Should I give my baby a pacifier?

DEAR DOCTOR K:

I’m pregnant with my first child. Do you have any advice about whether or not to give my baby a pacifier? Also, is it OK if my baby sucks her thumb?

DEAR READER:

My mother told me that when I was a baby I sucked my thumb a lot. And that she pulled it out of my mouth a lot. But since I have absolutely no memory of that, I doubt that it’s so.

Anyway, I checked in with my pediatrician colleagues on this question, and here’s what they shared. Don’t worry if your infant sucks her finger or thumb. You have little control over it, anyway, since those fingers and thumbs are attached to the baby, and babies seem to need to experience the world around them with their mouths.

Sucking a finger or thumb is not a sign of emotional problems, and it does help some babies sleep. Thumb-sucking won’t delay your child’s language development. And it won’t cause any harm to her mouth or teeth if it is stopped by age 4 or 5. Most children give it up on their own well before reaching school age.

If your infant does suck her thumb, make sure she is getting enough to eat. Once you’ve established that the sucking isn’t about food, allow her the comfort of her fingers or thumb.

Pacifiers are a little trickier, and many parents struggle with whether to use them. Pacifiers do have some advantages: They satisfy the sucking need, offer comfort and may help some babies sleep.

On the other hand, pacifiers can become a crutch for parents. They can become an easy way to quiet your baby without finding out what the baby wants or trying other forms of comfort. And if you put your baby to bed with one, she might wake up repeatedly when she loses it during the night.

If you decide to use a pacifier, make sure it is all one piece so it cannot break apart and become a choking hazard. Have several pacifiers on hand so there is always a clean one available, and wash them frequently. Never attach a pacifier to your baby’s clothing, crib, playpen or stroller; babies can be strangled by the cord.

Before putting the pacifier into your baby’s mouth, try rocking and cuddling the baby, or speaking softly. Sometimes that’s the best “pacifying” that a parent can do. If the baby remains fussy after feeding, try burping the baby — that may end the fussiness.

A breast-fed baby should not be given a pacifier until nursing is well established to avoid “nipple confusion.” Some pediatricians are not convinced that nipple confusion really is a problem. A pacifier may be most useful in infants 2 to 4 months old. That’s when the need to suck is strongest.

Like thumb-sucking, a pacifier should not harm your baby’s mouth or teeth if it is discontinued before age 4 or 5. A baby’s need for a pacifier should end a long time before that.