MEGAN PETSCHEL
Occupational Therapist
JULIE MONSON
Occupational Therapist
There is a never-ending debate regarding the use of a dummy/pacifier with your baby. For many moms, giving their baby a dummy calms an unhappy baby and helps them to fall asleep faster. This is likely due to the fact that sucking is a natural reflex in babies and is a soothing action for them. But what happens once they fall asleep, is it safe for them to sleep with a dummy?
The research indicates that it is completely safe for your baby to sleep with a dummy in their mouth when it is used properly. Using a dummy is linked to a lower risk of sudden infant death syndrome (SIDS) which is the most common cause of death in babies between 1 month and a year of age. Using a dummy can reduce this risk by almost half especially in babies under the age of 4 months. The American Association of Paediatrics (AAP) supports the use of a dummy whilst sleeping, even if the dummy falls out after the infant has fallen asleep.
While the research supports the use of a dummy whilst sleeping, there are still a few points to be aware of to ensure your baby’s safety.
SHOULD I REMOVE THE DUMMY ONCE MY BABY IS ASLEEP?
- Only use one-piece dummies preferably moulded from a single piece of plastic. This prevents parts from popping off and becoming a choking hazard.
- Ensure that the dummy you are using is age appropriate and fits properly. A newborn dummy is great for your small baby, however it may become a choking hazard for older babies and toddlers.
- Check the shield and make sure that it is not smaller than 3.5cm. This will help prevent your infant from being able to place the whole dummy in their mouth.
- The shield of the dummy needs to have ventilation holes so that it is easier for your baby to breathe.
- Do not attach the pacifier to any clothing, bedding, crib or item in the cot. The strap that is used to secure the dummy poses a strangulation hazard to your baby as it can wrap around their neck. Beaded dummy straps pose choke hazards if the string were to break.
- It is important to wash and sterilize your baby's dummy frequently. For babies younger than 6 months the dummy must be washed as well as sterilized. Make sure to use hot soapy water when washing and rinse it off well before allowing it to air dry. If you are using a sterilizing solution, do not leave it in the solution longer than is indicated on the bottle. For babies older than 6 months, washing the dummy with soap and water is sufficient as their immune systems are stronger.
CAN A BABY CHOKE ON A DUMMY?
A baby is able to choke on a dummy is if the dummy is too small for them, parts are able to pop off or the dummy is old and has weakened resulting in pieces breaking off. These pieces may become caught in a baby’s throat which can cause choking and breathing problems.
There are, however, things that you can do to prevent your baby from choking on a piece of dummy:
- Before you give the dummy to your baby it is important that you do the pull test every time. The pull test is easy to do and requires you to hold the teat and then pull on the handle or ring to make sure that nothing breaks under pressure.
- Your baby’s dummy should also be checked regularly for signs of discolouration or parts that have tears, holes or rips. This indicates that the dummy needs to be replaced as it could pose a choking risk to your baby.
- Do not leave a dummy in direct sunlight or near a heater as this can cause it to become brittle and discoloured.
- Read the insert in the packaging to check the manufacturer's recommendation as to when the dummy should be replaced. For example, some inserts insist that the dummy be replaced every 2 months for hygiene purposes.
- Avoid using a dummy when your infant or toddler is teething as the chewing action on the teat of the dummy can cause tears.
CAN A BABY CHOKE ON SPIT UP WITH A PACIFIER?
Some sources report that dummies can assist your baby who has reflux. This is because sucking stimulates the flow of saliva and helps with downward contractions of the oesophagus which helps keep the contents of the stomach down. What happens, though, if your baby has a dummy in their mouth and they spit up or vomit?
Babies have an automatic reflex which causes them to cough up or swallow the fluid that they have spat up or vomited. This reflex ensures your baby's airway remains clear.
WHEN CAN MY BABY START USING A DUMMY?
There are no specific guidelines as to when you should give your newborn a dummy. However, the AAP recommends that if you are breastfeeding your infant, you should wait until breastfeeding is established in order to prevent nipple confusion.
Nipple confusion arises because sucking on a dummy is easier for an infant than sucking on a nipple. This can potentially make it more difficult for them to latch. They may also get tired from sucking a dummy which leaves less energy for them to feed.
Establishing a good nursing routine can take up to 4 weeks. The AAP also advises that you only offer your baby a dummy in between feeds or after feeds when you are certain they are not hungry so that it does not interfere with breastfeeding.
CAN MY BABY USE A DUMMY TO SELF SOOTHE?
Learning to self soothe is a valuable tool for your baby to develop. The ability to self soothe means that they are able to calm themselves, relax and hopefully fall asleep on their own. Non-nutritive sucking such as sucking on a dummy can help your baby with this as sucking is a normal reflex which they develop in your womb. Sucking on a dummy reminds them of being in the womb and is therefore soothing for them. Sucking also helps lower their heart rate, blood pressure and stress levels.
IS IT SAFE FOR MY BABY TO SLEEP WITH A DUMMY CLIP?
Dummy clips pose a significant risk to your baby if attached to their clothing, their cot or any loose items around them whilst sleeping. These clips are used to keep your baby’s dummy close to them in the hopes that they can use it to self-sooth. They are generally made from beads strung together on a chain or string.
The concern is that these dummy clips can get caught around your baby’s neck and potentially lead to strangulation. The beads can also break or be chewed off leaving a choking hazard to your baby. Should you use dummy clips, it is important that they only be used when your baby is awake and alert and you are in close proximity to supervise and intervene if necessary.
in conclusion
Dummies are incredibly useful when your little one is upset or irritable as the sucking reflex helps settle them and distract them. When used correctly and when following the recommended guidelines, they are safe for your baby to sleep with.
References
https://pediatrics.aappublications.org/content/138/5/e20162938
https://www.healthline.com/health/parenting/newborn-pacifier#takeaway
https://onlinelibrary.wiley.com/doi/full/10.1111/jpc.12402
https://www.webmd.com/parenting/baby/features/using-pacifiers#2
https://infantcpr.com/blog/posts/sleeping-with-pacifier/
https://www.hellomotherhood.com/13683246/is-it-ok-for-baby-to-sleep-with-a-pacifier/
https://www.madeformums.com/baby/baby-dummies-7-safety-checks-every-parent-needs-to-know/
https://www.kidspot.com.au/parenting/real-life/in-the-news/dad-warns-to-check-your-babys-dummy-after-his-daughter-nearly-choked/news-story/3913f3744adddc5cf823706e410e93ac
https://gobstopperz.co.nz/blogs/life-with-a-baby/why-you-should-avoid-using-a-dummy-clip
https://raisingchildren.net.au/newborns/sleep/settling-routines/dummies
https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/What-is-the-safest-sleep-solution-for-my-baby-with-reflux.aspx