Doctor: Cara Familian Natterson, M.D., author of Your Newborn: Head to Toe and Your Toddler: Head to Toe (both Little, Brown and Co.), is in private practice in Santa Monica and is on staff at Cedars-Sinai Medical Center, St. John's Hospital, and Santa Monica UCLA Hospital.
Psychologist: Harold S. Koplewicz, M.D., psychiatrist and author of It's Nobody's Fault: New Hope for Difficult Children and Their Parents (Crown), is editor-in-chief of The Journal of Child and Adolescent Psychopharmacology. He is the director of the Child Study Center at New York University School of Medicine.
Why do children use pacifiers?
PSYCH Sucking is a natural instinct; ultrasound images show fetuses in the womb with their thumbs in their mouths. Sucking is soothing and helps the baby settle down. In addition, it stimulates the baby's mouth, and the rhythm of sucking also relaxes her gut and the large muscles in her arms and legs.
When do they usually stop?
DOC Between 2 and 4, though many doctors recommend beginning the process just after the child's first birthday because it's easier to convince a 1-year-old than it is a strong-willed toddler.
PSYCH The need for sucking generally diminishes at about 12 to 15 months, though experts disagree on exactly when to expect the child to give it up.
Why do some kids use pacifiers longer than others?
PSYCH For children who need to suck more than others, a pacifier supplies more satisfaction. As children grow, they may become very attached to a pacifier or to a particular object that is comforting and soothing for them—a blanket, a fuzzy animal, a piece of clothing. These are transitional objects. If a child is excessively dependent on a pacifier and shows undue distress when it's removed, that may be a sign of stress or anxiety. She may need more hugs, talking, playtime, and interaction with parents or caregivers.
When is the best time to intervene?
PSYCH It's generally a good idea to take the pacifier away at around 12 months. This is a time when a child is mouthing everything in sight, so he won't miss the pacifier. But usually the pacifier just drops out by the time the child is about 3.
Is it true that kids' teeth can be damaged if they use a pacifier too long?
DOC Dentists say the jaw and teeth become permanently affected by pacifier-sucking by 4 years of age. By 2½ or 3, though, most parents will already notice the changes: The lower teeth protrude, creating an underbite, and the front upper teeth sometimes cannot oppose the lower teeth at all. Between 2 and 4, the changes are generally temporary. So if you can wean your child off the pacifier before 4, the teeth should return to their native position.
What are the best strategies for weaning?
DOC The key is to let the child use a pacifier for sleep and comfort only, and to refrain from automatically popping a pacifier into the child's mouth out of habit. Parents should try to find alternative ways of calming or distracting the child and gradually withdraw the pacifier over time. They should also remind themselves and their child to view the pacifier as a temporary convenience, not a necessity.
Next Page: Specific weaning strategies
