Scientific Article

Using Pacifiers Responsibly

Bianca Happenhofer-Bileck

Development

The balance and interaction of a baby's orofacial muscles are of great importance not only in the development of speech but also for eating. Strong, coordinated sucking on the mother's breast during feeding ensures the healthy development of the mouth, tongue and jaw muscles (nutritive sucking). Sucking on a finger or pacifier has a calming effect (non-nutritive sucking) but can have negative consequences if used excessively over a long period. It can affect the development of strength in the lips and tongue, the formation of the hard palate and jaw and the position of the teeth. To avoid these negative effects, parents need to know how to use pacifiers responsibly.

The Responsible Approach

Pacifiers should not be used until sucking for feeding has become established and comfortable.

In general, parents should ensure that they are only used sparingly. As soon as the child has fallen asleep and the pacifier falls out of their mouth, it should not be given back to the child. Nor is a pacifier a playmate. When the child is playing, bathing, running or talking, the pacifier should remain in the parent’s possession. It is a good idea to keep it in a clean place where it cannot be seen.

Breaking the Habit Early

As soon as your child has first teeth and begins to talk sucking is naturally replaced by biting and chewing. Offering a teether instead of a pacifier should be considered. The amount of time for pacifier usage should be limited and you should think of starting breaking the habit. Parents often feel very anxious about breaking the pacifier habit. Yes, it will be a new experience for your child. Separation means giving something up, letting it go, but also making space for something new. It is a nice idea to exchange the pacifier for some other special thing that your child loves.

Shape and Features

Most important features are:

The part where the jaws and lips rest should be thin.
The neck/shaft of the nipple must be as thin as possible so as not to inhibit the growth of the incisors.
The nipple should be as flexible as possible.
A flexible nipple affects the functioning of the tongue less than a stiff one that is not at all pliable.
The nipple should occupy as little space as possible: The pacifier should be flat and oval in shape to affect the mobility of the tongue as little as possible.
A pacifier that is too heavy strains the muscles of the lips and tongue and, if it slips to one side, it can cause the muscles on one side to be overworked.
A pacifier should not grow bigger as the child does – they should break the habit as soon as possible. The increased space is for the tongue when talking and for learning how to swallow properly.

Myths

Children who use pacifiers are delayed in their speech development.

There are four aspects of "speech development": correct acquisition of grammar, understanding of speech, vocabulary and correct articulation. A pacifier may affect pronunciation or articulation but not necessarily the acquisition of vocabulary or the understanding of speech and grammar.

Sucking on a pacifier is better than sucking the thumb.

There is little difference when it comes to oral motor function and pronunciation. However, it is often easier to break the habit of using a pacifier. Furthermore, the thumb is inflexible, it stops the mouth from closing and it is not readily given up. A pacifier with a really thin neck would be a good alternative.

Children who use pacifiers are more prone to infection.

If a child who uses a pacifier does not develop sufficient strength in their lips because the neck of the pacifier takes up too much space, they can develop the habit of keeping their mouth open and breathing through their mouth. This can prevent the nose from performing important functions such as cleaning and warming the air. Viruses and bacteria can reach the child's respiratory system unfiltered and lead to more frequent infections.

Bianca Happenhofer-Bileck

Speech Therapist

Bianca Happenhofer-Bileck is a member of the board of logopädieaustria, head of its competence centre for PR, marketing and sponsorship, and regional chairperson for Vienna. She is also vice-president of the ÖGLPP (Austrian Society for Speech Therapy, Phoniatrics and Paediatric Audiology) and a freelance speech therapist in Vienna. She has two sons.