At what age should children stop using a pacifier (dummy)?

Pacifier Weaning Recommendations for Children

Children should stop using pacifiers between 6-12 months of age to prevent otitis media, with complete weaning recommended by 2-3 years of age at the latest to prevent dental problems.

Optimal Age for Pacifier Discontinuation

The timing of pacifier discontinuation should follow a structured approach based on developmental milestones and risk factors:

• 6-12 months: Initial weaning should begin during this period to reduce the risk of otitis media, as recommended by the American Academy of Pediatrics and American Academy of Family Physicians 1

• By 2-3 years: Complete weaning should be achieved by this age to prevent dental adverse effects 1, 2

• Critical threshold: Pacifier use beyond age 3 has increasingly harmful effects on dental development, with effects becoming more severe if continued beyond age 5 2

Dental Implications of Prolonged Pacifier Use

Continued pacifier use beyond recommended ages can lead to significant dental problems:

• Increased prevalence of anterior open bite
• Development of posterior cross bite
• Narrowing of maxillary arch width
• Formation of high, narrow palate 2

These dental changes become more pronounced the longer pacifier use continues, with effects becoming significantly more severe after age 3 2.

Effective Weaning Strategies

Two main approaches to pacifier weaning have been documented:

1. Gradual reduction (recommended):

   • Limit pacifier use to specific times (e.g., only for sleep)
   • Progressively reduce usage time
   • Approximately 24.8% of caregivers report this method as effective 1

2. Abrupt elimination:

   • Complete removal of the pacifier at once
   • Approximately 27.8% of caregivers report this method as effective 1

Supporting Children Through Weaning

To help children successfully transition away from pacifiers:

• Celebrate small achievements with praise and small rewards
• Use distraction techniques when child requests pacifier
• Offer alternative comfort objects (ensuring they're age-appropriate and safe)
• Maintain consistent routines during the transition 1

Special Considerations

• Breastfed infants: Delay pacifier introduction until breastfeeding is firmly established (typically 3-4 weeks)
• Formula-fed infants: Can start using pacifiers as soon as desired 1
• SIDS prevention: Pacifier use during sleep reduces SIDS risk by 50-60% in the first months of life 1

When to Seek Professional Help

Consider consulting a pediatrician or pediatric dentist if:

• Weaning attempts consistently fail after 2-3 months
• Child shows signs of significant regression, excessive anxiety, or sleep disturbances
• Dental problems are already developing 1

Parental Education

Higher maternal education is associated with earlier pacifier withdrawal, and regular dental visits significantly shorten pacifier use, especially among children with mothers having low or medium education levels 3. This highlights the importance of early and frequent dental visits for all children to promote timely pacifier discontinuation.

Remember that while pacifiers provide comfort and SIDS protection in early infancy, the benefits are outweighed by the risks of dental and oral development problems when use continues beyond the recommended ages.