Ahhh pacis. They are simultaneously lifesavers and sleep ruiners. If you're stuck doing 'the paci dance' all night long, then this blog post is for you!
Why pacis are great
There are a lot of pros to pacifier use:
Protection against SIDS. Pacifier use has been shown to help reduce the risk of SIDS and is recommened for sleep up to age 1. However, it is also recommended that you put baby down for sleep with the paci, but not to replace it once it falls out.
Helps babies pacify themselves and satisfies the suck reflex. A pacifier is a great way for baby to soothe themselves. As well, most babies have a need to suck that exceeds the time spent on the breast or the bottle. Instead of mom becoming a human pacifier, the paci meets this need.
Easier weaning. If your child has a strong suck reflex, it is a lot easier to wean the child off the paci vs. his own thumb/fingers. In terms of sleep coaching, tackling a pacifier association is much easier than a feeding to sleep association so if it's a matter of choosing between the two to help your baby sleep, the paci is the way to go.
Why pacis are not-so-great
There are also cons to pacifier use:
Risk of nipple confusion if introduced too early with a breastfed baby. Speak to a lactation consultant/educator if you have concerns about breastfeeding and pacifier use.
Overzealous suckers may change their tooth alignment or delay speech. Especially important for toddlers still using the paci.
May cause sleep associations and disturbed sleep. When a baby is dependent on a pacifier to fall asleep at night, they often will need these same conditions re-created when they wake up in the middle of the night. A baby under 8/9 months is likely not able to replace the paci on his own, so he will call to you to come do it for him.
How do I know if the paci's got to go?
There are a lot of babies that are completely okay with falling asleep for naps/bedtime with a pacifier and not really caring that it falls out at night. These babies may awaken at night (as all babies do) but are able to self-soothe back to sleep without having to call for their parents to replace their paci. For these babies, the parents may not perceive the paci as an issue and may choose to keep it for an undetermined length of time.
More commonly, however, a baby who needs the pacifier to fall asleep will also need it every time they wake up at night. For a newborn baby, these wakings happen a lot. You can check out my blog post here for more about how newborn sleep works. Even for an older baby, you may be having to do the 'paci dance' all night long every 45 minutes - 2 hours. If this is the case, your baby isn't getting the consolidated sleep she needs, and neither are you.
Even if your baby is in the former category and is able to fall asleep with the paci and sleep all night long, there are things you need to consider. How long do you plan to keep the paci? Eventually the child is going to need to learn how to sleep without it, and the longer they are using it, the harder it is for them to 're-learn' how to sleep. As well, taking a paci away from a toddler is often a much more difficult feat than taking it away from a baby.
When to ditch the paci
Unfortunately there is no magic age as to when we should be getting rid of the sucky but as I tell all my clients - the earlier, the easier.
Before the age of approximately 8 months, babies haven't grasped the concept of "object permanence". What that means in paci-terms is that if the pacifier is not right in front of their eyes, it does not exist to them. This isn't to say that if you try and put your baby down for a nap without the paci when they are used to always having it that they won't cry, but it's not the actual paci they are crying for, it is because they do not know how to self-soothe in any other way as they have not yet been taught this skill.
Between 8 months and 18 months, babies have now grasped the concept of 'object permanence' but it's still unlikely that they have formed a deep attachment to the pacifier. So taking it away in this age range may be more difficult than when they were young babies, but still not a huge undertaking.
If a toddler over the age of 18 months has routinely used his pacifier to sleep, taking it away after this age may be a bit more of a challenge. The child has now likely formed a real bond with it, it is like a lovey to them, and taking it away will likely cause tears and anger (from you and your child!) However, it is far from impossible.
How to take away the paci
Under 18 months: I'll be completely honest and tell you that at this age, cold turkey really is best. There are a lot of so-called 'gentle' methods of weaning the baby off the pacifier at an early age (one called 'The Pull-Out Method' involves letting the baby have the paci until he's almost asleep and then removing it from his mouth and continuing this until he is asleep. Torture!) While all of my families that I work with whose children have a paci addiction think it's going to be an awful and horrid process, it really is never as bad as they think it will be. It will take some sleep coaching because we really are re-teaching baby how to fall asleep, but it's likely the child is already used to falling asleep 'independently', it's just a matter of them finding a new way to soothe themselves that doesn't involve a dummy. As parents, you need to pick a sleep coaching method and stick with it, but more often than not it is one or two rough nights and then you are in the clear. For young babies as well, we are still able to keep the pacifier for use during awake times without confusion if you wish. Just make sure that once you take it away at sleep times, that you are 200% consistent with it. We use a pacifier still with my 15 month old and when he goes down into his crib, he will take his paci out and hand it to me. It's drilled pretty clearly into his head that he's not allowed to sleep with it :-)
Toddlers: there are lots of very creative ways that we can help a toddler ditch the pacifier, but the main components of any weaning process are:
Preparing your child in advance. Talk to the child about what's going to be happening and why you are taking the pacifier away. Toddlers do not like surprises; they thrive on predictability. We don't want him to just wake up one day and it's gone. Make sure that the paci weaning isn't occurring around the same time as another big event in the child's life (such as a move, travel, or the birth of another sibling). We don't want too much change at once.
Limit use up to the Weaning Day. Try only letting the child have it in certain locations like the car or the bedroom. Instead of giving them the paci, offer another security object for them to hold and walk around with.
Don't offer it. This one may seem plain and simple, but often children don't ask for the pacifier as much as parents are quick to offer it. As well, most kids will go through periods where they become disinterested in the paci. Take advantage of these 'lulls' and see if making the paci permanently disappear during this time is enough for them to forget about it completely.
Be patient and be firm. There are bound to be good days and bad when ditching the paci but this is to be expected, so be prepared. There may be days where you feel like quitting but especially with toddlers, consistency is key. If they have any inclination that their tantrums/crying/whining/screaming/etc. is going to 'break you' - they will do it. Toddlers are smart!
As far as the 'how' of weaning the toddler off the paci, I have heard lots of stories of different ways that parents have helped their child say bye-bye to the sucky. From cutting the nipple, to sending the pacis away to children who don't have any, to sticking the pacis in a Build-a-Bear teddy so that they are still near when they sleep. You know your child best and what kind of tactics will be the most successful.
I would love to hear your stories. How did you wean from the pacifier? Share your success stories below!