Sucking is a postnatal reflex and is a natural part of your child’s development. So it is no wonder that a large majority of infants and toddlers use pacifiers to help them self-soothe throughout their daytime and nighttime routines. Pacifiers may be helpful for comforting your child in stressful situations, distinguishing between a fussy and hungry infant, and also as a sleep aid. But how old is too old for pacifier use? And are there any negative affects from prolonged use of pacifiers?

Pediatricians recommend that babies be weaned from pacifiers around four- to six-months of age. Pacifier use is no longer needed as a calming strategy after six months, primarily because the sucking, or “rooting,” reflex has disappeared. Prolonged use may result in the pacifier becoming a habit and therefore more difficult to wean.

Speech-language pathologists also recommend discontinued pacifier use by 12 months of age for many reasons. First, your child’s oral development is changing rapidly during the first few years of life. Prolonged sucking may in fact create a raised or indented palate, resulting in an oral cavity that is too large for typical articulation. This may manifest as a speech disorder around four to five years of age, often requiring therapy to remediate. Additionally, sucking on a pacifier encourages an immature suck-swallow pattern, resulting in possible feeding difficulties and articulation concerns.

Pediatric dentists recommend that pacifier use be discontinued by 24 months of age at the latest. The constant sucking on a foreign object beyond 24 months may cause the palate, gums, and teeth to develop atypically. This is primarily seen in the atypical eruption of permanent teeth, leading to crowding and/or gaps in the teeth.

If you are ready to tackle the job of weaning your child from his/her pacifier, there are a few strategies that can ease the transition. It is not recommended to go ‘cold turkey’ at first; rather, tell your child that the pacifier is for sleeping only and keep it out of sight during the day. Once you have established this routine, remove the pacifier from nap times and eventually from bedtime. It is helpful to offer a brand new comfort item (such as a new blanket or stuffed animal) that your child can use as a replacement for self-soothing. The most important thing to remember for weaning your child from a pacifier is to remain consistent with the rules you set in place!

While there is variability in the recommended age for weaning your child from a pacifier, general consensus is that pacifiers should not be used at any time (day or night) after 24 months of age. Consult your speech-language pathologist or dentist if you have any questions about your child’s pacifier use, as well as for recommendations and support for weaning your child from the pacifier.