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Pacifier vs Thumb

​​Sucking on a pacifier, thumb or finger can be comforting for a baby. Many parents prefer the convenience of the thumb so they don’t have to scramble in the middle of the night or stop on the side of the road to retrieve a dropped pacifier. While both thumb or finger sucking and pacifiers are acceptable methods of soothing an upset infant, there are more benefits to using a pacifier.

Support for Pacifier Use

  • If a child does not stop sucking on his or her thumb or fingers once permanent teeth come in, a severe overbite can result. A pacifier puts less pressure on the teeth, creating less of an overbite than the thumb.
  • Children who suck their thumbs run the risk of the skin breaking down and becoming infected. In serious cases, this can lead to a required plastic surgery.
  • When a baby sucks on his or her thumb or fingers, parents can have a difficult time stopping the behavior. Although curbing either habit can be emotional for everyone involved, the use of a pacifier can be controlled more easily than a thumb or finger.

Pacifier Use Timeline

In order for a baby to accept a pacifier over his or her thumb, it must be introduced during the first two months. After that time, the urge to suck decreases. Medical literature suggests that if a baby is not a thumb- or finger-sucker by 1 month, pacifiers can be introduced for SIDS prevention. Several different types of pacifiers may have to be tested before a baby finds one he or she likes.

Once your baby begins to crawl, begin to wean him or her off the pacifier. At this time, speech begins to develop and a pacifier may interfere with progress. The following are a few tips to ensure your child doesn't walk around all day with a pacifier in his mouth:

  • Do not offer a pacifier every time your baby cries, especially during the first 6 months. There are many other reasons a young baby cries, including gas, sleepiness, overstimulation, etc.
  • Comfort your older infant by cuddling before offering a pacifier.
  • Keep the pacifier in your child's crib after the age of 15 months, 18 months at the latest, only allowing it during naptime and bedtime. Once asleep, take the pacifier out of his or her mouth.
  • Provide some other type of security object for your child while he or she is awake, such as a stuffed animal or soft blanket.

By the time your child turns 2, he or she should be ready to give up the pacifier completely. Do not try to take it away during a time that is stressful for your child, such as moving, starting daycare or when a parent is away on business. Offer your child the option of throwing away the pacifier or his or her own or leaving it out for the "pacifier fairy." Be sure to give your child lots of praise for being a big girl or boy.

Pacifier Safety Precautions

  • Use only a one-piece pacifier from a retailer. A pacifier made at home from a bottle nipple can become lodged in your baby's throat and cause choking.
  • Do not use a string to keep the pacifier around baby's neck – this could cause strangulation. Instead, buy a short pacifier clip that attaches to your child's clothing.
  • Rinse the pacifier if it drops to the floor and each time your baby finishes using it.
  • Do not clean or hold the pacifier in your own mouth. This can lead to early cavities and tooth decay for your baby by giving them the cavity-causing bacteria that are already in an adult mouth.
  • If the pacifier tears or becomes damaged, discard it and replace it with a new one.
  • Pacifier vs Thumb

    Is one better than the other?

    ​I really do think it does matter and there are really two big issues. The first is that the thumb does a lot more damage to the palate and to the teeth​. The structure of the thumb has a tendency to really push up on the palate, narrow it, and cause the front ​teeth to buck outward. If you look at kids who suck pacifiers or thumbs long-term, the thumb-suckers have more need for braces or other orthodontic procedures later in life.

    The second is it's really cute when a baby sucks the thumb or pacifier, but it's not so cute once they're a preschooler or kindergartner. It's a really hard habit to break. When you have a pacifier, you go cold turkey, you throw them away and they're out of the house and eventually, the problem is resolved.

    The problem with the thumb is it's connected to your child. I joke with parents sometimes, you can't chop their thumb off, you get in trouble for that. The reality of it is, to break thumb-sucking is a very hard thing.

    How do you encourage the pacifier over the thumb?

    Babies are born with an incredible drive to suck, it's necessary for them to get nutrition and a lot of babies use it as a mechanism of soothing. What I typically tell parents is, from the time you bring your baby from the hospital, breastfeeding is established, if they're going for their thumb, pull it out of their mouth and provide the pacifier as a good substitute. Just keep doing that until eventually they accept the pacifier over the thumb.

    If it's not just happening and your baby is going to suck their thumb, then they're going to suck their thumb. There isn't much you can do about that. It's a tough situation. It's a benefit on the front end because the sucking of the thumb or pacifier does decrease SIDS and because those babies learn to soothe and settle themselves and become good sleepers. But, ideally if you can avoid it, it's best.

    How do you break the habit of thumb-sucking?

    They really need to be motivated and want to stop sucking their thumb. If they aren't motivated to do it, it will be very hard to break them of the habit. Behavior modification charts, like a sticker chart, for periods of time gone without sucking their thumb or rewards system, like reading more books at bedtime if they don't suck their thumb. That's a big time when kids suck their thumb, when they're tired, so when you get them into bed and you're sitting and reading books, you tell them, well if you suck your thumb we only read one book, if you don't suck your thumb we'll read three. That somewhat motivates kids because they get more Mom and Dad time and more book time.

    When should you wean your child off of a pacifier?

    My rule of thumb is after 15 months of age, a baby should only have a pacifier in their crib at naptime and bedtime. It's really important that they not be walking around the house all day with the pacifier in their mouth while they're playing because this is the age where they're learning to talk. If they have the pacifier in their mouth they're going to talk less and they probably will learn to put their tongue in the wrong position and mispronounce words as well. ​​​​​

Newborn;Family and Parenting Pediatrics