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Ask the Experts: Pacifiers

Q: Is it wise to give my baby a pacifier? If so, what should I look for when choosing one?

pacifierA: There is much debate regarding the use of pacifiers. If you feel that you want to use one, it is best not to start until your infant is 4 weeks old because by that time breastfeeding habits will be more firmly established.

For many infants, pacifiers have a calming effect and go a long way not only to help prevent pain and anxiety, but also to reduce the incidence of sudden infant death syndrome (SIDS).

Pacifier selection can be tricky with fussy babies. But, it is wise to consider orthodontic pacifiers, which feature a flattened nipple on the bottom and are rounded at the top, allowing the pacifier to remain in the correct sucking position. This shape, which is designed to support the baby’s developing palate and jaw, is intended to prevent tooth misalignment and orthodontic issues later in life.

Take note, though, that pacifiers come with some risks. There can be long-term complications from use of pacifiers, including overbite from the upper teeth, posterior crossbite (when the upper back teeth are tucked inside the lower back teeth), the development of a gap between the teeth and possible mouth distortion.

It is best to restrict pacifier use to when your infant needs to fall asleep. Don’t place honey or sugary syrup on the pacifier, as doing so may cause dependence and ultimately withdrawal difficulties.

The best advice I can give you is to start discouraging your child from using the pacifier as early as 6 months with complete cessation by 2 years. Before age 2, any problems with growing teeth usually correct themselves within 6 months of discontinuing pacifier use.

— Sharde Harvey, DDS, mom of one and principal of New York-based Smiles Park Avenue Dental