Pacifiers, Do They Spell Trouble?

  • September 23, 2013


These days it is common to see children well over the age of one with a pacifier, or commonly called ‘binky,’ plugged into their mouths going about their daily routine of playing. It is also common to see children who are sucking their thumbs well past the toddler years. There is nothing wrong with utilizing the pacifier or having an infant suck their thumb unless they are overused. They help calm infants, encourage lip rounding and develop non-nutritive suckle at birth.

Normal Development
• When children are infants, they use an infantile ‘suckle’ pattern to be able to eat from a nipple for early nutrition. As the infants mature, the ‘suckling pattern’ is replaced by the more mature ‘sucking pattern.’ The difference is that in a suckle pattern, the infant has an in/out movement of the tongue and the fatty sucking pads are used for stabilization.

• The suckle/swallow reflex is normally present from birth to 9 months. Between the age of 4 and 6 months, the suckle is used in anticipation of the spoon during feeding. From 7 to 9 months, there is a mixture of tongue movements in/out and up/down.

• The true suck from this maturational pattern is found between 10 and 12 months of age. At that time the child develops the mature patterns that work to develop a normal swallow, where there is stabilization of the lips and jaw and the tongue retracts rather than moving forward.

Trouble Spots
Without eliminating the pacifier or thumb/digit sucking, there is an increased probability that a tongue thrust will develop. Tongue thrust will prevent the teeth from meeting properly, impact the child’s ability to bite and chew food efficiently, contribute to jaw joint problems and grinding of the teeth, in addition to poor articulation of sounds. Orthodontics can reposition the teeth, but without correcting the tongue thrust/muscle imbalance, the child may have orthodontic relapse where the teeth move after the braces are removed.

A helpful rule of thumb is if you no longer need to suck for nutrition, you no longer need a pacifier or thumb. If the child can talk, they don’t need a pacifier. Parents should educate themselves on the potential problems with dentition, oral musculature and speech production. Speech-Language Pathologists and orthodontists should be consulted if parents have concerns.

Written by Shelly Carr, M. S., CCC-SLP, Advanced Therapy Solutions, LLC, Gilbert, Arizona

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