Soothers

Love them or hate them, parents have used soothers or pacifiers for centuries. As the names suggest, parents use them to calm and settle babies and, sometimes, toddlers too.

Sucking is a natural behaviour for babies that helps them to feed and grow. The action of sucking is also calming for your little one (Caring for Kids 2017, Ponti 2018). You may find your baby needs to suck on something for comfort when they're awake and not feeding. As they get older and find other ways to soothe themselves, they’ll need to do this less (Borrie et al 2015).

What sort of soother is best?

It may be a question of trial and error before you find a soother that your baby will accept. Some babies refuse to take a soother at all (Joyner et al 2017).

Most soothers come with a silicone, rubber or latex nipple, and a plastic or silicone mouth shield and handle. The mouth shield prevents your baby from choking on, or swallowing, the nipple. Some brands are all one piece, so there are no joints or cracks that could come apart or carry germs.

Latex or rubber soothers are softer and more flexible than silicone, but they don't last as long. Silicone soothers may be easier to keep free from germs than latex soothers (Sexton and Natale 2009).

When could I start giving my baby a soother?

If you're breastfeeding it’s best to wait until breastfeeding is well established. This is usually when your baby is about four to six weeks old. Talk to your doctor or lactation consultant if you’re not sure when you can use a soother (Caring for Kids 2017).

Many parents use a soother during the first six months to help settle their baby to sleep at night, and for naps during the day. Alongside their usual feeds and plenty of cuddles from you, a soother may help to comfort and settle your little one (Caring for Kids 2017).

Will using a soother interfere with breastfeeding?

It’s hard to say. Some research shows that using a soother in a healthy breastfeeding baby can lead to fewer breastfeeds and reduced milk production, which may mean that babies are weaned earlier (Jaafar et al 2016). But other research shows that soothers do not have a big effect on breastfeeding (Jaafar et al 2016).

Until we know more, it's best to give your baby a soother only after breastfeeding is established (Goldman 2013, Moon 2016). This helps your baby get fully used to latching on and sucking your breast (Goldman 2013).

What are the advantages of using a soother?

A soother may calm your baby or help them settle to sleep (Caring for Kids 2017, Ponti 2018).

The act of sucking can relieve pain (Ponti 2018). For example, it may help your baby if you breastfeed them, or if they suck on a soother when they're having their immunizations.

A soother may help if your baby is premature. If they're given a soother to suck on before feeds, they may adapt more quickly from tube-feeding to bottle-feeding. They may also be calmer and settle more easily before and after their feeds (Foster et al 2016, Ponti 2018).

Premature babies who are given a soother also tend to have shorter hospital stays than babies who aren’t given one (Foster et al 2016, Ponti 2018).

Finally, a recent study has suggested that using a soother may help moms with postnatal depression to continue breastfeeding for longer (Sipsma et al 2017).

What are the disadvantages of using a soother?

Ear infections
Using a soother for long periods may mean that your baby suffers more frequently from middle ear infections (Lubbe and ten Ham-Baloyi 2017, Ponti 2018).

Sucking may push bacteria from your baby's mouth into the narrow tubes between their ears and throat (Eustachian tubes). And if your baby uses a soother a lot, it may affect the structure of their mouth, so that mucus doesn’t drain as well along their Eustachian tubes (Lubbe and ten Ham-Baloyi 2017).

Limiting the amount of time your baby uses their soother will guard against ear problems. If you only let them use it to settle themselves to sleep, it can make a big difference to the number of ear infections they get (Sexton and Natale 2009).

Teeth problems
The longer your baby uses a soother, the more likely it will change the way their teeth grow. This can result in an overbite or crossbite, where the top and bottom teeth don't meet properly (Lubbe and ten Ham-Baloyi 2017).

You may notice these problems if your child uses their soother beyond two or three years of age (Nelson 2012, Ponti 2018). The worst effects are usually seen in children who use a soother when their permanent teeth start coming in, around five years of age (CDA nd). Usually, though, soothers are not needed past one year as most children have learned other ways to soothe themselves.

Keep in mind that the Canadian Dental Association recommends soothers over thumb-sucking because it’s easier for you to control when your child uses a soother (CDA nd, Ponti 2018).

Will using a soother help prevent SIDS?

Several studies have suggested that using a soother may help to prevent SIDS (Alm et al 2016). It's unclear exactly how it works, and experts are still divided on the issue (Psaila et al 2017).

Some groups, such as the Canadian Paediatric Society, do not make a clear recommendation to use soothers to prevent SIDS (Ponti 2018). Others, such as the American Academy of Pediatrics, recommend that parents consider offering a soother at naptime and bedtime (Moon 2016). If you choose to use a soother for this reason, make sure you only give it to your baby for naps and night-time sleep, and don't worry if it falls out while your baby is asleep (Moon 2016).

Don't encourage your baby to take a soother if they don't want one. There are other, proven ways to reduce the risk of SIDS:

• Put your baby on their back for every sleep.
• Sleep in the same room as your baby for the first six months.
• Place your baby in a crib, cradle or bassinet that meets current Canadian regulations. All your baby needs for a comfortable sleep is a firm mattress and a fitted sheet. There's no need for extra bedding like quilts, comforters, pillows or bumper pads. These pose a risk of suffocation and increase the chances of Sudden Infant Death Syndrome (SIDS).
• To keep your baby comfortable, dress them in a one-piece cotton sleeper or use a sleep sack.
• Do not smoke anywhere near your baby or in your home.
  (PHAC 2018)

I've decided to use a soother. What else do I need to know?

If you’ve decided to give your baby a soother, here are a few tips:

• Never use a string or ribbon to attach a soother to your baby’s clothing or cot. And never tie a soother round your baby’s face or neck. Both carry a serious risk of strangulation (Caring for Kids 2017, Govt of Canada 2016).
• Keep the soother as clean as possible. Before the first use, sterilize the soother in boiling water for five minutes. Make sure it’s completely cooled before giving it to your baby (Caring for Kids 2017). Silicone soothers (Sexton and Natale 2009), or soothers that are all one piece, may be easier to keep clean.
• Check your baby’s soother every day. Cracks and tears can trap germs. If you find any problems, throw away the damaged soother and buy a new one. Make a habit of replacing a soother every two months (Caring for Kids 2017, Govt of Canada 2016).
• Never dip the soother in sweet foods. Don't coat your baby's soother in foods such as honey or juice to stop them crying (Caring for Kids 2017). Honey can harm babies under one year old, and sticky, sweet food and drink can cause tooth decay.
  (CDA nd)

How can I help my child stop using their soother?

Your child should stop using a soother by the time they're two to three. This will help avoid developing an overbite or crossbite (Caring for Kids 2017).

Here are some ways you can help your child give up their soother:

• Gradually decrease the times when you let your child use their soother.
• Limit soother use to key times, such as sleeptime and when your child needs comfort, instead of letting them use it all day long.
• Praise and reward your child with fun activities, stickers or star charts.
• Point out older girls and boys who don't use soothers. Preschoolers love being more grown-up.
• Be firm and don’t give in if your child asks for their soother again.
  (Caring for Kids 2017)

Read more about how a soother may interfere with your baby’s teeth and discover parents’ tips on getting your baby to sleep without a soother.