• Lauren Tandy

When to Wean Pacifiers and Why

I had my first baby at 25. I was the middle child of seven children. I had been around a lot of children, but didn’t know the rules. So I had a lot of questions about what to do with my first child.

One question that I hadn’t thought much about before going to the hospital and having my baby, was if I would offer him a pacifier or not. My mother is a nurse, and I rely on her recommendations for a lot of caretaking in my life. I knew there would be nurses, doctors, and lactation consultants at the hospital that would take care of me. I didn’t think that they would all have different opinions.



When it came down to labor, delivery, and then nursing, I quickly realized that my baby wanted to nurse 24/7. I was exhausted from delivery and wanted to know if I could offer a pacifier to keep my baby calm and get some rest myself. When I asked the lactation consultant who had been so helpful helping me navigate nursing, she gave me one answer. When I asked the nurses who came and went to check vitals, each gave me a different answer. The answers weren’t even down occupational lines. The party line of the hospital was to not offer pacifiers; however, the nurses who were in the trenches and saw how exhausted I was nursing nonstop recommended that I just offer a pacifier and get some rest.


I ended up taking the nurse’s recommendations because I barely made it through delivery consciously without passing out and it had been a long two days of labor. I felt delirious and needed some saving. But I also felt guilty for going against other professional’s recommendations.


This is but one example of why I love to research feeding development and issues. I love to be able to answer mom’s questions with evidence-based information.


TALKING POINTS

  • SIDS: Offering a pacifier during infancy has been found to reduce the risk of Sudden Infant Death Syndrome (SIDS)

  • MOUTH: Using non-nutritive devices (pacifiers, bottle nipples, digits or finger sucking) molds the mouth around whatever is being used on a regular basis to an extent.

  • BONE DEVELOPMENT: A baby’s bone structure for their face, head, and palate is flexible. If something is used and then taken away, their bone structure typically has the time before bone closure to adjust to natural development, depending on when the device is removed. There are certain time frames of sutures closing that are somewhat individual. For instance, if a helmet is needed to modify head shape and growth, it will have more effect on modification of the baby’s head shape if it is started at 6 months versus 8 months (dependent on where the baby’s head is in bone growth and development).

  • EMOTIONAL ATTACHMENT: If a pacifier is used past 6 months to 1 year of age, it typically becomes an emotional attachment instead of a device to meet their sensory integration needs of oral stimulation and suckling movement.

  • MEETING EMOTIONAL NEEDS: It is beneficial to offer an alternative emotional attachment piece or ritual when weaning the pacifier. Studies have recommended rocking the child, singing to the child, offering a lovey that can be taken away when they lay down for sleep, etc.

  • SLEEP TIMES (here is a big one): If your baby takes a pacifier, it is beneficial in order to reduce oral time with mouth molding around the pacifier to offer the pacifier only at sleep times. Then when the child falls asleep, remove the pacifier to allow the palate and mouth to mold naturally. If the child wakes up and cries, first attempt to soothe the child by rocking, singing, or calming them without offering the pacifier again first. This dramatically reduces the amount of molding a mouth and palate does around the non-nutritive device. This applies to bottle nipples, as well.

  • EAR INFECTIONS: One thing that we don’t think of is how using pacifiers affects our baby’s health. It is important to keep pacifiers clean when offering to the baby’s mouth. Bacteria-infested pacifiers have a tendency to help ear infections along. A baby’s mouth and throat area have a direct route to their middle ear via the eustachian tube. The eustachian tube runs from the back of the baby’s throat to their middle ear. If bacteria are living in the baby’s mouth and the eustachian tube becomes inflamed due to illness or cold, it is easy for the oral-pharyngeal bacteria to become trapped in the middle ear and cause ear infections. When this happens often, it is called chronic otitis media and may affect speech-language development due to poor hearing.


My goal is to provide mamas out there with some useful information that will help them make important early decisions for themselves and their babies. There are so many small and big decisions in the beginning of a baby’s life. My hope is that you feel confident as a mother in the decisions you make.


Lauren Tandy, M.S., CCC-SLP is a certified speech-language pathologist licensed in Idaho and Washington. She has a special interest in early intervention, feeding and swallowing issues, oromyofunctional disorders, and speech-language development. You may find more information at tandytherapy.com. Feel free to contact Lauren with any questions at hello@tandytherapy.com

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Tandy Therapy LLC

Phone: 208-981-1111

Fax: 208-908-0060

Email: hello@tandytherapy.com

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