Pacifiers are great tools to soothe babies. When a baby sucks, their heart rate slows down, blood pressure lowers, and stress decreases. Pacifiers comfort babies and help them fall asleep. Research has even shown that pacifier use is one of the factors that can reduce the risk of sudden infant death syndrome (SIDS) in infants up to 4 months old.

However, the question always arises: how long should children use pacifiers, and when is the best time to wean them off?

There are differing opinions on how good or bad it is to use pacifiers beyond a certain age. In Western countries, recommendations have generally been that the ideal age to stop using pacifiers is between 2 and 4 years. However, in recent years there has been more discussion about the harmful effects of pacifier use beyond a certain age, and it is common to recommend stopping pacifier use by 12 to 18 months of age.

In this article, I highlight some aspects of pacifier use and possible negative effects of prolonged use.

When should a baby be introduced to a pacifier?

It is recommended to wait to introduce a pacifier until breastfeeding is well established, often around one month old. If the baby uses a lot of energy sucking on a pacifier, there is less energy left for breastfeeding and getting nutrition. There is also a risk of “nipple confusion” if the baby gets a pacifier too early, since sucking a pacifier is very different from sucking a breast.

The strongest sucking need lasts until about 6 to 8 months of age. At that point, it is easiest to take the pacifier away because the baby is not emotionally attached to it yet. Around nine months, emotional attachments to the pacifier start to form, and the risk of problems related to its use increases. If the baby’s sucking need decreases and they show less interest in the pacifier, even beginning to bite it more than suck it, it is time to wean the child off it.

What problems can pacifier use cause?

There are few drawbacks to pacifier use in infants; on the contrary, pacifiers can be very helpful to soothe the baby and satisfy their sucking need. However, the longer the baby uses a pacifier as they grow older, the greater the risk of negative consequences such as:

• The child becomes dependent on the pacifier to soothe themselves, even when awake.
• The child often wakes at night when the pacifier falls out of their mouth.
• Increased frequency of ear infections, especially after 6 months of age.
• Effects on speech if used while awake.
• Effects on the palate and dental bite.

An open bite can develop, which can also affect pronunciation of certain sounds. Open bite often improves once pacifier use stops. However, sometimes the palate becomes deformed enough that the molar bite is skewed and requires orthodontic treatment later. The risk increases the longer the child uses the pacifier.

Considering the pros and cons of prolonged pacifier use, it is recommended to wean the child off the pacifier around 12 months of age or earlier. It is good to start reducing use by limiting it to naps and bedtime, then gradually take the final step of removing the pacifier entirely.

If a sibling is expected, it is necessary to wean the child off the pacifier before the new baby arrives. Otherwise, it can become very difficult to take that step when another little one arrives who is allowed to use a pacifier.

How to wean a child off a pacifier?

There are many methods for weaning a child from a pacifier. The internet is full of good advice for parents in this situation who need to say goodbye to this good friend. In most cases, especially when children are 9 to 12 months or older, it is best to gradually reduce pacifier use by first limiting it only to naps and sleep. Depending on the child’s development, parents can agree on a certain day to give away the pacifier — for example, at the zoo or letting Santa take it, or something similar. Some parents make all pacifiers disappear except one, then poke a small hole in the nipple so it stops working. This way the pacifier becomes useless, and the child understands that it must be thrown away.

For very young babies, 6 to 8 months old, the pacifier is simply taken away. It is fine for a breastfed or bottle-fed baby to stop using a pacifier. Weaning from breastfeeding or bottle-feeding often happens naturally when the baby begins eating solid foods.

Whatever method is used, it is important that no pacifiers are visible to the child and that parents are firm in their decision and do not give in. Most parents say afterward that it was easier and took less time than they expected.