What’s the Deal with Pacifier Use & Speech/Language Development

Parents of young children may hear healthcare providers, daycare providers, friends, and/or relatives talk about the negative impact of a child’s pacifier use.  There have been studies that show a link between prolonged pacifier use and dental abnormalities and increased ear infections, both of which have been linked to the development of speech and language disorders.  And, there was a recent study that indicates that freedom of tongue movement plays a part in an infant’s ability to perceive speech sounds accurately.  Yet, there has been inconsistent results in studies that have looked at the direct link from pacifier use to speech and language disorders.  As a pediatric speech-language pathologist, I have an interest in this link.  Afterall, if a child has prolonged and/or profuse pacifier use, it results in reduced opportunities for babbling, imitating sounds, exploring other oral skills, and engaging in conversation.  Pair that with abnormal dental development and ear infections and you can see where a child’s speech and language develpment can be at risk.  But, that does not mean pacifiers should be entirely avoided, so I’d like to suggest some general guidelines for parents to consider if they do choose to introduce pacifiers.
Guidelines for Pacifier Use
1.  the pacifier needs to fit the child’s mouth with a good lip lock and an even back and forth movement of the tongue.  As the child grows, the pacifier size and/or shape may need to be changed.  
2.  from birth-6 months the pacifier should be used only for calming purposes.  Once the child is calm or asleep, remove the pacifier.  If he/she is awake, engage him/her in other activities.
3.  from 6-10 months, begin weaning the pacifier to only bedtime or naptime.  Introduce other higher-level mouth activities, such as mouthing/biting on safe and appropriate toys and taking sips of water from an open cup.  Chewy Tubes and ARK Grabbers are excellent toys designed for infant chewing practice.
4.  by 10 months, your child will have learned to use his/her mouth in more appropriate ways and the pacifier can be completely eliminated
This appropriate use of the mouth for biting, chewing, and speech has an impact on the continued growth and function of your child’s mouth.  The placement of the tongue on the palate will help to maintain an appropriate palatal arch shape, practice with chewing will aid in the the growth and development of the jaw and teeth, and movement of the tongue thorughout the oral cavity will assist with improving feeding and speech development.  
For more information, there are numerous online resources that can be located by searching for:  oral motor development, feeding development, speech and language development.  Diane Bahr has a book for parents and professionals entitled “Everything from Bottles and Breathing to Healthy Speech Development” that is an excellent resource in ways to give your child an environment that encourages healthy speech and language development.  And, if you have questions specific to your child, please feel free to contact me or other local pediatric speech-language pathologists.