Updated: Feb 24, 2020
No really, that’s what they love to do, they just can't help it!
From around 32 weeks of pregnancy the sucking reflex begins to develop, and it lasts to around 12 months of age. This means that, within this time, when something touches the roof of the mouth the infant is triggered to suck and has no control over it.
Sucking can have a lot of different effects in the body of the baby. It is thought that sucking triggers the release of the hormone cholecystokinin in the gut which gives a feeling of fullness and sleepiness and in its turn triggers the release of oxytocin in the baby. Oxytocin is the incredible hormone which is so important throughout our lives but especially in the postnatal period and for infant development. It reduces stress, encourages social interaction, bonding and the development of a secure psychological attachment. As a result, sucking is soothing and calming and may provide a measure of pain relief.
The optimal place for a baby to suck is at the breast. Sucking at the breast protects and enhances the correct development of the infant’s craniofacial complex and there is no technological replacement yet which replicates the action.
Artificial teats can trigger the sucking but it is a less active form and the technique used is quite different and may encourage compensatory behaviours which can impact on development (and their breast sucking technique).
Some of that doesn’t sound great but there ARE situations when using an artificial pacifier could actually be beneficial:
Many studies have shown an association between artificial pacifier use and a lower risk of SIDS (sudden infant death syndrome) but the mechanism for this is not at all clear. In America the guidance is to introduce an artificial pacifier for sleep once breastfeeding is established but in the UK the view is that the evidence isn’t clear enough to promote that. What is clear is that exclusive breastfeeding is a significant factor in lowering SIDS risk and should be protected;
NICE guidelines currently state that babies who are used to using an artificial pacifier for sleep should not have it removed suddenly before 26 weeks.
Some studies have shown that use during tube feedings (eg with preterm babies) can reduce restlessness, increase the motility of the gut and result in better weight gain;
Preterm infants can also spend time practising non-nutritive sucking using an artificial pacifier;
If it isn’t possible, for whatever reason, to suckle at the breast an artificial pacifier may give relief during painful procedures;
For babies who are bottle fed use of an artificial pacifier may reduce the risk of overfeeding during periods of development or growth spurts when babies frequently demand non-nutritive sucking. It can meet their need for sucking time without giving milk above what they need;
Some parents who are suffering from depression and feeling overwhelmed may find that use of an artificial pacifier helps them to cope and for some actually breastfeed for longer.
So are there any other reasons why artificial pacifier use should be limited?
Studies have shown that babies who use artificial pacifiers tend to have shorter breastfeeding duration. This can impact on the future health of both the baby and the mother.
Less time spent at the breast means less time spent by baby becoming familiar with the breast and the mother and hanging out in their ultimate ‘happy place’. A crying baby is communicating a need and mostly that need can be met by time at the breast.
Less time spent at the breast can negatively impact on milk supply and compromise healthy weight gain.
Artificial pacifiers are harbours for bacteria, viruses and yeast. They are difficult to clean effectively and should be checked and replaced often.
There is a higher incidence of ear infections in babies who use artificial pacifiers.
Use of artificial pacifiers can contribute to changes in dental arch and tooth position.
In infants with Downs syndrome suckling at the breast is an important part of strengthening the oral musculature and this can be negatively impacted by artificial pacifier use.
Being fully informed about the possible up and downsides of artificial pacifier use can help you decide whether it is right for your baby, in your circumstances.
If you do decide to use one here are a few suggestions to reduce some of the downsides:
If you are breastfeeding avoid introducing an artificial pacifier until breastfeeding is well established and restrict use as much as possible.
Try to stop using altogether by 1yr (or earlier if all primary teeth have erupted) and consider restricting use to sleep times etc.
Make sure your older baby gets plenty of dummy free time to experiment with babbling and language.
Carefully check for damage at each use and replace regularly.
It is really important to remember that a baby’s need to suck and spend time at the breast is beneficial both for them and for you and there is always a valid reason. If at all possible don’t limit it.