There is not a clear-cut answer to this question. While the American Speech-Language-Hearing Association takes the position that overuse of pacifiers can negatively impact speech development, results of studies investigating this question have yielded mixed results when comparing the speech skills of pacifier users versus non-pacifier users.
What does the research say?
Pacifier use has been associated with conditions that are considered risk factors for speech and language issues.
Ear infections: Prolonged and frequent pacifier use appears to be a risk factor in the development of Otitis Media. Repeated middle ear infections can increase the risk of hearing loss – and even cause temporary conductive hearing loss. Children with hearing loss have more difficulty learning speech and language.
Dental problems: Malocclusion (misaligned or malpositioned jaw/teeth) is associated with prolonged pacifier use. Differences in dental structures can lead to distortions during the articulation of speech sounds.
However, research directly investigating the articulation (speech production) of pacifier users versus non-pacifier users has yielded mixed results. One study found no significant differences between the speech articulation of children who had no or minimal history of pacifier use, children who had a history of pacifier use for up to 15 months, and children who had a history of pacifier use that ranged from 18-55 months (Shotts, McDaniel, & Neeley, 2008).
Results from another study suggested that prolonged sucking outside of breastfeeding may negatively impact speech. More specifically, investigators found that children who used a pacifier or sucked their fingers for 3 years or more were three times more likely to develop a speech disorder (Barbosa et. al., 2009).
What do the professionals think about pacifier use?
Many speech-language pathologists recommend stopping pacifier use at approximately 1 year of age. At this age, important developments in your child’s speech and language learning are occurring rapidly; therefore, maximizing your child’s opportunities to babble and speak optimizes his or her ability to develop speech and language skills. A pacifier may decrease the likelihood of your child babbling or speaking and, if he or she attempts to babble while sucking a pacifier, your child’s speech will be distorted. Some speech-language pathologists also assert that pacifiers impede normal development of tongue and lip muscles and movements due to the unnatural position imposed on these structures by the presence of the pacifier.
What should I do?
As a parent, it is important to consider the specific needs of your child when deciding whether, when, or how long to allow pacifier use. There are some possible benefits to pacifier use, including protection against sudden infant death syndrome (SIDS) and pain prevention and management for infants. Additionally, no research has yet indicated that limited pacifier use negatively impacts speech development. Therefore, if you decide to allow your child to suck a pacifier, it is a good idea to keep the following guidelines in mind:
Try to limit your baby’s pacifier use to nap-time or sleep only.
Depending on the specific needs of your child, wean him or her from the pacifier after 6 months (when risk of SIDS drops) and before 18 months (when speech and language development is occurring rapidly).
Instead of offering your child his or her pacifier during moments of boredom or increased emotion, find new ways to assist in self-directed entertainment or self-soothing; for example, redirect your child to a fun activity, play music, read a book, or offer a preferred toy.
Restrict use if your child has a history of recurrent otitis media.
Use an appropriately sized pacifier.
Do not allow children to share pacifiers.
Wash pacifiers in soap and water to keep them clean between uses.
Use a pacifier with ventilation holes to let air in.
Do not sweeten a pacifier, as it can damage your baby’s teeth.
All in all, it is each parent’s personal decision whether or not to allow pacifier use. If used appropriately, pacifiers are not likely to impede speech and language development. However, if pacifiers are overused (e.g., child sucks on a pacifier too much) or misused (e.g., the pacifier is not appropriately cleaned or sized), they can increase your child’s risk of speech and language difficulties.
Stephanie is a speech-language pathologist practicing in the Chicago area.