Sunday, September 25, 2011

New Apartment, New Habits

Ever since we moved to the new apartment, and Raphaela has discovered the drawer with the (theoretically) decommissioned baby items, she has decided for the first time in her two years of life that she wants to start using pacifiers.  Since her birth, and as a baby she rejected them outright, and now the combination of peer pressure and the stress of the move has made them fashionable.

Many children in her Gan, including her best friend "Na Nu," have a pacifier perpetually attached and nearby. 

At the very least, Raphaela only asks for the pacifiers at home, and when it comes time to leave the house does not insist upon taking them (that's right, two of them) into the car or during outside errands.  I am very much hoping that this is a phase, a reaction and brief regression because of our recent change of address.

Other than the issue of future braces and their exhorbitant cost,  and other than the negative effect it has on language development and facial muscles;  I have observed too many Israeli parents using the pacifier as a way to shut up their children in public. Then the attachment goes beyond the original plan, with four and five year olds walking around the supermarket with their mouth stuffed and their emotional growth infantilized.

Raphaela turns two next week, and with all the increadible achievements I have witnessed since her surgery, it would be a shame to take several steps backward.


koshergourmetmart said...

here is a great site about sippy cup/pacifers use. the author deals with speech. the author has a M.A., CCC-SLP.

For some toddlers, pacifiers are not an issue since they never took one in the first place or easily gave it up as an infant. Sometimes not taking a pacifier hasn’t necessarily been a good thing either, since a child may not have found a successful way to self-soothe. Sucking is a very good way to regulate an out-of-control infant and toddler.

Many babies find their thumbs during this phase. While some parents and even experts prefer this habit, I think it’s a lot more difficult to kick, even for 6 and 7 year olds, because you can never truly get rid of it.

For some babies and toddlers (and their parents!), pacifiers are essential and even recommended. For babies with significant oral motor issues, learning to suck a pacifier and keep it in their mouths is a milestone. For cranky babies and toddlers with sensory integration differences, using a pacifier to soothe is the only thing that helps them calm.

Most children should be able to give up the pacifier between age 2 1/2 to 3, or at least relegate this for sleeping or calming only. Walking around all day with a pacifier in your mouth is not recommended as kids move closer to age 3, but not because it keeps you from talking. It makes you look like a big ol’ baby, but that’s another issue in and of itself, and one I’m not going to tackle today!

I think it’s a myth that pacifiers prevent children from talking. Most kids try to talk with it in their mouths and then take it out if their parents insist that they don’t understand them. If your toddler is not talking, is over age 2, and is addicted to his pacifier, try to limit the pacifier to naps, bedtime, and when he really needs it to calm down. You can monitor to see if having an open mouth during waking hours will help him vocalize more. In nearly every child I’ve seen in my whole career, the lack of language is the reason the kid isn’t talking, not because he takes a pacifier.

Some SLPs disagree with this and insist that a toddler be weaned as soon as they begin therapy. I usually advise parents to keep the pacifier until we find other ways to help a kid self-soothe. I think taking away the only method some kids have for calming down is too traumatic when they are also struggling to learn to communicate. I am not into torture, not for the kids I see, and especially not for their parents!

I will add that I don’t let children keep pacifiers in when I’m in their homes seeing them for therapy unless they are falling apart without it. Many children I see work so hard during treatment that they need it to calm down after we’re finished, and I think this is alright.

Parents of children with sensory issues tell me that they need the pacifier for times when no other option works to wind down a jacked-up toddler or end a tantrum. If your toddler, even at 3, still needs the pacifier to help calm his sensory system, keep it and don’t feel guilty. As a mom, I’m just fine with that. As a therapist, I’m fine with it too, but I’d like to see them learn to self-soothe in other more mature ways as they turn 3, and especially by 4, if at all possible.

Options that I’ve seen work are finding a special blanket, stuffed animal, or doll. You are still transferring dependence to an object, but usually one that won’t hurt your teeth, or cause grandma and the neighbors to raise an eyebrow or make those nasty, condescending comments that cause us all to cringe.

Kicking these habits aren’t easy, but it’s all part of growing up, for your baby and you!

Commenter Abbi said...

I agree, pacifier has nothing to do with talking. I've had three kids who all used pacifiers and their speech was never affected by them. R is curious, influenced by her peers (which normal) and found the goods in her house (why the heck did you keep them if you disapproved of them?). I don't think this is a step "backward". I'm a big believer in self soothing. If she finds using a motzetz soothing, a little use at home won't really hurt that much.

Midlife Singlemum said...

Exactly the same thing happened to us. After I'd tried to get DD to use a dummy too late, she never took to it. I had about six in the house and I got rid of them. Then, aged 2 1/2, she suddenly found one I'd missed under the bookcase. She started wanting to use it - but only because some of the other kids had them. I had to buy some new ones as we kept leaving the one we had at gan/home when she wanted it. She never really took to it and they became more like collectors items to play with. Over the summer she forgot that they go to gan (or anywhere) and they are now simply one of her collections that she plays with - rarely putting one in her mouth.

Nicole said...

Maybe she is also taking to them now because she can breathe better since the surgery. For a child you wasn't breathing properly, having a pacifier as well was probably not possible, but now she has discovered that it is.

Sarah said...

I just wrote an article yesterday on the age at which children should be weaned from pacifiers. How funny.

Basically, as long as she stops using them before she's 4, they won't have a permanent effect on her dental development. They might have an effect on her speech development, and a temporary effect dentally (on her baby teeth) -- but they are better than letting her suck her thumb, if that is what would happen otherwise, since it's much harder to quit the thumb than the pacifier. Also, since she's already two, at least she wasn't using it during the period between 12-24 months, when speech development is most dramatic.

Ideally, children shouldn't use pacifiers after 12 months, because of the possible speech issues and effect on baby teeth, but if she needs it to self-soothe, it's legitimate to let her use it until she turns four.

Doc said...

We kept getting free pacifiers when she was a baby, and I gave most of them away, in the package, unopened. There were two left, and that is what Raphaela found when I was unpacking the house after the move.

Sarah said...

Abbi, I don't think your own three kids constitutes proof; it's anecdotal evidence. I think pediatricians, dentists and speech therapists are in a better position to talk about possible risks of the pacifier since they deal with larger populations. I'm glad your kids are doing great but maybe that's despite the pacifier, not in addition to it. (I too used one as a baby and turned out fine, but again, that's anecdotal.)

Amy Charles said...

It's not a big deal, paci/thumb sucking. And orthodontists will now sell braces to anyone with teeth (and if you don't have teeth, they have a friend...). Apart from which entire nations of people with miserable bites have gone on to build empires. It's not a life-ender.

I wouldn't worry about it, in other words. Let her know you disapprove, if you like, but I wouldn't turn it into a fight, or lose sleep over it. She'll put it back down again when she discovers something new to be interested in.

Commenter Abbi said...

Sarah, I never claimed I was submitting evidence to the AAP for peer review nor did I claim it was anything other then my own experience. I've also never been warned by any doctors or dentists we've seen that the paci could cause delayed speech. Nor have I encountered this in any of the numerous kids I know. It's actually a well known fact that bilinguilism can cause speech delay- maybe Doc should stop speaking English to R.

Serious speech delay (the kind you really need to worry about, not "paci delay") usually comes with a host of other developmental delays, which hardly seems the case here. In short, I don't think Doc should worry about this for a second. But that's just my undocumented opinion.