To spit the dummy or not to spit the dummy? That is the question.

Dr Breanne Kunstler (BBiomedSci, BHealthSci, MPhysio, PhD).

Yesterday I went to pick up Abby from daycare with my husband, Ben. It was a really warm day so we walked the short distance to the centre, enjoying the sunshine and chatting about mundane things.

When we enrolled Abby in childcare we were asked 'Does your child have a routine?'. Well, no, I don't really think so. It's not like I watch the clock and once it hits 8.04am she must be fed, or changed, or have some playtime, or nap...we aren't strict when it comes to routines. We just respond to Abby's needs when she has them. I think this chilled approach has worked well for starting childcare because the educators get some freedom to do what works for them and Abby. I think this is a good thing; it's good for Abby to experience different ways of doing things. Although yesterday I discovered that there is one thing that I am passionate about Abby not having: a dummy.

I walked into the childcare centre and there is a calm looking Abby with some strange object in her mouth. It was a spare dummy they had at the centre and decided to use because she was unsettled. I said very nicely and calmly that I would prefer for them not to use a dummy in future and to use the other methods they have previously used to calm her. I didn't spit the dummy per se, but I felt a bit pissed off that neither myself nor Ben were consulted first. This childcare centre is great, don't get me wrong, but we're still new to each other and have some "teething issues" to work through...so to speak.

After we got Abby home from care I started to think about why I am so against dummies. What's the big deal? Now, I'm not demonising dummies and I am CERTAINLY NOT saying that people shouldn't use them. Use what works for you and your family. Abby has a habit of trying to fit her entire fist in her mouth when she wants some soothing (Image 1). This is fine with me. I'd much prefer her do that than use a dummy because she is in complete control over the situation. If she wants something in her mouth, she finds it and puts it there. I don't need to intervene and put it in there myself, which means less waking up in the middle of the night for me. Having a baby really teaches you how to appreciate and protect your sleep.

Image 1: Abby sitting with my mum on Christmas day making a feast out of her fist.

Apart from my own personal reasons for not wanting to use the dummy, I thought that there's surely some other reasons why people prefer to use or not to use dummies. The main reason that comes to mind is the potential effects on oral health as babies start to develop a mouth full of teeth. So, I thought I'd look into the literature a bit and see if there really are any harms (or benefits) associated with dummy or pacifier use. 

Benefits associated with dummy use

My mum used to soak our dummies in glycerol or sucrose and shove them in our mouths as a highly successful way to make us shut up and sleep if we were in pain or just generally grumpy. Other parents would do something similar, except instead of glycerol they'd be using whisky (Image 2). So, there's certainly anecdotal evidence that dummies (with some help from tasty fluids) can soothe an upset baby, and that's certainly a good thing.

Image 2: I'm pretty sure being drunk helps to mask pain (credit: Memedroid)

Using dummies is also thought to reduce SIDS risk, which is clearly a huge positive. It is thought that the forward position of the tongue, thereby avoiding blocking of the throat, and making it easier for a newborn to breathe through the mouth if the nose is blocked gives dummies this protective feature.

Harms associated with dummy use

Acute otitis media, or ear infections, can be caused by dummy use. It remains unclear how dummy use actually leads to the development of an ear infection though. This has led experts to recommend ceasing dummy use after 6 months of age.

Dummy use might also increase breastfeeding difficulties, leading to early breastfeeding cessation, as it has the potential to cause nipple confusion. Mothers have been actively warned to avoid dummy use for at least one month postnatally if they want to avoid nipple confusion and establish an effective breastfeeding relationship with their newborn. However, nipple confusion is thought to be more of a concern when using bottles rather than using dummies (Image 3) and the evidence to say that dummies can cause breastfeeding difficulties is currently contradictory.

Image 3: Abby feeds from the bottle and the boob perfectly fine. No confusion for this bub!

A lot of parents worry about dummy use causing crooked teeth, but there's high quality evidence to say that this won't happen as long as dummy use stops by age 2 to 3. 

Dummy use is also thought to increase the chance of infants developing cavities because the dummy stops the natural movement of saliva through the mouth, limiting natural cleansing. Furthermore, parents are also often concerned that dummy use might negatively impact speech. However, there's no evidence that dummies cause either of these things. 

I found a study that suggested that infants who use dummies for more than 24 months have an increased chance of becoming smokers when they are teenagers. I never thought about that!

Verdict

I can't be stuffed getting up in the middle of the night just to put Abby's dummy back in her mouth, so I'm going to avoid introducing it. When it comes to the benefits and the harms associated with dummy use, I wonder if the same apply to her using her fist? Let's wait and see if she becomes a teen smoker before I can answer that one.

Thanks for reading.