Dear Melissa,
Thanks for your pacifier post last week. Should I be concerned about pacifier use impacting my child’s speech development?
To respond to your question I have reached out to one of our Children's Therapy TEAM's Pediatric Speech/Language Pathologist, Connie Clark.
Melissa: Should
infants be allowed to use pacifiers? Why or why
not?
Connie: I think
pacifiers are OK if the infant wants it. It should not be forced, but they are perfectly
fine for helping to learn a coordinated sucking pattern before feeding. Also, pacifiers are certainly helpful if they help to
comfort the baby.
Melissa: Are certain
pacifiers better than others from a speech/language pathology perspective?
Connie: I prefer for a child to use pacifiers with a smaller nipple. Unless the child uses a pacifier for an extended period of time and until they are older, it should not effect dentition or tongue placement. However, it is generally a good idea to limit the time an infant uses a pacifier, particularly if the child is not actually requesting it.
Connie: I prefer for a child to use pacifiers with a smaller nipple. Unless the child uses a pacifier for an extended period of time and until they are older, it should not effect dentition or tongue placement. However, it is generally a good idea to limit the time an infant uses a pacifier, particularly if the child is not actually requesting it.
Melissa: At what age do you recommend
weaning/eliminating use of a pacifier?
Connie:
Generally, I feel that babies should start weaning from a pacifier when their teeth start to come in, or before 1 year of age.
Melissa: What specific problems might occur if an infant continues to use a pacifier well into toddler-hood?
Melissa: What specific problems might occur if an infant continues to use a pacifier well into toddler-hood?
Connie: There is some mixed literature as to what extent prolonged pacifier use will
impact language skills. We do know that there is some correlation between
pacifier use and an increased risk of ear infections in infants (Nimela, Uhari,
& Mottonen, 1995) and this can cause temporary disturbances in
hearing. We also know that prolonged
pacifier use can cause dental anomalies such as cross bites, open bites, and
dental arches (Larsson, 1994). These
dental anomalies can then in turn impact articulation (Boshart, 2001) as
well as create a tongue thrust which will also distort articulation (Van
Norman, 2001).
Melissa: What literature supports the efficacy of prolonged pacifier use?
Connie: Shotts et al (2008) found no real
difference between children who never used a pacifier, children who stopped
pacifier use by 15 months, and children who continued to use a pacifier past 18
months. This said, while not every child
who uses a pacifier past the age of 1 year will develop problems, I think it is still a good idea to begin to eliminate the use of pacifiers at this time to help
make sure that the young child’s speech can develop as normally as
possible.
Melissa: What is your biggest concern regarding pacifier use?
Melissa: What is your biggest concern regarding pacifier use?
Connie: If a child is old enough to communicate with words, phrases and sentences, it is very difficult to speak clearly with a pacifier in your mouth. So whether there are long term effects or not, communication can definitely be interrupted by constant and prolonged use of a pacifier.
Thank you Connie Clark! Also, thank you to TEAM Speech Therapist Amy Love-Smith for your consultation. Next week I will offer my own thoughts on this from an occupational therapy perspective.
What are your thoughts on
the risks/benefits of pacifier use?
We
would love to hear from you! Also if you have a questions that you would like me to address in my weekly blog please don't hesitate to reach out to me.
email: share@childrenstherapyteam.com
Resources:
- Boshart, C. A. (2001). The pacifier: Making the decision. Termecula, California: Speech Dynamics Inc.
- LaPrarie, D. Goldacker, F. E., Throneburg, R. M., & Calvert, L. K. (2010). Effect of Pacifier use on Speech Articulation, Poster retrieved from http://www.asha.org/events/convention/handouts/2010/1313-laprairie-danielle/ American Speech and Hearing Association Annual Convention in Philadelphia (downloaded May 2015)
- Larsson, E. (1994). Artificial sucking habits: Etiology, prevalence and effect on occlusion. International Journal of Orofacial Myology, 20, 10-21.
- Niemela, M., Uhari, M., Mottonen, M. (1995). A pacifier increases the risk of recurrent acute otitis media in children in day care centers, Pediatrics (1995)
- Shotts, L., McDaniel, M., Neeley, R. (2008). The Impact of Prolonged Pacifier Use on Speech Articulation: A Preliminary Investigation, Contemporary Issues in Communication Science and Disorders. Volume 35. 72-75 (accessed May 2015)
- Van Norman, R. A. (2001). Why we can’t afford to ignore prolonged digit sucking. Contemporary Pediatrics, Van Norman, R. A. (2001). 18(6), 61-65.
- Pacifiers, American Academy of Pediatrics (accessed May 2015)
- Pacifier Overuse May Harm Speech Skills, American Speech-Language-Hearing Association (Downloaded May 2015)
- Pediatric Dental Associates, Northwest Arkansas
- Sudden Infant Death Syndrome, (SIDS), Mayo Clinic (accessed May 2015)
- Thumb Sucking and Pacifier Use, American Dental Association (accessed May 2015)
- 10 Tips to Breastfeeding for a Year, La Leche League (accessed May 2015)
