Are there any health risks from a Pacifier?

Are there any health risks from a Pacifier?

Are there any health risks from a pacifier?
Yes! There are many disadvantages to using a pacifier. But let us talk about the advantages first. According to aafp.org,Pacifiers provide a calming effect and have been used for pain and anxiety prevention. A subgroup of the American Academy of Pediatrics (AAP) lists pacifiers as one of the key methods for pain relief in newborns and infants younger than six months undergoing minor procedures in the emergency department.4 A small amount of sucrose solution (2 mL) can be given within two minutes of a procedure, alone or in combination with a nipple or pacifier; the combination appears to be more effective.12,13 Several studies of full-term and preterm newborns showed that pacifiers were superior to various sweet solutions,14-16 whereas a study of very preterm newborns showed that pacifiers in combination with sweet solutions were no better than sweet solutions alone.17 A more recent study confirmed that pacifier use reduces crying time in infants undergoing venipuncture in the emergency department, especially in those younger than three months.18 Pacifiers have been studied or recommended by the AAP for use with the following procedures: catheterization, circumcision, heel sticks, immunizations, insertion of an intravenous line, lumbar puncture, screening for retinopathy of prematurity, and venipuncture.

A Cochrane review found that nonnutritive sucking is associated with shorter hospital stays, earlier transition to bottle feeding from enteral feeding, and improved bottle feeding.20 Although the review did not show that pacifiers have a significant impact on weight gain, behavior, energy intake, heart rate, oxygen saturation, intestinal transit time, or age at full oral feeds, none of the studies reported harmful effects from pacifier use. Overall, pacifier use appears to be a reasonable and inexpensive option for preterm infants.

Here are some disadvantages, though, ├ČObservational studies23├▒25 and a randomized controlled trial (RCT)21 showing that pacifier use is associated with early breast weaning have led to concerns. However, an RCT that studied the effect of pacifier use on breast-feeding in 281 mother-infant pairs for three months postpartum had a different conclusion.26 Although an observational association was noted between pacifier use and early weaning, when the data were analyzed further, the intervention (advice to avoid pacifier use) did not significantly reduce weaning at three months. The authors concluded that pacifier use may be a marker of breast-feeding difficulties, but does not appear to be the cause of early weaning. The intervention group used pacifiers less often, but had no significant difference in crying or fussing, suggesting that other soothing methods are as effective as pacifier use. A more recent RCT on preterm infants did not demonstrate a significant effect of pacifier use on early weaning.

A systematic review found inconsistent results regarding the effect of pacifier use on early childhood caries, suggesting that there is no proven correlation.29 A meta-analysis concluded that pacifier use after three years of age is associated with a higher incidence of malocclusion.30 In one study, the prevalence of malocclusion was roughly 71 percent in children who used a pacifier or sucked a digit for more than 48 months, compared with 32 percent in those who ceased sucking between 36 and 48 months, and 14 percent in those who ceased sucking before 24 months.31 The most significant malocclusions occurred in children who continued sucking habits beyond 48 months, but there were notable changes in children who continued beyond 24 months. A more recent study confirms these negative dental effects with pacifier use after two years of age.

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