8 harms of the pacifier and tips to put it aside

The habit of giving the baby a pacifier is common to most families, especially with the aim of calming the child. Whether at bedtime, at times of pain or prone to stress, such as when taking blood.

However, it is not today that it causes controversy. There are those who argue that all the harmful effects of the pacifier do not justify its use. There are those who point out benefits in using the accessory.

In any case, in addition to the pros and cons, for many parents, there is also the question of how to “replace” the pacifier at times when it is necessary to calm the baby. See below for the main clarifications on the subject.

8 harms of using a pacifier

But why, in general, is the use of a pacifier contraindicated?

1. It can harm breastfeeding

Nathália Sarkis, pediatrician at Hospital Santa Lucia, in Brasília, and a member of the Brazilian Society of Pediatrics, explains that the use of a pacifier is associated with a shorter duration of breastfeeding. “This is because the baby’s tongue is positioned differently during breastfeeding compared to the pacifier. In this way, it can cause nipple confusion and make breastfeeding difficult,” she says.

“However, each case must be evaluated by a multidisciplinary team, in order to carry out preventive actions regarding exposure to artificial nipples and early interventions of changes in the first days of breastfeeding”, adds the pediatrician.

2. More prone to ear infections

With the use of a pacifier, according to Nathália, there is a greater propensity for middle ear infections. “The pacifier provides a migration of microorganisms to the ear due to the lack of stimulation of the tensor muscle of the membranous palate (mainly responsible for opening the Eustachian tube and important in the prevention of otitis media)”, he explains.

3. More chances of infections in general

The pacifier falls on the floor and is often not properly sanitized… With all this, it poses risks to the baby.

Nathália highlights that pacifiers are considered potential reservoirs of infection, which can affect the immune system. The use of pacifiers is associated, for example, with a higher incidence of diarrhea, canker sores, oral candidiasis, among other conditions.

4. It can harm your child’s teeth

Nathália explains that the pacifier can cause anatomical and functional changes. “The most frequent occlusal changes are anterior open bite and posterior crossbite,” she says. It also increases the risk of cavities.

5. It can cause speech difficulties

Excessive pacifier use can lead to teething and speech problems, especially if use continues beyond three years of age.

As the accessory usually stays in the child’s mouth for a long time, it can cause structural changes, in addition to inhibiting the imitation of sounds, babbling and the emission of words in general.

6. Can influence intelligence in adulthood

One study linked pacifier use to lower performance on intelligence tests in adulthood.

The hypothesis, as Nathália comments, would be that the child who uses a pacifier is less demanding for attention (from parents/caregivers). For this reason, it ends up being less stimulated.

7. It can encourage some negative habits

Nathália comments that there is evidence that prolonged pacifier use can “be replaced” throughout life by negative habits, such as smoking, excessive eating or other compulsive disorders.

8. Risks from the accessory

There is a possibility of choking and strangulation caused by parts of the pacifier that occasionally come off. In addition to the risk of injury to the mouth or nose if the child falls with the pacifier in the mouth.

Although the harm of the pacifier is much discussed today, it is rare for children who have never used it at some point in their childhood. This is especially due to the view of the pacifier as something “therapeutic” – which soothes – having been passed on from generation to generation.

Faced with so much controversy, it is still practically impossible to talk about an “ideal age” to remove the pacifier. But, generally speaking, around the age of two or three, most children start to let go of the accessory… But, of course, this is not a rule.

Are there any benefits to using a pacifier?

But a habit that has been passed down from generation to generation certainly has some advantage. Check below which are the main benefits attributed to the use of pacifiers.

feeling of well-being

Nathália highlights that the suction movement, resulting from the use of the pacifier, releases neurotransmitters that cause a feeling of well-being. “These positive effects are related to pain management in the newborn and also to the modulation of the baby’s agitated behavior,” she explains.

In this sense, the use of a pacifier is usually also beneficial when it comes to reducing stress in babies during painful procedures. Use it when you need to take blood, for example.

Solution for special cases

The pacifier can also be indicated in special cases, for example, to stimulate sucking in children with neurological diseases or to anticipate the beginning of oral feeding in premature babies.

Protection from sudden death

Although the subject is quite controversial, there are studies that associate pacifier use with a reduced risk of sudden death. One hypothesis would be that the pacifier prevents the tongue from “falling back” during sleep (which would cause asphyxia and could lead to death).

On the other hand, it is known that breastfeeding reduces the risk of sudden death in babies by 50%. And, as the use of a pacifier is responsible for the shorter duration of breastfeeding, its use can also be seen as an aggravating factor in cases of sudden death.

How to put the pacifier aside

A big question among parents is: what can I use instead of a pacifier? And in the case of children who already use the accessory, how to make them put the pacifier aside?

• Use other objects: Nathália suggests offering, for example, rattles and teethers.
• Keep breastfeeding: it is worth remembering that the baby has a physiological need for suction. Breastfeeding already offers this, helping to exclude pacifier use.
• Give affection and attention: try to find out the reason for crying, talk to the baby and make him “swaddle”. These are very important elements when it comes to calming the child.
• Use music: Calm and/or engaging music can help soothe or entertain your baby. Studies have even shown that music associated with breastfeeding has calming effects.

In the case of older children who are already used to the pacifier, as highlighted by Nathália, the ideal is the conversation of parents or caregivers with the child. “Parents should talk to the child about their growth and the importance of giving up the pacifier,” she says.

“They may allow the use of a pacifier at specific times of the day, such as before bed or during episodes of illness.”, adds the pediatrician.

Among so much controversy, being aware of the harmful effects of pacifiers is essential. As well as understanding the advantages of the accessory, being “open to new alternatives” and clearing your doubts with professionals you trust are the best guidelines.