From the Guidelines
Pacifiers can have side effects for children, particularly when used excessively or for too long, including potential dental problems, increased risk of middle ear infections, and hygiene concerns, but they also offer benefits such as satisfying the natural sucking reflex and potentially reducing SIDS risk when used during sleep in the first year of life. The main concerns with pacifier use include potential dental problems such as misaligned teeth or altered palate development, especially if used beyond age 2-3 1. Pacifiers may increase the risk of middle ear infections as the sucking motion can change pressure in the ear canal and allow fluid buildup. Some children may become overly dependent on pacifiers, which could potentially delay speech development or create sleep associations that make it difficult for children to self-soothe without them. There's also a hygiene concern, as pacifiers can harbor bacteria if not cleaned regularly. However, pacifiers do offer benefits including satisfying the natural sucking reflex, providing comfort, and potentially reducing SIDS risk when used during sleep in the first year of life, as supported by studies such as those published in Pediatrics 1. To minimize side effects, choose orthodontic pacifiers, limit use to sleep times after age 1, clean pacifiers regularly, and work on weaning by age 2-3 years. The American Academy of Pediatrics considers pacifier use generally safe when used appropriately and discontinued at the right time. Key points to consider when using pacifiers include:
- Limiting pacifier use to sleep times after age 1
- Cleaning pacifiers regularly to prevent bacterial growth
- Weaning children off pacifiers by age 2-3 years to prevent long-term dental problems and other issues
- Choosing orthodontic pacifiers to minimize the risk of dental problems
- Being aware of the potential risks and benefits of pacifier use, including the risk of middle ear infections and the potential reduction in SIDS risk.
From the Research
Potential Adverse Effects of Pacifier Use
The potential adverse effects of pacifier use in children include:
- Negative effect on breastfeeding 2, 3
- Dental malocclusion 2, 3, 4
- Otitis media (ear infections) 2, 5, 3, 4
- Accidents during infancy 3
- Failure of breastfeeding 3, 4
- Dental deformities 4
- Recurrent acute otitis media 4
- Development of latex allergy 4
- Tooth decay 4
- Oral ulcers 4
- Sleep disorders 4
Age-Related Adverse Effects
Adverse dental effects can be evident after two years of age, but mainly after four years 2. The American Academy of Pediatrics and the American Academy of Family Physicians recommend weaning children from pacifiers in the second six months of life to prevent otitis media 2.
Recommendations for Pacifier Use
The American Academy of Pediatrics recommends that parents consider offering pacifiers to infants one month and older at the onset of sleep to reduce the risk of sudden infant death syndrome 2. The American Academy of Family Physicians recommends that mothers be educated about pacifier use in the immediate postpartum period to avoid difficulties with breastfeeding 2.