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Should We Use Soothers (Pacifiers) For Infants?

Before I became a mother, I did not realize how attached an infant can be to their soother. Madi loved her soother, and we lovingly nicknamed it “soo-soo.” Madi would reach for her “soo-soo,” call out for it, and we always make sure we had it in her diaper bag. Then one day, at around 8 months old she was done with her “soo-soo.” George, on the other hand, does not seem interested in his soother at all.

During my pediatrics rotation during medical school I learned that the sucking motion can be very soothing for infants. I also learned that there are benefits to an infant using a soother in their first year of life. There is research that soothers in the first year of life for infants may decrease the risk of sudden infant death syndrome (SIDS). There may also be some benefit in soother use during painful procedures and helping infants self sooth in term and pre-term infants.

However, there is also research that shows that soother use can cause problems with breastfeeding and may increase the frequency of ear infections and dental infections.  There are recommendations that suggest to avoid soother use until breastfeeding is well established I chose to have Madi use a soother while we were still trying to establish our breastfeeding relationship.  

The American Academy of Pediatrics and the American Academy of Family Physicians recommends weaning infants from soothers after 6 months of age to reduce the risk of ear infections. When Madi was 8 months old, she suddenly decided that she didn’t like her soother anymore and self weaned. 

The Canadian Pediatric Society has some useful suggestions for soother use below:

  • It’s best not to start using a pacifier until breastfeeding is going well. Talk to your doctor or lactation specialist if you feel your baby needs to use one at this early stage. One exception is for premature or sick babies in the hospital who can benefit from using one for comfort.
  • Always see if your baby is hungry, tired or bored before giving him a pacifier. Try solving these things first.
  • Always check for cracks or tears before giving a pacifier to your baby. Don’t give your baby a pacifier right after giving medicine (like a pain reliever, antibiotics or vitamins), because some of these medicines can cause the material in the pacifier to break down. If there are cracks or tears, throw it out.
  • Never dip the pacifier in sugar or honey. This will hurt your baby’s teeth. Honey can lead to botulism, which is a type of food poisoning.
  • Never tie a pacifier around your baby’s neck. This can cause strangulation and death. Instead, you can use clips with short ribbons attached to them. They are available where you buy pacifiers and are safe to use.
  • Never make your own pacifier out of bottle nipples, caps or other materials. These can cause choking and death.
  • Use the pacifier only when your child needs comfort. Using it all day long can affect your child’s ability to learn to talk and can cause problems with teeth.

This post was co-authored by Stephanie Liu, MD, MSc, CCFP, BHSc and Erin Manchuk, BScPharm, BCGP.

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