Extended use of pacifiers associated with reduced vocabulary in children, experts say

Pacifiers are not only addictive but are slowly damaging your child's oral health, speech and vocabulary, if used for extended periods. Doctors explain that restricted use is the key here.

Does giving a pacifier to comfort a child who is crying his lungs out look like the best option? If the answer is yes, you will be shocked to know that pacifiers might be doing more harm than good.

Pacifiers are not only addictive but are slowly damaging your child's oral health and speech.

A recent study by Frontier revealed that pacifier use was corelated with a reduced overall vocabulary size and a specific underrepresentation of abstract words.

What's the connection, you ask?

Dr Harini Sreedharan, Consultant - Paediatrician & Neonatologist, Motherhood Hospitals, Sarjapur, Bangalore, tells you that prolonged use of pacifier put continuous pressure on the hard palate.

"This can reshape it into a narrower, higher arch. This change affects the phonation and speech of the child as it affects the tongue strength and movements as well as the lips movements. These movements are essential for oral motor development and speech development," Dr Sreedharan explained.

Furthermore, this structural abnormality also affects the facial expressions during speech.

Dr Madhuri Nagaraj, Consultant- Dental, MDS (Pediatric Dentistry), Rainbow Children’s Hospital, Bannerghatta, chimed in and said that children learn abstract words better when they experience interactive storytelling sessions which include emotional discussions between themselves and their parents who explain concepts to them.

"Children who use pacifiers will have fewer chances to learn new language skills because these devices will decrease their interaction time with people who talk to them. The relationship between pacifier uses and language delay exists but it does not establish certainly that pacifiers cause this condition," Dr Nagaraj said.

Experts recommend that parents should restrict their children from using pacifiers during daytime hours because this practice interferes with their ability to practice speaking after they start learning to talk.

Representative image

Beyond the bone structure of the mouth, Dr Sreedharan said, the teeth and jaw alignment shift significantly, which causes issues like anterior overbite, posterior cross, and overjet or buck teeth.

"These increase the risk of dental caries and temporomandibular joint issues. Furthermore, it even affects different parts of the dental arch, leading to stagnation of food in the mouth and difficulty to clean the teeth during routine brushing, which would further lead to dental caries," Dr Sreedharan said.

Dr Nagaraj pointed out that dental issues develop in children who use pacifiers after turning three because the nipple of the pacifier applies persistent pressure which disrupts their dental growth and tooth positioning.

The condition will develop into dental problems which result in open bite and overjet and other dental misalignments.

"A pacifier itself does not cause cavities but trouble starts when it is dipped in sweet substances like honey, sugar, syrup or when prolonged sucking is linked with poor oral hygiene and delayed weaning from comfort habits," Dr Nagaraj emphasised.

She explained that the cavity-causing bacteria consume sugars that children encounter during their daily activities which makes them more prone to developing early childhood caries.

This is not all. There's much more in the list of effects of using pacifiers.

"If the pacifiers are unsterile, it brings the risk of ear infections and the risk of diarrhea. Another important aspect to note is that the child may have problems in breaking away from the habit as they may be emotionally and psychologically dependent on the pacifier. The excessive use may lead to weight loss as the babies may not be able to differentiate hunger from sucking, which will interfere while feeding them," Dr Sreedharan said.

Studies have also found that pacifier usage leads to higher oral bacteria levels which result in more gastrointestinal infections. Early introduction of pacifiers can also disrupt breastfeeding.

However, not all is bad with pacifiers as, Dr Nagaraj said, that pacifier use during sleep leads to reduced sudden infant death syndrome (SIDS) risk.

Thumb sucking is just as bad

If not pacifiers, thumb sucking can be just as harmful as pacifier use. And in some cases it may be harder to stop.

"Parents have the ability to remove pacifiers from their children but thumb sucking functions as a self-soothing mechanism that proves difficult for children to manage without it," Dr Nagaraj explained.

The American Academy of Pediatric Dentistry advises stopping non-nutritive sucking habits by about 36 months to reduce the risk of dental problems. Reviews in pediatric dentistry note that finger-and thumb-sucking habits are more likely to continue to older ages than pacifier habits, which may make their long-term effects more noticeable.

The harmful effects of thumb sucking vary between children because some children experience more severe problems than others.

Should pacifiers be completely avoided?

The answer doesn't lie in completely avoiding pacifiers, but knowing when and how to start does the magic.

"Pacifiers are useful if used in moderation, with a careful watch on the weight of the baby. It is essential to ensure they are not a substitute for feeds. It is also important to identify the actual reason for a baby's fussiness rather than using a pacifier simply as a band-aid," Dr Sreedharan concluded.

The better approach is to use this method in a restricted way under an expert's supervision.

Tips to use a pacifier safely

• Should be given only during night or sleeping

• Use a single piece pacifier to avoid choking hazard

• Replace every two months

• Sterilise/clean it after every use

(Disclaimer: This content is for informational purposes only. Always seek the advice of a qualified medical practitioner with any questions about a medical condition.)