DO DUMMIES REALLY SUCK?

There are a lot of misconceptions about dummies (also known as pacifiers) leaving parents feeling guilty and unsure about using them. Parenting is really hard- especially a child with additional needs. Young babies cry a lot. They have no way of self-settling. A dummy can offer comfort to a baby that has already been fed, changed, burped and just needs to settle, sleep or go in the car. As a speech pathologist I have looked at the scientific research and have found the evidence about dummies so parents can make an informed decision about whether to introduce them or not.

The positives of dummy use:

• Dummies are helpful for stimulating and coordinating the suck, swallow, breathe pattern needed for feeding in premmie babies
• Comforting to distressed infants
• Relieving pain from reflux and after/ during surgeries
• Improved sleep and self-settling in a cot
• Protecting against sudden infant death syndrome (SIDS) when offered to a baby consistently at sleep time when they are laying on their back, in a cot, alone
• Not offering a dummy means babies will often seek other forms of comfort such as thumb and finger sucking. Thumb sucking changes the shape of the palate and dental bite and is much harder to stop than dummy use. Thumbs are attached to the end of your arm but dummies can be put away.

For the first 6 weeks sucking is a reflex and babies find sucking comforting and pain relieving. Sucking on a breast or bottle has the same effect so a dummy being introduced after the baby has had a full feed but still wanting to suck is perfectly ok. Plus it gives parents a break. Parents who are calm and well rested are more likely to be interactive, use a wider range of language and play with their babies which will help with speech and language development.  Also, babies who are calm and have more sleep are better able to learn language and develop interaction skills. So in the first 12 months of life a dummy can be beneficial. However, while it helps in the short term, there are negative long term impacts of introducing a dummy. 

Negatives of dummy use:

• Dummies may interfere with breast feeding patterns and confuse an infants hunger cues
• Babies who use a dummy may not feed as often and this may impact on weight gain and the mothers breast milk supply if used in the first 6-8 weeks
• Increased incidence of ear infections due to the introduction of germs via the dummy
• Dental malocclusions can form if a dummy is used once teeth start coming in
• Reduced opportunities for babble and early sound making when the dummy is in the mouth during awake play time
• Speech sound errors may develop including distortions of s, sh, z and alveolar sounds t, d

So how bad are dummies for speech sound development? Strutt Et al did a research study in 2021 and found that only prolonged use (2-3 years) of a dummy over several hours  and particularly during the day when the child should be talking and interacting impacts on speech. However, the biggest impact was on toddlers using dummies during the day having reduced opportunities for babbling, sound production practice and less opportunity to develop early words (Burret al. 2020, Shottset al. 2008). Research has also found children who overused a dummy (for more than 3 years) were less able to clearly distinguish between concrete and abstract emotional concepts. They tend to refer less to their experience and to social and emotional situations when telling a story. This may be because parents are less able to read their cues or emotional reactions are dampened by use of the dummy in early years.

In summary:
For the first year of life a dummy can be convenient helper to a parent and baby. The research shows that if a baby is premmie or you’re bottle feeding using a dummy from birth is ok. For breastfed babies wait until 6-8 weeks of age when breastmilk supply and feeding skills are established before introducing a dummy. Equally, if they don’t want a dummy or don’t need it- Don’t force it. Beyond 12 months of age using a dummy tends to have more negative outcomes, and all researchers say to wean off completely by 2 years. Some researchers say it’s harder to wean off a dummy once children are really used to it and therefore it’s easier to start weaning from 6 months  or not to introduce it at all. For parents of children with developmental disabilities or neurodivergent kids with sensory differences  who seek oral sensory input- the dummy can be very calming and regulating. When it’s taken away they may become distressed. For these children I recommend talking to a speech pathologist about ways to gently wean off the dummy, stimulate oral exploration and develop oral motor and speech skills.  Occupational therapists can also help with finding alternative oral sensory and regulation strategies before taking the dummy away. 

 
​References:
NT J LANG COMMUN DISORD,MAY/JUNE2021,VOL. 56,NO. 3, 512–527Research Report Does the duration and frequency of dummy (pacifier) use affect the development of speech? Charlie Strutt, Ghada Khattaband Joe   and Language Sciences Section, School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
Front. Psychol., 01 December 2017 | https://doi.org/10.3389/fpsyg.2017.02014 Pacifier Overuse and Conceptual Relations of Abstract and Emotional Concepts Laura Barca1*, Claudia Mazzuca2 and Anna M. Borghi, 1.Institute of Cognitive Science and Technologies, Italian National Research Council (CNR), Rome, Italy, 2.Department of Philosophy and Communication, University of Bologna, Bologna, Italy, 3.Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
American Dental Association 2003, Canadian Paediatric Society 2003, Karabulutet al.2009, Van Norman 2001, World Health Organisation1989
Adair SM. (2003) Pacifier use in children: a review of recent literature. Pediatric Dentistry. 25(5):449-458.
Alm B, Wennergren G, Molborg P, Lagercrantz H. (2016) Breastfeeding and dummy use have a protective effect on sudden infant death syndrome. Acta Pardiatrica. 105: 31-38. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5049485/ [Accessed 19th September 2019]
Ball, H. (2019) Dummies, baby sleep info source. University of Durham. Available at: https://www.basisonline.org.uk/hcp-dummies/[Accessed 
Cinar ND. (2004) The advantages and disadvantages of pacifier use. Contemporary Nurse. 17:1-2, 109-112. https://www.tandfonline.com/doi/abs/10.5172/conu.17.1-2.109 
La Leche League GB. (2019) Dummies and breastfeeding. Available at: https://www.laleche.org.uk/dummies-and-breastfeeding/ 
Fleming PJ, Blair PS, Pollard K, Platt W, Leach C, Smith I, et al. (1999) Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study. Arch Dis Child. 81(2):112-116. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1718026/ [Accessed 19th September 2019]
Grocock R, Robertson C, Brown N. (2018) Dummies: a review of the evidence; Journal of Health Visiting. 6(4). Available at: https://www.magonlinelibrary.com/doi/full/10.12968/johv.2018.6.4.182 
Hauck FR, Omojokun OO, Siadaty Ms. Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Paediatrics. 116(5):e716-e723. Available at:  https://www.ncbi.nlm.nih.gov/pubmed/16216900 
Horne RSC, Hauck FR, Moon RY, L’Hoir MP, blair PS. (2014) Dummy (pacifier) use and sudden infant death syndrome: Potential advantages and disadvantages. J Paediatrics Child Health. 50:170-174.
Jaafar SH, Jahanfar S, Angolkar M, Ho JJ. (2011) Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. (3):CD007202. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007202.pub2/full 
Kronborg H, Vaeth M. (2009) How are effective breastfeeding technique and pacifier use related to breastfeeding problems and breastfeeding duration. BIRTH. 36:1. Available at: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1523-536X.2008.00293.x 
Levrini L, Merlo P, Paracchini L. (2007) Different geometric patterns of pacifiers compared on the basis of finite element analysis. European J Paediatric Dentistry. 8(4):173-178. Available at: https://www.ncbi.nlm.nih.gov/pubmed/18163851  
Poyak J. (2006) Effects of pacifiers on early oral development. Int J Orthod Milwaukee. 17(4):13-6. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17256438 
Rovers MM, Numans ME, Langenbach E, Grobbee DE, Verheij TJ, Schilder AG. (1999) Is pacifier use a risk factor for acute otitis media? A dynamic cohort study. Fam Pract. 2008 Aug;25(4):233-6. Available at: https://www.ncbi.nlm.nih.gov/pubmed/18562333 
Uhari M, Mantysaari K, Niemela. (1996) A meta-analytic review of the risk factors for acute otitis media. Clin Infect Dis. 22(6): 1079-83. Available at: https://www.ncbi.nlm.nih.gov/pubmed/8783714 ​