Pacifiers and Digit sucking in infants

Pacifiers can be beneficial to infants when used at the correct stage of their development. Negative outcomes can occur if pacifiers are used for longer than necessary.

General guidelines for pacifier use:

• Avoid dipping pacifier in any sweet substance.

• Anatomic (also called ‘orthodontic’ or ‘physiological’) pacifiers are preferred, as they stimulate normal muscle movements.

• Should never be tied or affixed to child with any material.

Timeline for best use of pacifiers.

0-1 Months

•If your child is breastfeeding, it is recommended to avoid pacifier use until 1 month of age.[1]

1-6 months

• Pacifiers are recommended for use, useful for soothing/pain relief in infants.[2]

• Recommended to offer pacifier to infant at onset of sleep to reduce risk of SIDS.[3]

6 months – 2 years

• Around 6 months, pacifiers transform from a means of non-nutritive sucking to objects of affection.

• Recommended to reduce or stop pacifier use, to reduce risk of ear infections.[4]

2 years +

• Recommended to actively discourage pacifier use. If use continues til age 4, dental malocclusion (crowded or misaligned teeth) can occur.5

Digit Sucking

It is normal for infants to suck fingers or thumb. Most children give up digit sucking by age 4. By the age of 8 however, 4% of children will still be digit sucking.

Prolonged digit sucking habit (5 years+) have been associated with dental malocclusion, and alteration of the shape of the palate and jaws.

How to stop digit sucking

Encourage stopping by at least age 4. If the child is ready to quit and just needs a reason to stop, positive reinforcement will help. Reinforcements, a calendar tracking progress, rewards will all be successful.

More deeply ingrained habits can be stopped by applying sticky tape to the offending finger. If these basic measures are unsuccessful, a dental appliance can be worn to break the habit.

Dr John Bresnan

[1] Gartner LM, Morton J, Lawrence RA, et al., for the American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2005;115(2):496–506.

[2] Zempsky WT, Cravero JP, for the American Academy of Pediatrics. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2004;114(5):1348–1356.

[3] American Academy of Pediatrics. The changing concept of sudden infant death syndrome.Pediatrics. 2005;116(5):1245–1255.

[4] American Academy of Pediatrics. Diagnosis and management of acute otitis media. Pediatrics. 2004;113(5):1451–1465.

[5] For the dental patient. Thumb sucking and pacifier use. J Am Dent Assoc. 2007;138(8):1176.

[6] Nutritive and Non-Nutritive Sucking Habits – Effect on the Developing Oro-Facial Complex; A Review: Jyoti S* and Pavanalakshmi GP

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