Pacifier vs. thumb-sucking--is one better?

Todd writes: "My 10-month-old son loves to suck on his thumb and his pacifier. Is one better for him?"

Yes, the pacifier beats thumb-sucking. There are several reasons: Thumb-sucking pushes the top jaw forward and the bottom jaw backward, which can cause jaw misalignment and malformation over time. Also, a baby's thumb can be dirty, which introduces bacteria into the mouth that could cause illness.

It can also be a tough habit to break since a baby's thumb is always handy. So, you might want to discourage thumb sucking by giving your baby a pacifier whenever you catch him with his thumb in his mouth. But wean your baby off a pacifier by age 2. Prolonged use of a pacifier can change the shape of your baby's growing jaw, and also increase the chance of ear infections.

Instead, help your child "graduate" to a "sippy" cup with a collapsible rubber straw, for example. And always consult your pediatrician for advice on this and any other health issue.

See our reports on baby bottles and nipples, baby formula, and breast pumps for more information.

Comments

[-----]

I am 15 i still suck my thumb i haven't bin ill from it i don't think my teeth are fine but i think a dummy would be better t suck easy to sleep with.

[Jessica]

I have two girls and they both use the pacifier. My oldest is already staring to give it up herself. My thought about the pacifier vs the thumb is whatever the child wants. When i was younger I never got a pacifier so i started to suck on my lip and to this day i still do it! So I think it should be up to the kids.

[hilary]

I sucked my thumb until I was 12. My mother thought she'd lose her mind. I totally agree with this article and when my son needed addtional sucking after feeding it was definitely a pacifier. He outgrew it before he was walking--11 months. The sippy cup never had anything in it but milk or water since sugary drinks are what cause tooth decay.

[Sandra Gordon]

Thanks for your comments. Our pacifier guidelines aren't the opinion of Consumer Reports, but of the American Academy of Pediatrics. Their latest recommendations say there's little evidence that pacifiers harm teeth before age 1 or cause infants to lose interest in breast-feeding. The AAP recomends that babies up to age 1 use pacifiers at bedtime or naptime because pacifiers appear to substantially reduce the threat of Sudden Infant Death Syndrome. However, the AAP also recommends waiting until your breast-fed baby is 1 month old before introducing a pacifier to ensure that breast-feeding is firmly established.

[Kelly]

I also just found some research that has linked pacifier use with early weaning:

* Victoria, CG., Tomasi, E., Olinto, MTA, et al: “Use of pacifiers and breastfeeding duration.” Lancet (1993) 341:404

* Vogel AM, Hutchison BL, Mitchell EA., “The impact of pacifier use on breastfeeding: a prospective cohort study.” J Paediatr Child Health (2001) Feb; 37 (1):58-63

and also with ear infections:

* Niemela M, Uhari M, Hannuksela A , “Pacifiers and dental structure as risk factors for otitis media.” Int J Pediatr Otorhinolaryngol (1994) Apr; 29 (2):121-127

* North Stone K, Fleming P, Golding J., “Socio-demographic associations with digit and pacifier sucking at 15 months of age and possible associations with infant infection. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.” Early Hum Dev (2000) Dec; 60 (2): 137-148

I think these are some pretty strong arguments against using a pacifier, especially for an extended period of time. Please present a more balanced point-of-view Consumer Reports or at least cite your research that backs up your argument.

[Kelly]

Wow, I am really surprised by this article. As far as I am aware, this is not a settled debate in the medical field at all. Consumer Reports makes it seem like there is only one opinion to the issue. I don't think that there has been any comprehensive research on the subject. If there has been, please cite it Consumer Reports. Otherwise, don't make it sound like you know everything. My gut feeling is that this is wrong. My baby used a pacifier for the first 4 months, and then we helped her wean from it, since I noticed she was using it for hours a day and also in her sleep. She now occasionally sticks her thumb in her mouth for a few minutes but nowhere near the time she used to spent using the binky.

[TK]

Also, I believe sucking on fingers rather than pacifer develops more of the brain since there is multiple contact points/feelings as well as allows babies to learn how to soothe themselves.

[Karen]

The Michael Olaf Montessori Company sells a product called the "Perfect Pacifier". It has various nubs all over it for holding/sucking and is phthalate free. When the infant needs non-nutritive sucking, the parent needs to hold it in place until the child can hold it on his own. I think it's a better idea than a typical pacifier that is constantly in the child's mouth. This way, it is used only when the child's needs are to be met.

[Q]

This is absolutely the stupidest thing I have ever read. Not only that but certain people are contributing unecessary info. when writing a review. Breast or bottle?? That is NOBODY'S business other than the mother and the Dr.!! People need to stop nosing into other's lives and worry about their own. We have more important things to worry about in this world other than breast or bottle, thumb sucking or pacifier Etc. Let's all try to get along. I have never personally met a child who has some major disfunction because they sucked their thumb or were not breastfed. Give me a break!

[Jane]

Oops! I noticed an error on my comment. It's probably NOT a good Idea to encourage thumb and/or pacifier sucking.

[Jane]

Anything can cause tooth decay if the parent (and child) do not practice god oral hygiene. I do agree that it is probably good to encourage thumb or pacifier sucking. My First daughter was given a pacifier and she only used it for about 2 months( she didn't care for it; she is now 10 yrs old). However my second daughter loves her pacifier she is quote attched to it. I didn't encourage it though. She is 2 1\2 yrs old. Her use of the pacifier has lessened greatly though. I am a dental assistant and from this experience, I have noticed that as long as you practice good oral hygiene and do not make the pacifier readily available constantly it won't cause any long term damage to the childs' teeth.

[w]

this whole discussion of pacifier vs thumb is a moot point. if a baby decides to start sucking thier thumb it's near impossible to stop them short of tying thier arms down. as a former thumb sucker and the mother of a current thumb sucking three month old there really is very little downside. i stopped sucking my thumb before school with the bribe of a carebear, and my daughter has been sleeping soundly through the night since she was seven weeks old thanks to her thumb. what people should really be discussing is the impact of bottle vs breast, with the breast being the clear winner.

[Zoe]

This is incorrect information, I am surprised Consumer reports would publish such badly researched information. Thumbs can be cleaned much more easily than pacifiers. And children wash their hands more often than pacifiers are sterilized. There are always microscopic fissures in pacifiers where bacteria live and they can never be completely cleaned. Everything the child touches has bacteria from his or her hand on it anyway, but pacifiers are always dropped on the floor or ground picking up all sorts of nastiness. By nature, if the child is playing the thumb comes out of the mouth to use his/her hand. But pacifiers can be in the mouth for much more extended periods of time because the child can use his/her hands to play or even sleep with it still in.

[Beth]

Sippy cups do not lead to tooth decay. Instead choose better beverages, like water instead of juice or an beverage with aded sugar. After teeth are brushed, no milk, just water.

[sally]

Agree, skip the sucking style sippy's. They are no different from a bottle. Very few babies really need a pacifier. It is more for the parent than the child.

[Gerry]

As if a pacifier doesn't get dirty. Older babies toss them onto the floor, then pick them up and put them back into their mouth. Lots of bacteria there (not that that's really a problem though, they have to develop their immune system anyway). Younger babies who rely on pacifiers need their parents contant help in putting the darn things back in their mouths.

[Clarissa's Mommy]

Pacifier - Our Good Experience

Our daughter had a strong sucking reflex. We felt because her sucking reflex was so strong and she needed something constantly (probably mentally soothing during her tummy aches) we would try the pacifier. I was worried that she would become too attached. On the contrary!

Once the sucking reflex started to diminish (around the time she was ready for solids) we limited the pacifier use to her bed and the car seat. She is 7 months and doing great thus far! She is so busy during the day she doesn't miss the pacifier a bit.

[J]

Skip the sippy cups! Terrible for teeth! May lead to tooth decay etc.

[J]

Skip the sippy cups! Terrible for teeth! May lead to tooth decay etc.

[J]

Skip the sippy cups! Terrible for teeth! May lead to tooth decay etc.

[J]

Skip the sippy cups! Terrible for teeth! May lead to tooth decay etc.