Are Pacifiers Blocking Speech Skills?

New research indicates that pacifier use may negatively affect the speech skills of children if used for a longer time than is typical, according to data presented during the American Speech-Language-Hearing Association Annual Convention, which is taking place this week in Philadelphia, PA.

According to presenter Danielle LaPrairie and colleagues, the presence of a pacifier in the mouth may interfere with the development of the tongue tip movement needed for the production of certain speech sounds.

“There isn't a gold standard in the pacifier literature about an ideal age to eliminate pacifier use. Opinions vary,” LaPrairie said in a statement. “However, a study in The Journal of the American Dental Association found that children who continue to use a pacifier past age 2 increased their risk of developing protruding front teeth and an improper bite, which can affect speech production. Our study highlights the importance of continued research with pacifier use and the possible effects on speech articulation.”

In terms of recommendations from other medical societies, the American Academy of Family Physicians and the American Academy of Pediatrics (AAP) advise parents to reduce or stop pacifier use in the second six months of life to reduce the risk of otitis media, and the Institute for Clinical Systems Improvement recommends avoiding pacifier use after 10 months of age.

For the first year of life, the AAP has issued the following guidelines:

• Pacifiers should be used when putting the baby to sleep, but should not be reinserted once the baby falls asleep. If the baby refuses the pacifier, he or she should not be forced to take it.
• Pacifiers should not be coated in anything sweet.
• Pacifiers should be cleaned often and replaced regularly.
• For breastfed babies, delay pacifier use until 1 month of age to ensure breastfeeding is firmly established.

The reasoning for this, according to the AAP, is because the quantity of milk a mother makes in the long-term is largely determined by how well the baby drains the breasts in the first weeks. For example, the more frequently a baby nurses in the first week, the more prolactin receptors develop in the glandular cells of the breast, and the more milk the mother will make.

Over the next several weeks, a baby's increasing appetite will increase the mother's supply, until it reaches a plateau at around one month, it said. The quantity of milk produced is largely regulated by a feedback inhibitor of lactation (FIL). If too much milk is left in the breasts, the FIL will decrease milk production; however, if the breasts are drained, then the supply can increase. Pacifier use can break the milk production cycle and result in chronically low milk production.

Finally, the AAP stated that it is important to ensure a pacifier is not used to reduce breast stimulation. Therefore, pacifiers should not be used regularly to delay or reduce a baby's access to his or her mother's breasts. If breastfeeding is so overwhelming for a mother that she is tempted to use a pacifier to avoid breastfeeding, it would be wise to seek the help of a lactation consultant.

For more information:

• Pacifier Use When Breastfeeding
• Pacifiers: Are they good for your baby?
• American Family Physician: Risks and Benefits of Pacifiers

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