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infants and dummies

A dummy is an object that is shaped for a baby's mouth and is used for comforting a baby when there is a need for extra sucking. Some babies have a constant need for sucking on their fingers, thumb, or dummies, while others do not show a need for extra sucking. Extra sucking is usually a self-comforting behaviour. Sucking on a dummy can offer security and comfort to many babies. The need for extra sucking is a natural habit. Many babies sucked their thumb or fingers even before being born. While some caregivers rely on letting the infant suck on their thumb or fingers, others may offer a dummy to a baby.

What is the information for this topic? 
There are different opinions about using dummies. Parents often wonder if it is okay to use them. All babies have a need to suck, but the amount of sucking varies from baby to baby. Some want to suck all of the time, and others suck only during feeding. With some infants, the urge to suck seems to be more than what's needed for nutrition. It appears babies suck to comfort themselves when they're upset. It's also a way of exploring things. In some cases, sucking might be just a way for babies to pass the time.

Babies appear more willing to take a dummy between the ages of 2 to 4 months old. This appears to be the peak age in the need for extra sucking. After this age the sucking drive usually decreases. Many parents oppose the use of dummies, as they see the dummy as an "object used to pacify a baby" rather than an object used to satisfy the sucking need. Other parents favour the use of a dummy to meet the need for extra sucking, and as an alternative for thumb sucking.

There are many suggestions to consider when using a dummy. These include:
  • Using the dummy between meals, when a baby is not hungry, will minimise interference with normal feeding patterns.
  • A dummy may be soothing at naptime or bedtime to help an infant fall asleep. When an infant is young, he or she may need a caregiver to find the dummy if it falls out of their mouth. As the infant becomes older, he or she may be able to find the dummy and start sucking independently.
  • When an infant cries, it is important to try to hold and cuddle the infant. Dummies should not take the place of bonding between a caregiver and an infant. A dummy should not be placed in a baby's mouth every time he or she cries. A dummy may be used to satisfy the need for extra sucking above and beyond feeding from a bottle or breast. When a child is upset or stressed he or she may have a need for extra sucking as a security. A caregiver can also provide security by holding, rocking, singing to, or playing with a child.
When purchasing a dummy, the following points may be helpful:
  • Look for one-piece dummies that have a soft nipple. Some two piece dummies can come apart and be a choking hazard.
  • dummies usually come in two sizes, one for children under 6 months of age and another for children older than 6 months. Purchasing a dummy that is age appropriate will offer more comfort based on the way the dummy fits in the mouth.
  • The shield of the dummy should be at least 3.5cm to 4.0cm across, so it cannot fit entirely into a child's mouth, again becoming a choking hazard. A dummy with a shield made of firm plastic with air holes will reduce skin irritation around the mouth.
  • Purchasing a dummy that is dishwasher safe helps to keep the dummy cleaner. It's a good idea to boil the dummy or run it through the dishwasher before using it for the first time and frequently after use. This is especially important with a child 6 months of age or younger, who is more vulnerable to germs.
  • dummies come in different shapes. Some are almost a square orthodontic-shaped, and some are shaped like the nipple on a baby bottle. The orthodontic shaped dummy is often recommended by dentists and doctors because it may prevent tongue thrusting. However, the standard dummy that is shaped like the top of a baby bottle usually causes no problems. Trying different dummies and allowing a baby to choose the dummy they like, by trial and error, is another option.
  • It is helpful to buy extra dummies in case one is lost, dirty, or broken.
Some precautions to consider with dummy use are:
  • Never tie a dummy around the baby's neck. The cord may strangle the baby's neck. There are holders for dummies that have a clip that can attach to the baby's clothes. This special cord is short enough to prevent it from wrapping around the baby's neck, but will also help keep the dummy from falling on the ground.
  • dummies wear out and fall apart over time. It is a good idea to check the dummy frequently for torn rubber or any change in colour.
  • Homemade dummies, made from a nipple taped to a bottle cap, can also come apart and present a choking hazard.
  • Coating the dummy with honey may cause a serious disease, known as infant botulism.
  • Coating a dummy with any sweet fluids may cause dental caries.
  • The dummy should be rinsed after each use or after it drops on the floor, to decrease exposure to germs.
  • Certain chemicals that were once used in production of dummies are no longer recommended. dummies made with diisononyl phthalate (DINP) or phthalate esters are not recommended for use. These chemicals are "plasticisers" that can be released during sterilisation and contaminate the nipple of the dummy.
Parents may hear controversy over dummy use. In most cases, limited use of dummies will not cause medical or dental problems as long as a child stops using the dummy before the permanent teeth erupt. In some cases, if a dummy is used frequently or a child sucks vigorously on a dummy, damage to the top of the mouth or the alignment of the permanent teeth can occur. If dummy use continues after the permanent teeth begin to come in, damage to the roof of the mouth or alignment of the teeth can also occur. If a caregiver is concerned about the way the child's teeth are erupting, consulting with a paediatric dentist is appropriate.

It may be helpful to stop using a dummy in stages. This may make the transition of discontinuing dummy use smoother. When the child starts to crawl, it may help to decrease the availability of the dummy. As language and speech begin to develop, especially after 12 months of age, it may help to limit the dummy to times of stress or fatigue. Sometimes keeping the dummy in the crib for use at nap time or bedtime is also helpful. Picking a special occasion or way of giving up the dummy may make the transition of getting rid of the dummy smoother. Caregivers should pick a time to discontinue dummy use when the child is not coping with new stresses, such as travelling, moving or adjusting to a new baby. A child should not be forced to give up a dummy through punishment or humiliation. If there is great difficulty getting a child to stop using a dummy, parents may consult with the child's doctor. When a child is stressed and doesn't have the dummy any longer, a parent can offer cuddling, comforting and support. Playing games, holding or talking may also distract the child from stressful periods. When the child does give up the dummy, caregiver should offer praise and support for doing a grown up thing.

Author: Eileen McLaughlin, RN, BSN
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 14/12/2004
Potential conflict of interest information for reviewers available on request

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