What to know before Introducing a dummy to baby

Dummies (also called pacifiers or soothers) have been used for centuries to help settle babies. If you’re considering introducing a dummy to baby, you will first want to weigh up the potential associated advantages and disadvantages, the current recommendations, when you should avoid dummy use, and what to look for when choosing one. Here we have collected evidence-based advice from Red Nose to help you make an informed choice before you give your baby a dummy.

Will a dummy protect my baby against SIDS?

There is strong evidence that dummies are associated with a reduced risk of sudden infant death when used consistently. The mechanisms that provide this protection are not fully understood, so dummy use could be a marker for something else that is yet to be identified. Some of the proposed mechanisms include the protection of the airway because a dummy keeps the tongue forward, reduction of reflux through non-nutritive sucking, and perhaps a baby who is soothed by a dummy might not move as often during sleep, thereby limiting the chance of becoming covered by blankets. Head to Red Nose to read more on the studies conducted.

What are the advantages associated with dummy use?

1. Dummies can be incredibly effective for settling and soothing babies. It’s always handy to have an extra comforting tool when they’re upset!
2. Studies in preterm babies have also shown that non-nutritive sucking using dummies has been linked with a reduced length of hospital stay for the infants.

What are the potential disadvantages?

1. An issue with dummy use to consider is that it may negatively impact the establishment, frequency, and duration of breastfeeding. However, it’s unclear whether dummy use causes the reduced motivation to breastfeed, or is associated with it.
2. Dummy use has been associated with a significantly higher risk of respiratory, ear, and gastrointestinal infections.
3. Babies can get very upset when dummies are lost or misplaced, as they may start to depend on them to get to sleep.
4. Your baby will cry out for the dummy to be replaced by you, until you can teach them dummy independence when they’re eight months or older.
5. Finally, other potential disadvantages include accidents (airway obstruction), strangulation by the attached cord, eye injuries, and adverse dental effects.

What are the current recommendations – yes or no?

Weighing up the advantages and disadvantages might leave you a little confused. So, what is the official advice? Debate continues surrounding dummy use as a strategy to reduce the risk of SIDS, and the recommendations vary around the world. In Australia, the conservative approach advocates that while it is appropriate to not actively discourage the use of dummies, in light of the significant disadvantages, dummies are not to be encouraged as a risk reduction strategy. Instead, here are 6 ways to sleep your baby safely to avoid SIDS.

If I choose to give my baby one, what is the evidence-based advice for everyday dummy use?

• If you’re breastfeeding, it’s best to wait until your milk supply has been established (usually after the first 4-6 weeks).
• Dummies can be offered to bottle-fed babies from birth.
• Dummies should be cleaned often and replaced regularly. Babies under 6 months should use dummies that have been sterilised.
• Dummies shouldn’t be coated in anything sweet, such as the tip dipped in honey.
• Use dummies for all sleeping periods, and only for sleep.
• If your baby refuses a dummy, it’s advised not to force it.
• Try to avoid reinserting the dummy when it falls out during sleep.
• Choose a dummy that complies with Australian standards.
• Don’t tie the baby’s dummy around their hand, neck, or cot.

When and how should I wean my baby off the dummy?

Be prepared that it can be a hard habit to break. According to current recommendations, dummies should be discontinued between 6 months and 12 months to reduce the risk of ear infections (otitis media) and dental issues (dental malocclusion). Phasing it out by the end of the first year may require strategies such as activities, rewards, toys, or perhaps introducing a comforter. 

When should I avoid or discontinue dummy use?

If you notice any of the following problems, it would be a good idea to remove the dummy, at least until the problem is resolved:

• Your baby feeds less often or for shorter periods when the dummy is used (newborns should feed between 8 to 12 times per day).
• Your baby is having breastfeeding difficulties or problems with weight gain (in which case your baby needs to nurse as often as possible).
• You’re having problems with sore nipples (which your baby may be causing due to nipple confusion), or you’re experiencing milk supply problems (in which case, your baby needs to put to the breast as often as possible, rather than the dummy)
• You and/or your baby have thrush, and particularly if you have repeated episodes of it or it’s difficult to get rid of.
• If your baby is having repeated ear infections.

How do I choose a dummy?

Look for a one-piece model with a soft nipple, a firm plastic shield with air holes, and ensure that your baby can’t put the whole thing in their mouth. Check that you can easily grab the handle or ring to pull it out quickly if it becomes lodged, and read the label to make sure that it’s the right size for your baby’s age.

A final word on dummy use…

A dummy can be wonderful for soothing an unsettled baby, but shouldn’t be used in place of parental comfort. As much as possible, offer your reassurance and support before the dummy. Babies need hugs, warmth, rocking, singing, skin-to-skin contact, and perhaps extra sucking time if you’re breastfeeding. If you do offer the dummy, it’s a great idea to remove it once your baby is calm.