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The Pacifier Predicament
by Natalie J. Dahl, MS, CCC-SLP
Binky, paci, bink, soothie. A pacifier goes by many different names, but the one thing that remains the same is that it can play an important role in the life of a baby, a toddler, or even parents. It can provide comfort to an infant, distraction during immunization shots or while a parent is making dinner, and can increase a baby’s sucking satisfaction without eating food or liquid. However, some may question if pacifier use is appropriate for infants and toddlers. Ultimately, this is a decision for the parents to make. The following is a compilation of positive and negative effects of pacifier use in order to help parents determine for themselves what is appropriate for their children.
A Pacifier’s POSITIVE Effects
  • Decreases the risk of Sudden Infant Death Syndrome (SIDS). A baby who sleeps with a pacifier doesn’t often sleep as soundly as one without a pacifier, making it possible for the baby to wake up from a deep sleep that might result in stopped breathing.
  • Provides a source of security to an infant and increases sucking satisfaction.
  • Is a common substitution for a mother’s breast or baby bottle for the purpose of comforting and settling a newborn.
  • Allows a baby to suck without ingesting food or liquid.
  • Is an easier habit to break than thumb-sucking.
A Pacifier’s NEGATIVE Effects
  • Can cause alignment problems with the teeth or developing bone in the mouth after age two. Use of pacifiers should stop by this age so that any problems can be corrected naturally.
  • Can cause problems with proper development of the mouth and changes in the shape of the roof of the mouth with prolonged use. Poor dental development is also linked to disordered speech articulation.
  • Correlates to otitis media, or acute middle ear infections. Continuous sucking on a pacifier causes the auditory tubes to be abnormally open, allowing secretions from the throat to seep into the middle ear and cause infections.
  • Causes misaligned teeth (dental malocclusions) in 60% of children.
  • Can lead to specific dental problems in 3- to 5-year-olds, including anterior open bite, posterior crossbite, mean overjet, and smaller intercanine distance of the upper arch.
  • Can limit babbling and imitation of sounds and words.
  • Can distort vocalizations while held in the mouth or may keep a child from attempting to speak at all.
  • May interfere with breastfeeding, as a different sucking technique is required.
If pacifier use is what is most appropriate for the child, here are some tips to stay safe:
  • Restrict use to when the infant is falling asleep.
  • Always keep the shield on the outside of the lips. Severe lacerations can occur if the shield is held inside the lips.
  • Do not place a cord around the child’s neck to hold a pacifier. Look for pacifiers that have a ring, in order to prevent strangulation.
  • Look for a pacifier with ventilation holes in the shield. These will permit air passage if the pacifier accidentally becomes lodged in the child’s throat.
  • Select a pacifier with a symmetrical nipple. This permits the pacifier to remain in the correct sucking position.
  • Dispose of the pacifier after use; it is not sanitary to keep or give it away.
  • Dip them in white vinegar or lemon juice, making them unappealing.
  • Pierce the nipples with a needle or cut them shorter to reduce the sucking satisfaction.
  • Leave them behind on a trip.
  • Take them away “cold turkey.”
  • Make sure everyone is onboard, including caregivers, grandparents, and siblings.
  • Offer alternative comforts, such as rocking, soft singing, and gentle massage.
  • Explain to the child that there is another baby who needs the pacifiers more and make an event of gathering up all of the pacifiers and putting them in a box to “give away.” Give the child lots of praise for being so generous and for being a “big kid.”
  • Introduce and stage a visit from the Binky Fairy. Explain to the toddler that the Binky Fairy will come whenever he or she is ready to give up his or her pacifiers. Collect all pacifiers and put them in a box or fancy basket on the doorstep. After the production, the Binky Fairy will “pay a visit” to take the pacifiers away and leave a toy or treat in their place.
“10 Tips for Weaning Your Child off the Pacifier,” accessed June 5, 2017,
McDaniel, Mike, Neeley, Richard A., and Shotts, Laura L., “The Impact of Prolonged Pacifier Use on Speech Articulation: A Preliminary Investigation,” Contemporary Issues in Communication Science and Disorders 35 (2008): 72-75.
“Pacifiers Have Negative and Positive Effects,” accessed April 11, 2017,
“To Give Or Not To Give: Pacifier Pros and Cons,” accessed April 11, 2017,

*Handy Handouts® are for classroom and personal use only.
Any commercial use is strictly prohibited.

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