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Dr. Baig's Tip of the Week, Pacifiers & Thumb Sucking

Non nutritive sucking behavior, for example sucking on a pacifier, thumb or fingers is a normal part of early development that may become a learned habit. Sucking reflex appears in the fetus in early second trimester and is the first reflex the infant uses after birth after starting to breathe. Its present in almost all infants and decreases with age, and by age 4 to 5 years it's replaced by other coping mechanisms.


Pacifiers and Teeth

Dental effects like overlapping teeth malocclusion and anterior open bite are more likely to appear if the pacifier use is continued beyond two years of age. Orthodontic pacifiers do not appear to reduce the chance of dental malocclusion in children with pacifiers. There is limited evidence of children having more ear infections during the use of pacifiers. juice. Dental trauma is also more likely while pacifier is being used in ambulation.



Pacifiers and SIDS

Pacifier use is associated with the lower risk of SIDS in a number of studies even when the pacifier falls out at night. There appears to be no association between pacifier use and breastfeeding duration. Pacifier should be offered while infant is placed in a back to sleep position no earlier than 3 to 4 weeks of age after breastfeeding has been established.


Strategies to Stop Pacifier use;

  • Discontinue comments about pacifier or thumb sucking.

  • Manage stress and anxiety in children.

  • Positive reinforcements of avoidance.

  • Limit time of pacifier starting at 18 months of age for example only in bed and in highly stressful situations.

  • Dental appliances to discourage pacifier use can be used in recalcitrant cases.


 

References:

Nelson Text Book of Pediatrics 22 edition page 2535. Up to Date 2025.


While there is a lot of information on the Internet, I present tips based on current Pediatric knowledge combined with many years of experience dealing with issues relating to children and young adults. - Dr. Baig


We invite readers to comment below with questions for Dr Baig, along with suggestions on any topics that might be of interest in the future.

 

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