gold, pearl or coral, and sugar teats have been used to soothe babies for thousands of years. The use of pacifiers is still widespread in Canada, with an estimated 84 percent of parents using them with their infants at least some of the time. Pacifiers have been accused of causing many problems, so should we still be using them?

Pacifiers have mainly been implicated in premature weaning of breastfed babies, increased frequency of otitis media and dental problems. The link with premature weaning remains uncertain. While pacifier use does appear to increase the risk of suffering otitis media, it is only one of the many factors involved, especially with prolonged and more frequent use.

It is well known that pacifiers can have a negative impact on dentition, but most studies seem to indicate that these problems only develop with prolonged use (after age five) or with sweetened pacifiers (which can cause cavities). The most common effect observed with prolonged use is an obvious gap between the upper front and lower front teeth when the jaw is closed. In other words, the back teeth touch, but the front teeth don’t. Despite this, the Canadian Dental Association recommends pacifiers over thumb-sucking because it is easier for parents to wean children off pacifiers.

Lastly, several studies have shown an association between pacifier use and a reduced risk of sudden infant death syndrome (SIDS). No definite explanation for this has yet been found, but one theory is that pacifiers may provide a physical barrier that protects the airways. The sucking action keeps the tongue forward, maintaining the upper airways active. Pacifier use has also been found to have a calming effect on infants during painful procedures.

While many specialists agree that pacifier use increases the risk of premature weaning of breastfed babies, otitis media and dental problems, it may protect infants against SIDS. The key is therefore to be vigilant. Pacifiers should only be used when the baby is falling asleep, and then withdrawn as soon as possible. The habit should be broken by the child’s second birthday.