Pacifier, or no pacifier?

TO many parents, pacifiers are like magic plugs, bringing comfort to fussy, crying babies. But these magic devices are not given the nod by some health care professionals, care givers and parents.

“The use of pacifiers, also known as dummies, soothers or artificial teats has been a controversial topic over the years, with many advocates for and against the practice,” said Dr Anona Griffith, paediatrician at Gateway Plaza, Old Harbour.

She pointed out that the pacifier, which has evolved from its rudimentary clay form to the more recent latex or silicone variety has proved very beneficial to soothing crying babies.

But there are pitfalls.

“There are a number of concerns surrounding the use of the pacifier, including a negative effect on breastfeeding, an increase in misalignment of teeth and dental caries, and the occurrence of otitis media (ear infections). On the other hand, however, some of the benefits ascribed to the use of pacifiers include analgesic (pain relieving) effects, shorter duration of hospital stay in preterm infants, as well as a reduction in the risk of sudden infant death syndrome,” Dr Griffith explained.

Using established research papers that focused on the use of the pacifier and its associated or possible effects as reference, Dr Griffith said the concerns are valid, but have been found upon research to be increased with certain practices and habits.

“The use of pacifiers from different authorities such as the American Academy of Paediatrics and the American Association of Family Physicians, stresses at its foundation parental education and anticipatory guidance and the acknowledgement that its use is ultimately a parental choice,” Dr Griffith explained.

Recommendations regarding the use of pacifiers include:

1. Introduction of the pacifier should occur after one month of age in order to fully establish proper breastfeeding techniques. Early introduction of a pacifier may be a red flag or indicator of challenges with breastfeeding; as such, prompt intervention should occur.

2. The pacifier should be used for brief periods, especially just before bedtime and should not be reintroduced once it has fallen out of the infant’s mouth.

3. Discontinuation of its use is recommended in the second to sixth month after the first year of life to reduce its association with otitis media and dental abnormalities.

4. Infants with recurrent or chronic ear infections should be restricted in their use of the pacifier.

The CDA (Canadian Dental Association) and ADA (American Dental Association) recommend the use of pacifiers over thumb sucking, as it is thought that the sucking habit, which should stop before the eruption of permanent teeth, can be more easily controlled using a pacifier.

In order to reduce the risk of dental caries, application of sweeteners such as sugar, honey or corn syrup should be avoided.