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A pacifier is a
rubber Rubber, also called India rubber, latex, Amazonian rubber, ''caucho'', or ''caoutchouc'', as initially produced, consists of polymers of the organic compound isoprene, with minor impurities of other organic compounds. Thailand, Malaysia, and ...
,
plastic Plastics are a wide range of synthetic or semi-synthetic materials that use polymers as a main ingredient. Their plasticity makes it possible for plastics to be moulded, extruded or pressed into solid objects of various shapes. This adaptab ...
, or
silicone A silicone or polysiloxane is a polymer made up of siloxane (−R2Si−O−SiR2−, where R = organic group). They are typically colorless oils or rubber-like substances. Silicones are used in sealants, adhesives, lubricants, medicine, cooking ...
nipple The nipple is a raised region of tissue on the surface of the breast from which, in females, milk leaves the breast through the lactiferous ducts to feed an infant. The milk can flow through the nipple passively or it can be ejected by smooth mu ...
substitute given to an
infant An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to ...
to suckle upon between feedings to quiet its distress by satisfying the need to suck when it does not need to eat. Pacifiers normally have three parts: an elongated
teat A teat is the projection from the mammary glands of mammals from which milk flows or is ejected for the purpose of feeding young. In many mammals the teat projects from the udder. The number of teats varies by mammalian species and often corre ...
, a handle, and a mouth shield which prevents the child from swallowing or
choking Choking, also known as foreign body airway obstruction (FBAO), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract. An obstruction that prevents oxygen from entering the lungs results in oxygen de ...
on it. Pacifiers have many different informal names: ''binky'' or ''wookie'' (
American English American English, sometimes called United States English or U.S. English, is the set of variety (linguistics), varieties of the English language native to the United States. English is the Languages of the United States, most widely spoken lan ...
), ''dummy'' (
Australian English Australian English (AusE, AusEng, AuE, AuEng, en-AU) is the set of varieties of the English language native to Australia. It is the country's common language and ''de facto'' national language; while Australia has no official language, Engli ...
and
British English British English (BrE, en-GB, or BE) is, according to Lexico, Oxford Dictionaries, "English language, English as used in Great Britain, as distinct from that used elsewhere". More narrowly, it can refer specifically to the English language in ...
), ''piece'','' paci'', '' bo-bo'', ''nookie'', ''teething ring'', ''device'', ''sugar tit'', ''teether'', ''comforter'', ''soother'' (
Canadian English Canadian English (CanE, CE, en-CA) encompasses the varieties of English native to Canada. According to the 2016 census, English was the first language of 19.4 million Canadians or 58.1% of the total population; the remainder spoke French ( ...
and
Hiberno-English Hiberno-English (from Latin ''Hibernia'': "Ireland"), and in ga, Béarla na hÉireann. or Irish English, also formerly Anglo-Irish, is the set of English dialects native to the island of Ireland (including both the Republic of Ireland a ...
), and ''Dodie'' (Hiberno-English).


History

Pacifiers were mentioned for the first time in medical literature in 1473, being described by German physician
Bartholomäus Metlinger Bartholomäus Metlinger (born in Augsburg – died c. 1491) was a German physician of the Late Middle Ages. Metlinger graduated in 1470 from the University of Bologna. He was city physician () in Nördlingen from 1476 to 1483, when he took the sa ...
in his book ''Kinderbüchlein'', in later editions retitled ''Regiment der jungen Kinder'' ("Caring For Young Children"). In England in the 17th–19th centuries, a ''coral'' was a teething toy made of coral, ivory or bone, often mounted in silver as the handle of a rattle. A museum curator has suggested that these substances were used as "sympathetic magic" and that the animal bone could symbolize animal strength to help the child cope with pain. Pacifiers were a development of hard teething rings, but they were also a substitute for the softer ''
sugar tit Sugar tit is a folk name for a baby pacifier, or dummy, that was once commonly made and used in North America and Britain. It was made by placing a spoonful of sugar, or honey, in a small patch of clean cloth, then gathering the cloth around the s ...
s'', ''sugar-teats'' or ''sugar-rags'' which had been in use in 19th century America. A writer in 1873 described a "sugar-teat" made from "a small piece of old linen" with a "spoonful of rather sandy sugar in the center of it", "gathered ... up into a little ball" with a thread tied tightly around it. Rags with foodstuffs tied inside were also given to babies in many parts of Northern Europe and elsewhere. In some places a lump of meat or fat was tied in cloth, and sometimes the rag was moistened with brandy. German-speaking areas might use ''Lutschbeutel'', cloth wrapped around sweetened bread or poppy-seeds. A
Madonna Madonna Louise Ciccone (; ; born August 16, 1958) is an American singer-songwriter and actress. Widely dubbed the " Queen of Pop", Madonna has been noted for her continual reinvention and versatility in music production, songwriting, a ...
and child painted by Dürer in 1506 shows one of these tied-cloth "pacifiers" in the baby's hand. Pacifiers were settling into their modern form around 1900 when the first teat, shield and handle design was patented in the US as a "baby comforter" by
Manhattan Manhattan (), known regionally as the City, is the most densely populated and geographically smallest of the five boroughs of New York City. The borough is also coextensive with New York County, one of the original counties of the U.S. state ...
pharmacist Christian W. Meinecke. Rubber had been used in flexible teethers sold as "elastic gum rings" for British babies in the mid-19th century,The history of the feeding bottle
babybottle-museum.co.uk
and also used for feeding-bottle teats. In 1902, Sears, Roebuck & Co. advertised a "new style rubber teething ring, with one hard and one soft nipple". And in 1909 someone calling herself "Auntie Pacifier" wrote to the ''New York Times'' to warn of the "menace to health" (she meant dental health) of "the persistent, and, among poorer classes, the universal sucking of a rubber nipple sold as a 'pacifier'." In England too, dummies were seen as something the poorer classes would use, and associated with poor hygiene. In 1914 a
London London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
doctor complained about "the dummy teat": "If it falls on the floor it is rubbed momentarily on the mother's blouse or apron, lipped by the mother and replaced in the baby's mouth." Early pacifiers were manufactured with a choice of black, maroon or white rubber, though the white rubber of the day contained a certain amount of lead. ''Binky'' (with a ''y'') was first used in about 1935 as a trademarked brand name for pacifiers and other baby products manufactured by the Binky Baby Products Company of New York. The brand name is currently owned by Playtex Products, LLC as a trademark in the U.S. (and a number of other countries).


Drawbacks

There are negative effects from using a pacifier during
breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that br ...
for healthy babies. The AAP suggests avoiding pacifiers for the first month. Introducing a pacifier can lead to the infant ineffectively sucking at the breast and causing "
nipple confusion Nipple confusion is the tendency of an infant to unsuccessfully adapt between breast-feeding and bottle-feeding. It can happen when the infant is put back onto breast-feeding. Nipple confusion can turn into nipple refusal in which the infant refuse ...
". Babies will take their suck out on the pacifier instead of nursing or comfort nursing at the breast which is good for the mother's supply. Evidence in premature infants or infants that are not healthy is lacking but shows that it can have benefits. It may have clinical benefits for preterm babies, such as helping them progress from tube to bottle feeding. Infants who use pacifiers may have more ear infections (
otitis media Otitis media is a group of inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, ...
). The effectiveness of avoiding the use of a pacifier to prevent ear infections is not known. Although it is commonly believed that using a pacifier will lead to dental problems, it does not appear to lead to long-term damage if used for less than around three years. However, prolonged use of a pacifier or other non-nutritive sucking habit (such as finger or blanket sucking) has been found to lead to
malocclusion In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855-1930), ...
of the teeth, that is teeth sticking out or not meeting properly when they bite together. This is a common problem and the dental (
orthodontic Orthodontics is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, and misaligned bite patterns. It may also address the modification of facial growth, known as dentofacial ...
) treatment to correct it can take a long time and can be expensive. A Cochrane Review of the evidence found that
orthodontic braces Dental braces (also known as braces, orthodontic cases, or cases) are devices used in orthodontics that align and straighten teeth and help position them with regard to a person's bite, while also aiming to improve dental health. They are ofte ...
or
psychological intervention In applied psychology, interventions are actions performed to bring about change in people. A wide range of intervention strategies exist and they are directed towards various types of issues. Most generally, it means any activities used to modif ...
(such as positive or negative reinforcement) were effective in helping children stop sucking habits where that was necessary. An orthodontic brace that used a palatal crib design seems to have been more effective than a palatal arch design. There appears to be no strong evidence that using a pacifier delays speech development by preventing babies from practicing their speaking skills.


Benefits

Researchers have found that use of a pacifier is associated with a substantial reduction in the risk of
sudden infant death syndrome Sudden infant death syndrome (SIDS) is the sudden unexplained death of a child of less than one year of age. Diagnosis requires that the death remain unexplained even after a thorough autopsy and detailed death scene investigation. SIDS usuall ...
. They are divided over whether this association is sufficient reason to prefer pacifier use. Some argue that pacifiers should be recommended on the strength of an association, just as back sleeping was recommended on the strength of an association. Others argue that the association is not strong enough or that the mechanism is unclear. Pacifiers have also been found to reduce infants' crying during painful procedures such as venipuncture. Some parents prefer the use of a pacifier to the child sucking their thumb or fingers. Researchers in Brazil have shown that neither "orthodontic" nor standard pacifiers prevent dental problems if children continue sucking past the age of three years. It is commonly reported anecdotally that pacifier use among stimulant users helps reduce
bruxism Bruxism is excessive teeth grinding or jaw clenching. It is an oral parafunctional activity; i.e., it is unrelated to normal function such as eating or talking. Bruxism is a common behavior; reports of prevalence range from 8% to 31% in the gene ...
and thus prevents tooth damage. It is also known to help infants to get to sleep and also keeps infants calm.


Medical policies

The
American Academy of Pediatric Dentistry American(s) may refer to: * American, something of, from, or related to the United States of America, commonly known as the "United States" or "America" ** Americans, citizens and nationals of the United States of America ** American ancestry, pe ...
's "Policy on Thumb, Finger and Pacifier Habits" says: "Most children stop sucking on thumbs, pacifiers or other objects on their own between 2 and 4 years of age. However, some children continue these habits over long periods of time. In these children, the upper front teeth may tip toward the lip or not come in properly. Frequent or intense habits over a prolonged period of time can affect the way the child's teeth bite together, as well as the growth of the jaws and bones that support the teeth." A study of
sudden infant death syndrome Sudden infant death syndrome (SIDS) is the sudden unexplained death of a child of less than one year of age. Diagnosis requires that the death remain unexplained even after a thorough autopsy and detailed death scene investigation. SIDS usuall ...
(SIDS) states that "It seems appropriate to stop discouraging the use of pacifiers." The authors recommend the use of pacifiers at nap time and bedtime throughout the first year of life. For breastfeeding mothers, the authors suggest waiting until breastfeeding is well established, typically for several weeks, before introducing the pacifier. The British Dental Health Foundation recommends: "If you can, avoid using a dummy and discourage thumb sucking. With prolonged use (see Drawbacks above), these can both eventually cause problems with how the teeth grow and develop. And this may need treatment with a brace when the child gets older."


Prevalence of attachments to pacifiers and their psychological functions

In the late 1970s researchers dispelled the notion that pacifiers were psychologically unhealthy and aberrant. Richard H. Passman and Jane S. Halonen at the University of Wisconsin-Milwaukee traced the developmental course of attachments to pacifiers and provided norms. They found that 66% of their sample of babies who were three months old in the United States demonstrated at least some attachment, according to their mothers. At six months of age, this incidence was 40%, and at nine months it was 44%. Thereafter, the rate of attachment to pacifiers dropped precipitously until, at 24 months of age and later, it was quite rare. These researchers also provided experimental support for what were then only anecdotal observations that pacifiers do indeed pacify babies. In an unfamiliar playroom, one-year-old infants accompanied by their pacifier evidenced more play and demonstrated less distress than did babies without them. The investigators concluded that pacifiers should be considered to be attachment objects, similar to other security objects like blankets. Passman and Halonen contended that the widespread occurrence of attachments to pacifiers as well as their importance as security objects should reassure parents that they are a normal part of development for a majority of infants.


See also

* Pacifier-activated lullaby * Security blanket


References


External links

{{Commons category, Pacifiers
"Who Made That Pacifier?"
by Dashka Slater, ''
The New York Times Magazine ''The New York Times Magazine'' is an American Sunday magazine Supplement (publishing), supplement included with the Sunday edition of ''The New York Times''. It features articles longer than those typically in the newspaper and has attracted man ...
'', June 20, 2014
Information for parents on preventing middle ear infections
from
PubMed Health PubMed is a free search engine accessing primarily the MEDLINE database of references and abstracts on life sciences and biomedical topics. The United States National Library of Medicine (NLM) at the National Institutes of Health maintain the ...
Dental equipment Infancy Rubber products