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  • Teresa Newmark, MA, CCC-SLP

The Great Pacifier Debate

When my father-in-law first met my daughter, he dubbed her Maggie Simpson. Although it was meant affectionately, I cringed every time I heard it. The decision to indulge my daughter’s passion for the pacifier had been informed, researched, and conscious, but my own historical pacifier prejudice prevented me from being fully confident.

Speech therapists, dentists, doctors, nurses, parents, teachers, and others have divergent opinions about pacifier use. In this article, I present you with factors associated with pacifier use and challenge you as a parent to weigh these factors and make your own decision about what is best for your unique child.

The Factors

Self Soothing

Sucking is an important and appropriate way for infants to soothe themselves, particularly from birth to three months old. Sucking on either a pacifier or on fingers/ thumb will accomplish the goal of comfort.

Oral-Motor Development

Pacifier use is preferable to finger or thumb-sucking from the perspective of oral-motor development. Due to shape and placement in the mouth, thumb and finger sucking are more likely to negatively impact the shape of the palate, upper and lower jaws, and teeth.


There is evidence that using a pacifier at night can reduce the risk of Sudden Infant

Death Syndrome.

Middle Ear Infections

There is evidence of a correlation between pacifier use and middle ear infections.

Pacifier Use and Breast Feeding

Some children demonstrate difficulty learning to breastfeed when a pacifier is introduced right away. Experts recommend establishing breastfeeding before introducing a pacifier. Some suggest waiting 6 weeks to introduce a pacifier. Opportunity to Talk

Pacifier use may discourage babbling if used incorrectly. It is important to use the pacifier for its intended purpose: to soothe an infant. If your child is awake and happy, take that pacifier away.


As children grow, they learn new ways to comfort themselves, and pacifiers or finger/ thumb-sucking should be discontinued. It can be difficult to wean children from something that has given them comfort, but since a pacifier can be taken away (and fingers/ thumbs can’t!), it is easier to wean a child from a pacifier.


A pacifier should be used to soothe a child through sucking. It should not be used to quiet a child and should not replace the other means of comfort that an adult can provide.

When to Wean

When to Stop Using a Pacifier and Bottle

Pacifiers, bottles, breastfeeding, and sippy cups all function through the use of a “suckle” oral-motor pattern. This pattern is positive and appropriate for infants; however, children should be transitioning from this pattern between six and twelve months. The reason is that suckling does not use complex, dissociated oral movements. It also encourages a “reverse” or tongue thrust swallow, which can lead to tongue protrusion or tongue thrust. This can have a negative impact on a number of areas, including feeding and speaking skills. If a bottle, pacifier, or another mode of suckling is continued past 24 months, it has a negative impact on the dentition.

Skip the Sippy Cup: An Important Tangent

Move from the Bottle Directly to an Open Cup and/ or Straw Cup. Skip the sippy cup altogether. It maintains the suckle pattern and, although it looks more grown up, is actually no more mature than the bottle from an oral-motor perspective. Start teaching your child how to drink from a regular cup and, especially if you are worried about spillage, introduce a straw cup to encourage better speech and feeding skills.


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