How Pacifiers Affect Speech & Language Development
Does your little one use a pacifier? And do you worry that their pacifier might affect speech and language for them? If so, you’re not alone. Especially if you’re confused by what you’ve heard!
Pacifiers are a hot topic in our field, and if you research the pros and cons, you’ll find there’s a lot of information out there supporting both sides. So today, we want to share with you what we know to be true, what we—and other experts—officially recommend, and what we often tell the families we work with.
We hope you can use this post to educate yourself on the topic, then make the decision that’s right for you, your child, and your family!
The Perks of Pacifiers
First of all, it’s okay if your family decided to use a pacifier! Experts are pretty much all in agreement that until babies reach 6 months old, as long as pacifiers aren’t overused, they’re more helpful than anything else.
The American Academy of Pediatrics (AAP) recommends pacifier use for up to 6 months at sleep times to help reduce the risk of SIDS! And, research has shown that until your child is six months old, pacifiers have other benefits too, like:
Helping babies self-soothe to sleep
All in all, experts aren’t worried about babies under six months old using pacifiers around sleep times. This is considered a completely appropriate and even recommended way to use a pacifier. So if this describes your child, you don’t need to be concerned!
When To Wean: Expert Recommendations
Until six months, experts aren’t worried about pacifiers. But things start to change after age one when the American Academy of Pediatrics (AAP) no longer encourages the use of pacifiers. Their official recommendation is to wean your child from the pacifier during the second six months of life, to prevent any complications, like middle ear infections, that can result from prolonged pacifier usage.
Most dentists also seem to agree that weaning should begin by two years of age, if not sooner. And, the American Dental Association and the American Academy of Pediatric Dentistry recommend that pacifier use be fully stopped by 4 years of age. Although clear links between pacifier use and early childhood dental complications haven’t yet been established in the research, some studies have found that pacifier use after age three leads to a higher incidence of dental malocclusion. And one recent study found that negative dental effects from pacifier use could show up as early as two years of age.
As speech therapists, we agree with and follow these recommendations. We would love to see pacifier use limited as your little one gets older because we don’t want them to run into any issues.
Prolonged Pacifier Use
Experts and health professionals are only worried about pacifiers affecting development if pacifier use is what we’d call “prolonged”.
Your child’s pacifier use would be described as “prolonged” if they:
Are older than six months old (and especially if they’re over one year old)
Rely on their pacifier throughout the day, not just at sleep times
After six months of age, pacifiers become way less beneficial for children. They can even have some not-so-great effects on development.
The Risks of Prolonged Pacifier Use
We are not about trying to scare you with risks and what-ifs, but for the sake of being well-informed, it is good to keep in mind the negatives of prolonged pacifier use!
Prolonged pacifier use can:
Make it way harder to take the pacifier away (We know it's hard. We've been there! 😅)
It may also have negative effects on speech and language development!
How Prolonged Pacifier Use May Affect Speech Development
The research isn’t 100% conclusive on the idea that prolonged pacifier use will affect speech development, but it seems like, after the age of one, it might! The research we do have points to three main pacifier issues that may have negative implications for speech and language development: the risk of middle ear infections, tooth formation, and the amount of time your child uses a pacifier daily.
Middle Ear Infections
There is some evidence that using a pacifier too much can lead to middle ear infections in babies and toddlers. Ear infections can potentially cause fluid to build up in your child’s ear which can cause temporary hearing loss, and a lessened ability to hear can have an impact on their speech and language development.
Tooth Formation
Using a pacifier too much can negatively affect tooth formation, which can affect speech because some speech sounds. The /s/ sound is a good example because if kids have bites that aren't even or teeth that are misaligned, a sound like an /s/ can slip through and sound slushy.
Try this: Next time you talk, pay attention to all the different movements that happen when you speak. Notice the ways your teeth are involved, too, like when the tip of your tongue taps the back of your teeth, and when your tongue is between your teeth. You’ll have a better understanding of how our teeth play a role in saying speech sounds!
Amount Of Time With The Pacifier
To learn to speak, kids need to practice! For babies, that means spending lots of time babbling and moving their lips, tongues, and jaws. Having a pacifier in their mouth frequently throughout the day could limit the amount of time your little one can spend babbling and making different speech sounds.
Some experts also worry that issues may also arise if your child is often trying to talk with their pacifier in their mouth. Having an object in the mouth like this could stop them from correctly producing all the speech sounds, which, again, may become a problem. But only if it happens regularly!
Your Takeaway: Give Them Lots of Pacifier-Free Time!
We never want to worry you or make anything into a bigger deal than it needs to be. So here are the main things we want you to keep in mind:
We don’t have clear research to support that pacifier use definitely affects speech or language development. And, your child’s pacifier itself isn’t inherently bad. So it’s not like letting them use a pacifier now and then—or as needed—past the age of six months means the damage is done. If your child is still using one, you don’t need to go into full-on panic mode.
That said, we do know it’s ideal for kids to get a lot of practice babbling, making sounds, and participating in conversations without a pacifier in their mouth! And, we do want to encourage better tooth formation and reduce the risk of them coming down with ear infections. So after six months of age, we want to see them using their pacifier less and less.
In her blog post on Tips for Weaning the Pacifier, our friend Dr. Anjuli Gans shares this note on finding the best time to wean that we love:
We know that it’s hard to find a time when it feels “right” to wean a pacifier – so much happens in toddler years that it can feel like a constant whirlwind. And pacifiers do offer so much comfort. We think of them in terms of child development – try to avoid times of big change or disruption in your daily lives. For example, you might wait to wean if your child/family:
+ has an illness or is teething
+ is dealing with a lot of separation anxiety
+ is neurodivergent or has sensory sensitivity (work with your care team)
+ has a chronic medical condition (work with your care team)
+ is going through a big transition (a big move, new sibling, etc.)
Remember, it’s always okay to balance what’s recommended with what’s best for your family and child.
How To Wean Your Child Off The Pacifier
As always, we want you to do what works for your and your family. There’s no one right way and no way that’s wrong or bad. But, in case you need them, here are some ideas for getting your child to stop using their pacifier with minimal pushback and tears. (We hope!)
#1 Pacifier Fairy
Have your child leave their pacifier somewhere special for the “Pacifier Fairy” to take to a little baby who needs it. The pacifier fairy will leave a little gift in exchange for the pacifier! This is our favorite way to say goodbye for toddlers!
#2 Give It Away
Give the pacifier to a younger sibling, friend, or cousin. Tell your child they’re so big now that they just don’t need a pacifier! They might be excited and proud of being bigger now, even if they feel a bit sad about losing their binky at the same time. Some kids get excited about giving it as a gift to another child but feel it out. We never want them to feel shame around this transition.
#3 Swap It Out
Slowly introduce a lovey, or another comfort item, in its place. Some little ones have success with this because they still find the comfort they need—just not from their pacifier.
#4 Stop Cold Turkey
Sometimes you just have to go all-in on this as a family! You can do it!
#5 Take It Slow
Slowly wean down pacifier use until it’s only happening at nap time. This option is great because your little one still gets comfort when they need it most, but it keeps their pacifier time to a minimum. We love this option if you (or they) aren’t quite ready for the full commitment.
#6 Take It Out
For example, if they’re happily playing, they might be totally okay if you slipped the pacifier out! We know it’s easier said than done, but it’s best to just start trying to take the pacifier away sometimes if you see the opportunity to do that.
Should I Give My Child A Pacifier?
Maybe! There’s not a clear right or wrong answer here, so we recommend considering your why. When it comes to parenting, we want to help you learn the facts. Then, it’s up to you to weigh those facts against what you know about your child and your unique family circumstances. This way, you can make the best choice for YOUR family.
Pacifier Dos & Don’ts
Whether you’re deciding to introduce a pacifier, limit use, or wean completely, here are a few tips to help you go forward in the recommended ways—the ways that are most beneficial for their development!—while avoiding anything that could cause problems down the road.
Do:
Know it’s safe to offer the pacifier until 6 months of age
Reserve the pacifier for sleep times and soothing
Use safe, age-appropriate pacifiers
Clean your pacifiers often
Give baby lots of time to babble and ‘talk’ without their pacifier
Start the weaning process before they turn one
Talk it out: If your little one is talking with their pacifier in their mouth, try saying in a non-emotional tone of voice, “Oh, I can’t understand you with your paci in your mouth. Will you take it out and say it again?” Usually, little ones respond well to this!
Try Not To:
Offer the pacifier very often past one year of age
Use the pacifier when your child is awake or playing happily
Encourage talking with the pacifier in their mouth
Keep Track Of Their Speech & Language Development
Understanding how your child’s speech and language skills develop can play a big role in making parenting decisions—like deciding whether or not to wean the paci!
Keep your learning going by downloading our free talking milestones checklist for children one to five. This way, you’ll always know what skills they’ve got down, which ones they’re working on, and what you can expect next.
References:
Adair, S. (2003). Pacifier Use in Children: A Review of Recent Literature. Pediatric Dentistry, 25: 449-458.
Niemelä M, Uhari M, Möttönen M. (1995). “A pacifier increases the risk of recurrent acute otitis media in children in daycare centers.” Pediatrics 5 Pt 1, 884-8.
Risks and Benefits of Pacifiers, American Family Physician, 2009.
https://www.aafp.org/afp/2009/0415/p681.html?_ga=2.155815096.2041091098.1549652094-139084436.1549652094