While there are medical reasons for phasing out a pacifier by a certain age, they are often important comfort items for children, which can make the weaning phase a difficult time. There will probably be tears (from them, and maybe from you!) and that is OK. Pacifier-weaning can be stressful for parents, so let’s hash it all out: When to wean, why to wean, and some that are important to remember. Here’s how I help my patients wean their children off of pacifiers—and how I handled it with my own son!
When Should I Wean My Child Off a Pacifier?
Your child should be weaned off a pacifier by 3 years old, according to dentists, speech therapists, and pediatricians. In fact, we would love your child to be weaned earlier, if able. Understandably, parents may be confused or concerned, especially if their child really loves their pacifier. The goal of weaning should be to balance your child’s desire for the comfort of a pacifier with other areas of development, like speech and language. From a developmental perspective, a pacifier is a great soothing mechanism in the newborn and infant years. For some babies, it can also mean they sleep for longer stretches, due to the soothing mechanism of a pacifier. (Sucking is comforting to a baby!) Pacifiers are also thought to reduce the risk of SIDS because of the repetitive sucking motion.
The Doctor Answer
There is no doubt that pacifiers are convenient and useful—they can calm a fussy infant or toddler so easily! But there is a time where we have to wean a child off them. Whenever I see parents in my office who have not weaned their child off a pacifier by 2 years old, I give them calm reassurance but encourage them to begin the weaning process. The goal is to have your child off a pacifier by 3 years old. Starting at 2 means they can work towards this goal as quickly or slowly as they want. I find that sometimes parents feel shamed for their parenting choices—including pacifier use. At the 2-year mark, I ask them how often their child is using the pacifier and discuss if they’re open to a plan for weaning. If they’re resistant, I explain the benefits of weaning and remind them that their child is capable of living life without the paci! Then, I assess their child’s speech, confirm that they have seen a dentist, and work with the parents to decide on a plan for weaning. My goal is to balance the family’s desire to wean slowly with the developmental needs of the child. This doesn’t have to mean weaning cold turkey. That will not work for all children or families! But it is important to have a plan in place so that everyone knows how to proceed when it is truly time to wean. Overall, I personally advise my patients to follow this schedule with their child for using a pacifier. Do note, this plan can wean the pacifier by two (weaning earlier than 3 is never a problem): Consider introducing the pacifier in the first month of your baby’s life. Not all babies will need it to sleep, so this is a tool to have in your arsenal to soothe your baby. The goal is to introduce the pacifier by one month of age. It becomes increasingly difficult to introduce it after this point as your baby is not used to it. Remember: It’s great to try a pacifier, but not all babies need one! Try it, and be repetitive, but if your baby doesn’t take it that’s okay. However, when pacifier use is extended beyond 2 to 3 years of age, it can impact the shape of your child’s mouth, teeth, and palate. In turn, this can affect their speech development and articulation as they get older. Pacifier use can also increase the risk of inner ear infections. The constant sucking motion can lead to the colonization of the inner ear with bacteria. Additionally, relying too much on the pacifier for soothing may take away opportunities for teaching other coping skills. This could be singing a song they love, taking a walk outside with a loved one, doing deep-breathing exercises, or laughing. If your baby does take to a pacifier, great! Try to limit their use of it, though. This will make it easier to wean when your child is a toddler. A child who is constantly using a pacifier before 1 year of age will have a harder time weaning off of it in the toddler years. By 6 months, you should be able to reduce the amount of time your child spends with a pacifier. Limit pacifier use to naps, bedtime, illnesses, travel, and/or emergencies. (Emergencies are situations where you have truly exhausted all other calming techniques and your child still needs to be soothed.) At this age, your child is likely beginning to babble and vocalize more. Keeping their mouth free from a pacifier helps this development—it gives them the opportunity to “talk” to you! I like to think about weaning the pacifier at this age because the longer we allow a child to use it, the harder it will be to take it away. At 18 months, you can be working to wean the pacifier entirely. You can even start this process earlier. In the toddler years, language development is blossoming. Pacifiers can impact the alignment of the teeth, so it’s important to start any later than 18 months. The ideal goal is to have the pacifier weaned by 3 years of age at the latest. Some parents will ask if it’s harmful if their child over 3 still has a pacifier. It is not harmful! Your toddler just needs to develop different soothing strategies (and hopefully ones that won’t affect their teeth or speech). You can teach them other coping skills, like breathing exercises. For example, when they are frustrated, have them place their hand on their belly. Instruct them to feel their belly move up and down as they breathe deeply. Practice this when your child is calm. Then, when they are frustrated again, remind them of their breathing exercise and model it for them, as well. You can also use a calm-down corner. This is a pleasant area in the living room or their bedroom where they can go sit and regroup if they are feeling big emotions. Sometimes we need some space when we are frustrated. The calm down corner allows them a safe space for them to decompress. These tools can replace the soothing sensations they got from the pacifier. When you hear “wean the paci,” it can give you anxiety. You may worry that if don’t wean, your child will be destined for speech delay or dental issues. Not all children will have issues with tooth alignment, nor will all children have issues with speech because of a pacifier. It really comes down to how often the pacifier is being used and how strong the child’s suck is, as well as if they are using it during times of play and potential vocalization. If they constantly have a pacifier in their mouth in the toddler years, they may not be able to express and practice language skills. If pacifier use is extremely limited, this may not be the case. If your child is 3 and has no issues with speech and dentition, you may be able to continue to use a pacifier. Talk to your healthcare provider, and closely monitor the situation.
Tips to Wean Off the Pacifier
If you’re looking for weaning strategies, these are the ideas I share with my patients! Overall, these methods will work with consistency—so don’t be afraid to keep at it. First, you can always quit a pacifier cold turkey. This method can work for a child who has a more easy-going temperament. It can also work if you’re a parent who can handle a couple of days of fussing and giving some strong direction. With the cold turkey method, throw away the pacifier and when your child asks for it, say it’s gone. Your child may be upset with the removal of their pacifier. Verbally reassure them and redirect them to other activities or a lovey, like a stuffed animal or blanket, that can be their soothing item. If you’re not ready to go cold turkey, you can move more slowly, taking the pacifier away at certain times, or only introducing it in times of emergency. It can be helpful to get your child involved in the removal process. If they only use the pacifier at night, for example, you can ask them to hand it back to you every morning. This can train them to remember that they no longer need it. They may even start handing it to you on their own! You can also physically and visibly remove the pacifier. Make a little ceremony out of throwing it in the trash. Let your toddler drop it in themselves, and say “bye-bye.” Let them see you wave bye-bye to it too. This can give your child a measure of control and make them feel like it was their idea. If they want it back, tell them that they are doing amazing without the pacifier and that they don’t need it. The key to weaning the pacifier is consistency in your plan, understanding that there may be some tears and that those tears will be short-lived.
The Mom Answer
My son Ryaan loved his pacifier in infancy. Before 6 months, we used it for sleep and during fussy episodes. It was very soothing to him. If we were playing on a mat on the floor, we took out the pacifier so he could coo and babble, and we could coo and babble back. This was important for us to encourage the foundations of language development. At 6 months, we weaned it to sleep time and during emergencies, such as illnesses or air travel. I think this was key in allowing him to wean off of it easily in the toddler years. During the day, if he fussed when we would normally place a pacifier in his mouth, we instead redirected him to other toys or activities or took him for a walk outside. This redirection was vital for about five days before he didn’t miss it anymore. We still kept the pacifier around for if he got sick and we needed it for extra comfort, but generally we were able to go without it. To continue his progress, we decided to sleep train him without the pacifier. We used a Ferber method of sleep training and put him in the crib with the pacifier next to him. Doing this gave Ryaan the ability to decide if he wanted his paci or not. This worked wonders because he was in control. Sometimes he wanted it and sometimes he didn’t, even from 6 months of age. (Yes, 6 month-olds are capable of deciding this!) There were mornings where he would wake up with it in his mouth and other mornings when he wouldn’t. We proceeded like this until we fully began to wean him off. At 14 months, we went to the dentist and they noticed that some of his teeth were beginning to get crooked. They also noticed he had a very strong suck and determined it was from the pacifier; we’d need to wean sooner than later. While our initial plan was to wean after 2 years old, we knew we’d have to adapt. Luckily, since we’d already weaned Ryaan to using his pacifier for sleep, it didn’t feel like a stretch to wean him off of it entirely. We began to wean him off during the day, even during emergencies and illnesses, but not at night. It meant a lot of re-direction as we had done in infancy, as well as some tears. However, it also meant he had the opportunity for a whole lot of verbalization and understanding. We would say “Ryaan, we see you are upset that you don’t have your pacifier, but we know you are so brave and strong to not have it or need it!” At around 16 months, we began to wean him off the pacifier altogether. Every morning for the week leading up to the wean, I would ask for the pacifier from him. He would hand it to me when he woke up. After five days, he would begin to hand me the pacifier when he woke up without me asking, signifying he knew he didn’t need it anymore. At 17 months, we weaned him completely. He showed that he was capable of giving it to us in the morning or waking up without it in his mouth. The day before we eliminated the pacifier altogether, I told him at bedtime that we weren’t going to give him the pacifier tomorrow. I put him to sleep without the pacifier. He cried for two minutes and then went to sleep. He didn’t ask for it again! All in all, he was weaned off his pacifier before 18 months. I was pleasantly surprised, given that we weaned him before 2 years old, and our methods resulted in minimal tears. Sometimes, it won’t be this easy. Do your best to limit the pacifier use before 1 year of age and employ some techniques that allow your child to be in control of their pacifier use. This can help make the process as tear-free as possible.
The Takeaway
The best advice I have for parents about pacifier weaning is to remember that for some kids, the transition can be harder. The goal is for us to minimize the use of the pacifier as much as possible before 1 year of age so it can make it easier for eventual weaning. Children should be weaned no later than 3 years old, so starting earlier and limiting pacifier use in infancy can make the transition much smoother. Always choose a weaning method that works for your parenting style and the temperament of your child. If your child is upset with the transition, verbal reassurance goes a long way. Say things like, “I see you’re upset about your paci, but you are so brave and I know you can do this!” And then redirect them to another activity. They will get through the pacifier weaning stage and so will you!
