Should I offer my baby a Dummy or Pacifier?
To use a dummy. Or not to use a dummy. Like so many parenting choices, the introduction of a dummy can cause a lot of confusion and controversy. Today I’m going to break it all down so you have the information you need to decide what is right for you and your family.
Why do we offer a Dummy?
The first thing to understand is why we might want to offer a dummy in the first place. And as you’ll see from the list below, it isn’t just to soothe an upset baby.
* Using a dummy may lower SUDI/SIDS risk
SIDS & Kids NZ and the American Academy of Paediatrics (AAP) agree that there is strong evidence that dummy use is associated with a reduced risk of SUDI/SIDS when used consistently. The reasons why this is true are still uncertain but it could be that babies who use a dummy are less likely to roll onto their tummy; protection of the airway as sucking on the dummy keeps the airway open; a reduction of reflux symptoms; lowering of the arousal threshold (woken easier) and/or that sucking on the dummy may enhance development of neural pathways that control the upper airways.
Find out all about SUDI and safe sleep methods in my previous blog How to set up a safe sleep environment for your newborn.
* Soothing/sucking reflex is activated by dummy use
Dr Harvey Karp devised a newborn settling technique called The 5S Technique and the 5th and final S is for sucking! Non-nutritive sucking is sucking that isn’t feeding and can include a dummy, breast, bottle, fingers or hands. Babies just love to suck! They start doing it in utero and they continue to love it for the first 12 months of their life. Dr Karp talks about how sucking triggers baby’s Calming Reflex. And when this Reflex is activated babies are calmer, happier and easier to settle.
* Dummies can help soothe Reflux symptoms
A dummy can be a saviour for a Reflux baby as sucking stimulates saliva which helps to reduce the acidity of the spit up milk, thus reducing the burn that baby experiences. The constant swallowing caused by sucking on a dummy can also help reduce the physical reflux action too. You can read more about Reflux here.
* Dummies can help clear Wind
Windy babies often tense their body due to the pain or discomfort caused by their wind. As mentioned above, sucking activates the Calming Reflex which helps baby to relax. A relaxed baby will have an easier time releasing their burp. The position of the tongue and the downward pressure of the tongue on the dummy can also help to release baby’s trapped burps.
* Dummies can be an effective Sleep Association
Dummies can be a fantastic sleep association for 2 main reasons. Firstly they are not attached to a person. And secondly they activate that all important Calming Reflex which enables them to settle calmly and easily. Sleep associations are often given a bad rap for being habit forming etc. But if treated appropriately they are a very powerful sleep aid. The key question to ask is “how will I help my baby to disassociate from this sleep association when it is no longer age appropriate or no longer working for us”. If you keep that idea in mind and you formulate an exit strategy from the beginning you’ll understand how and most importantly when, to start changing the association.
Sleep associations, whether that’s the parent’s presence, feeding, swaddles, movement etc, are the number one reason people seek my help. So if you get yourself in a tangle and need help to change or remove your baby’s sleep association find me here.
When to offer a Dummy to your baby
When to start offering a dummy varies depending on hold old your child is. When to stop using the dummy is a little less vague! And the answer to “when” is largely up to whether you want the dummy as a short or long term solution. The earlier you offer the dummy, the easier baby will likely accept it. The older baby is when you decide to wean, the harder it gets.
0-6 months – avoid offering a dummy before breastfeeding is well established; around 4-6 weeks old. This is to ensure good milk supply is established and avoid nipple/teat confusion. In the first few months, baby will settle and resettle well and will transition through sleep cycles easily. This is a fantastic time to introduce a dummy as it is likely that baby won’t notice when the dummy falls out of their mouth and wake up! The dummy is a very effective way to calm and assist baby to sleep and forms the 5th step in the 5S newborn settling technique created by Dr Harvey Karp. This is especially effective when paired with a good sleep environment.
Weaning – if baby is happy to take the dummy, keep using it!
6-8 months – if keeping the dummy long term isn’t your plan, now is the time to take action. After 6 months old the connection your child has with their dummy becomes very strong and it can be difficult to break that connection without being able to clearly explain to your child why the dummy is disappearing. If you wait longer than this age group to wean from the dummy you will probably find that the dummy is here to stay until baby is closer to 2.5 years old!
Parents often introduce a dummy now in an attempt to support sleep training efforts. This can have mixed results especially if you only want the dummy around as a short term solution. Yes it can help with settling but pretty soon baby will start waking every time the dummy falls out so it can quickly become more of a burden especially as baby approaches 8 months or older.
Weaning – this is the ideal time to wean from the dummy if you do not want it to stick around until about 2.5 years old.
8-12 months – if the dummy remains beyond 8 months, you need to teach your child how to Find & Replace their own dummy so they can put it in themselves overnight. Find & Replace is a very simple process but it must be adhered to by parents otherwise it can be confusing for the child. Without Find & Replace, it is common to find that baby starts to wake more and more looking for their dummy. If they can’t Find & Replace it themselves, guess who they call to help them all night long!
Weaning – I do not recommend weaning from the dummy at this age. The bond between baby and dummy is too strong and they are too young to comprehend where or why the dummy has gone. Find & Replace is the best strategy at this time to help everyone get a good night’s rest!
2.5 years old – this age can be both easier and harder to wean! Easier because they understand when you talk to them about why and when the dummy has to go away. But harder because the attachment they have is so much stronger. If you still have a dummy at this age, I strongly recommend you wean now. If not the case already, the attachment your child has to their dummy becomes deep rooted and more and more difficult to wean.
How to teach your baby to Find & Replace their Dummy
Move from one step to the next every 2-3 days as outlined below. Once you move forward a step, do not move back again. For example, once you are placing the dummy on your child’s chest in step 3, do not be tempted to guide the hand/dummy for them as in step 1. Attaching a Sleepytot or similar to the dummy can make it easier for baby to find in their cot.
1. Give the dummy to your child and then guide their hand/dummy to their mouth.
2. Hand the dummy to your child but let them put it in their mouth on their own.
3. Place the dummy on their chest but let your child find it and put it in their own mouth.
4. Put the dummy near to your child on the mattress and encourage them to pick it up and place it in their mouth.
Practice in their cot and on the playmat so they can see that it isn’t just a technique for the cot.
Once you start the process, do not put the dummy in your child’s mouth again. Some babies will find this process tedious and will wean themselves off their own dummy.
How to get your baby to stop using their dummy
In my experience there are three successful options. Regardless of which one you choose, the key is to remain consistent. Once you decide its time for the dummy to go, throw it away (yes, I mean in the bin!) so you are not tempted to offer it again. Having physically removed it from temptation also reduces the chances that baby/toddler will find it by mistake.
Cold Turkey – this method works by simply taking the dummy away completely. This is most successful with younger babies especially when used in tandem with an age appropriate settling technique. I have seen success with this method up until around 8-9 months old. After that baby starts to have too much awareness and understanding of their world for them to accept that the dummy just vanished one day. It takes around 3 days to break the habit if you are consistent and don’t occasionally give in.
Replacement – this is where you provide something else in place of the dummy, for example a cuddly or comforter. This new comforter is offered to baby at each sleep time and becomes the new sleep association. Offering the new comforter during a feed is a great way to introduce baby to their new friend and also helps them associate it with close contact and snuggly times.
Dummy Fairy – this is for older children who can understand the process. This method is great as it helps them relate to the process. It doesn’t have to be a Fairy; choose something you think your child will connect with. Basically the Fairy is like the Tooth Fairy in that it comes to take the dummies away while your child is asleep.
* I like to talk about this for about a week before holding a ceremony of sorts to farewell the dummy. Talk to your child about how they are a big girl/boy now and they have other friends (soft toys) to comfort them while they sleep. Of course it is important to tailor the chat to your child so they connect with the story.
* On the day of the ceremony, I like to encourage the child to write or draw something for the fairy to thank them for looking after their dummies or something along those lines. Having the child engage in the process is important so they don’t feel like the Fairy stole the dummies!
* Ask your child to place the dummies in a bag with their notes or drawings and find somewhere to put them at bedtime so the Fairy will find them, for example next to the bed or hanging in a tree etc.
* Overnight, while your child sleeps, the Fairy (ie you!) will take the dummies away and throw them in the bin so they can’t be found by your child in the morning.
* In the morning, talk to your child about how the Fairy has come and taken the dummies away so there will be no more dummies for sleep time now.
* A small reward after a few days of no dummy could be appropriate if it feels right to you.
Whichever method you choose, there are two golden rules
* Once the dummies are gone. They are gone forever. Do not give in to temptation as it is very confusing for the child.
* Try not to replace the dummy for something that involves the parent (eg movement, in arms rocking, feeding etc) as you will simply be replacing one thing for another, neither of which is sustainable long term.
Long term concerns of dummy use
Although most concerns are related to long term use (3+ years) it is important to understand the risks before choosing what is right for you.
Sleep issues – wakefulness caused by the dummy falling out of baby’s mouth.
Dental problems – if baby keeps their dummy until 3+ years old it can start to affect their dentition and there can be issues with occlusion of adult teeth (how they bite together).
Speech difficulty – when used frequently beyond 12 months, dummy use has been linked to speech problems. It is thought that with the dummy in their mouth reduces their opportunity to practice their speech and restrict the full range of tongue movements used to make sound.
Middle ear infections – have been found to be more prolific in children who use dummies.
Attachment - Children can become very attached to their dummy and breaking that bond can be a difficult time for the child. It is really important that weaning is handled delicately to avoid any form of trauma for the child.
Tips for Dummy success
* Decide early on if the dummy is a short or long term solution so you can create an exit strategy to suit.
* If you decide the dummy is for the short term, don’t increase the size of the dummy when they “outgrow” it. For example if the dummy is introduced as a newborn, don’t offer a toddler one. As baby grows we often find they get annoyed by the small size and lose interest on their own if we don’t upgrade it.
* Keep the dummy in the bedroom and don’t let it become a “goes everywhere” item. This ensures the dummy is a true sleep association and lessens the chance it will become their best friend!
* Please remember that the dummy should never be used to replace a feed or cut a feed short.
Whether you choose to use a dummy or not, is 100% up to you. Everyone has an opinion on dummies so it is important to do your own homework and decide what feels right for you. Dummies can be a very effective settling tool. But they can also become a hassle if not managed well. So I guess my final piece of advice is that if you do introduce one, plan your exit strategy early so you get the best of both worlds.
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