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  • Ana Sofia Valdes

Pacifier: to use or not to use?

This is a question you might be wondering about, or maybe you think it is something that shouldn't even be questioned, but it is not so simple, or at least for me, it wasn't.

When I thought about pacifiers, I had the idea that giving my baby a pacifier ensured him a life of braces and dentist appointments. But I kept asking myself: if they are so bad, why does every baby I see have one? Why are they sold everywhere and in every shape and color? So, I decided to do a little research and found that overall, experts state that a pacifier is not a bad thing. It has even been considered a way to reduce the risk of SIDS in the first months of life. What experts disagree on is when we should stop using them. And here lies the real problem and question with pacifiers because getting rid of it is not an easy thing to do.

Here is a summary of what leading experts say:

American Academy of Pediatrics

· Recommends using one after the first 6 weeks and for the first 6 months of life to reduce the risk of SIDS

The American Academy of Pediatric Dentistry

· Recommends stopping by age 36 months

The American Dental Association

· Recommends stopping by age 2 years

The American Academy of Pediatrics

· Recommends use for the first 6 months and should stop before 12 months

The American Academy of Family Physicians

· Recommend weaning children from pacifiers during the second six months of life

It is recommended to wait until after the first six weeks because, on average, it is the amount of time it takes to establish breastfeeding. During the first weeks, your baby is learning how to suck. Giving him a different shape, texture, and material will change the way he sucks on your nipple, making it more painful and therefore harder. In addition, if your baby is sucking a pacifier 24/7, you could miss babies hunger cues, which could impact weight gain. Some studies show a correlation between pacifiers and an unsuccessful breastfeeding journey or shorter periods of lactation.

The reasons to remove the pacifier earlier rather than later vary but include ear infections and oral malformations; it prevents oral exploration fundamental for their development and modifies suction and swallowing patterns and tongue position.

Even after all the research, I was still unsure; I had a lot of conflict with the pacifier because of external forces pushing against each other. I don't know if the is a cultural thing that varies from place to place, but here in Germany, everyone seemed to be pushing for the paci. From the hospital nurses who wanted to give him one from the second he got to our room to my in-laws, who, every time Max cried, wanted to put one in his mouth.

I understand and don't blame either of them. With the nurses, I can see that giving babies a pacifier makes their job easier, especially with the maternity wing at total capacity. For Opa and Oma, of course, they don't want to see their newborn grandchild cry, and momentarily the pacifier seems a great idea.

On the other hand, Mexico was pushing against it. My lactation consultant said definitely don't use it or wait at least 6 weeks. My Mexican pediatrician also said I should avoid it. My mom and even my grandma were firmly against it (I have to say my grandma just thinks babies don't look so cute with a paci, so that doesn't really count as a reason, but it was still in my head).

And then there was Max. He had a very strong sucking reflex and wanted to be sucking all the time. Unfortunately, he also managed to bite off a part of my nipple in his first weeks, making it incredibly painful to breastfeed him. Also, because he wanted to be stuck to me, it was impossible to heal.

At around week 4, I developed mastitis and was in terrible pain. I would cry every time I needed to feed him. In turn, he would cry because he wanted to suck constantly, so I finally gave in to my husband's casual not so casual suggestions and gave him the pacifier.

Giving it to him was the first time I felt mom guilt. I felt like nothing was going according to plan (newsflash, nothing ever does). I felt like an incapable mother and was really scared it would affect breastfeeding, which was proving to be hard enough. It didn't help that it didn't seem to be the magic solution everybody seemed to suggest. At least not at the beginning. It took a couple of days and maybe weeks and trying different brands and types of pacifiers for it to actually help, but I must accept it did.

I have to say, I did feel a change in the way he was sucking. I felt he was doing it harder and with a different pattern. Still, I cannot say if this change was related to the pacifier or to us getting better at breastfeeding. In my case, at 4 weeks, it gave me a much-needed rest, and maybe if I hadn't had the break, I would have given up on breastfeeding.

Based on the research that I did, I set rules and tried to stick to them. I felt that it could become easy to just put the pacifier in if we didn't have them every time he got fussy.

Here are the rules that we use:

  1. We just used it after checking everything else: hunger, diaper, temperature, colic, and snuggles.

  2. Once he is deeply asleep, I try to take it out so he doesn't spend much time with it.

  3. After the first months, I always offer him a teether before giving him the paci.

  4. We only use pacifiers approved by odontologists and recommended by our pediatrician.

  5. We have a paci weaning deadline of 1 year.

For us, it has worked well, and now that he is 8 months, we have been using it less and less, just for sleep and when he gets really annoyed in the car seat or in the stroller.

Apart from the negative medical aspects that I have already covered, I discovered some additional negatives that might be worth considering beforehand:

First. Pacifiers fall off babies' mouths, and it takes tiny humans a while to learn how to put them back in themselves. Even when they know how to do it, pacifiers tend to disappear in cribs, so putting the pacifier back in becomes an around-the-clock job for mom and dad (as if you didn't have enough things to do for your baby already!).

Second. The pacifier becomes necessary for falling asleep. The baby is not really learning to fall asleep without assistance, which could become a problem with time.

Third. The pacifier becomes a toy. As the baby grows and especially when going to sleep is a fight, the pacifier becomes a toy, a projectile, or anything else entertaining.

Fourth. I am not there yet, but I guess that the most significant negative will be trying to take it away. When I get there, I will give you an update for sure.

Deciding to use it is as with every decision up to you. It will depend on your baby and your family dynamic. All I can say is listen to what your baby is telling you and adapt to his needs. If you do decide to use it, here are some things to consider:

  • There are a million types of pacifiers, but not every baby will want a paci, and not all pacifiers work for every baby. Don't go overboard buying a lot of them; try one at a time until you find one that works.

  • You need to renew your pacifiers often. It depends on the use, but be on the lookout for any wear and replace them whenever you see changes in the material's surface, size, shape, or rupture. As a rule of thumb, they should be replaced every 1 to 2 months but each brand will give specific instructions.

  • There are different stages, so make sure you give your baby the right one.

  • Choose a one-piece; pacifiers made of two pieces pose a choking hazard if they break.

  • Keep it clean: until your baby is 6 months old and their immune system matures, frequently boil pacifiers, or run them through the dishwasher. After age 6 months, simply wash pacifiers with soap and water.

  • I highly recommend glow-in-the-dark pacifiers to help with the whole lost and found problems.

To sum up, using a pacifier is a matter of preference. From a medical standpoint, the problem is not the use but prolonged use, and from a practical perspective, it has its pros and cons. Do what works for your family. If you decide to use one, try to hold off until after breastfeeding has been established; be on the lookout for overuse; keep in mind that weaning should happen sooner rather than later.

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