THE PACIFIER, IS IT STILL WORKING FOR YOUR BABY'S SLEEP?
PART 6 OF 7 AREAS COMMONLY OVERLOOKED OR NOT STRATEGICALLY PLANNED
Ahhh. The paci, dummy, nookie, soother, bo-bo, comforter, binky, piece, or whatever you choose to call your child's pacifier! For a lack of better words, it can be a double edged sword. On one hand, it can be extremely helpful with sleep and contribute to reducing the risk of SIDS. On the other, it can hinder consolidated sleep for both your infant and yourself and cause other issues with prolonged use. So, what to do about it?
FIRST, UNDERSTAND THE EXTENT OF THE PACIFIERS BENEFITS
Use of the pacifier is one of the nineteen suggested safe sleep guidelines by the AAP for infants under one year of age. Here is what is mentioned in the journal article, "SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment":
"Although the mechanism is yet unclear, studies have reported a protective effect of pacifiers on the incidence of SIDS. The protective effect of the pacifier is observed even if the pacifier falls out of the infant’s mouth.
1 - The pacifier should be used when placing the infant for sleep. It does not need to be reinserted once the infant falls asleep. If the infant refuses the pacifier, he or she should not be forced to take it. In those cases, parents can try to offer the pacifier again when the infant is a little older.
2 - Because of the risk of strangulation, pacifiers should not be hung around the infant’s neck. Pacifiers that attach to infant clothing should not be used with sleeping infants.
3 - Objects, such as stuffed toys and other items that may present a suffocation or choking risk, should not be attached to pacifiers.
4 - For breastfed infants, pacifier introduction should be delayed until breastfeeding is firmly established. Infants who are not being directly breastfed can begin pacifier use as soon as desired.
5 - There is insufficient evidence that finger sucking is protective against SIDS."
The main message I want you to get from this?
DON'T LET THE PACIFIER BE AN EXCUSE FOR SLEEP ISSUES OR THE REASON FOR ADDED WORRY IN YOUR LIFE. YOU DO NOT NEED TO REINSERT THE PACIFIER WHEN IT FALLS OUT.
SECOND, REFLECT ON YOUR ANSWERS TO THE FOLLOWING QUESTIONS
Is your child at an age where the pacifier's benefits outweigh the risks or vice versa?
As mentioned in the first section, the pacifier is recommended for children under one year of age with an emphasis on children six months of age and younger to reduce the risk of SIDS. Along with this huge benefit, the pacifier can also provide soothing and better sleep.
However, if pacifier use is prolonged, a child is more likely to experience difficulty with speech articulation (Shotts et al.), development of abstract language (Barca et al.), hindered mouth and teeth development (Butler Mitchell, DDS), increased ear infections (Hanafin and Griffiths), and other issues. The suggested age by most pediatric dentists is removal of the pacifier by age two and even by some pediatricians six months of age to reduce the risk of ear infections.
Your child will reach a point where the risks of the pacifier outweigh the benefits. Keep an open mind so that you are able to recognize that what use to help no longer does. This leads to our next question!
Is the pacifier hindering sleep?
Unfortunately, the exact device we expect to help with sleep can actually be the reason for the struggle. I have had several clients in the past who have faced this truth. Some knew the pacifier was preventing quality sleep while others didn't want to admit it but eventually had to in order to reach their sleep goals.
This usually means one of two things. One, the baby heavily relies on the pacifier in order to fall asleep and is unable to do so without it. Given the nature of sleep, this means difficulty falling back asleep between sleep cycles resulting in short naps and assistance from Mom and Dad in the middle of the night when transitioning from one sleep cycle to the next. Two, the baby wakes up due to the pacifier falling out of their mouth. This results in short naps and even more night wakings.