Monday, June 29, 2015

Pacifier Mistakes

 
Dear Melissa,
Should my child use a pacifier?

 I think pacifiers are great...when used correctly. There are times such as car rides, church, etc..., where the pacifier is your best friend at trying to keep a child happy, quiet, and calm when you have few alternatives. However, a pacifier is not always the best option. Try to avoid common mistakes parents often make. 

 1. Do not let your child form a bad pacifier habit.
I sometimes see an infant/young child happily and fully engaged in an activity, but still have a pacifier in his/her mouth. In this case, the pacifier is simply a bad habit. I have been at the park a lot lately with my own kiddos, and I am amazed at the number of children running, climbing, and playing on the equipment that are still using a pacifier. Yes, a child that is this old is probably too old for a pacifier, but that is beside the point. If a child is getting all of that fantastic sensory input from running, jumping and playing, then the pacifier is probably not necessary for calming, and is just a bad habit.

2. Do not offer a pacifier without regard for the child's actual needs.
Listen to and observe your child. Respond to their need for a hug, play, attention, etc... When you respond to your child's actual need, you will likely find the child is more content than they would be with a pacifier.

3. Do not offer a pacifier while your child is talking.
Now, I’m not a speech therapist. For that perspective, please see TEAM Speech Therapist Connie Clark's comments on pacifiers in my blog from last week. However, my experience has been that whenever a child is trying to speak to me with a pacifier in their mouth, they are nearly impossible to understand. If a child is old enough to talk, then he probably shouldn’t be using a pacifier during the day. If the child is still using a pacifier during the day (and you are an Auntie or family friend), have the child spit the pacifier out at least while talking so you can understand them more clearly. 

4. Don't allow an older child to continue use a pacifier.
Weaning a child from a pacifier is hard. Pacifiers are calming! If you take away what calms him down, you will have a cranky child, and who wants that? I agree with the pediatricians, dentists, and speech therapists that its ideal for babies to stop pacifier use by 1 year of age. I prefer to gently start weaning from the pacifier at 1 year of age, and slowly take away more and more environments in which the pacifier is used, until the pacifier is completely eliminated by 2-2 ½ years of age. In my experience working with children with sensory processing disorders, I know that children sometimes find other, less desirable, calming methods when their pacifier is taken away. So, a gradual approach to weaning is highly recommended.

Finally, my take as a pediatric occupational therapist is that babies use “non-nutritive” sucking (that is sucking without eating or obtaining nutrition) even before they are born. It is probably an infant’s first “occupation”. I remember my daughter sucking on her hands in the delivery room when she was only minutes old. Given correct use, I recommend pacifiers as I would much rather a child use a pacifier to calm themselves, instead of sucking on their hands (which are often germy) or over using the bottle/breast.

So, there you have it. I have provided a multidisciplinary approach to the question “should my child use a pacifier?” I have discussed a dentist's concern about orthodontic problems. A speech therapist's concern about articulation problems. And finally, my sensory-based OT perspective.

Related to this topic, in next week's post I will tackle this parent question, "Whenever my 10 month old cries at night I respond by giving him a pacifier. The problem is he cries 4 or 5 times a nights until a pacifier magically reappears in his mouth again. Help, I'm sleep deprived. How do I wean this child from his pacifier?"

Do you have questions you would like me to explore on my weekly blog? 

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