New parents have a lot of decisions to make regarding their children’s physical well-being, many of which can be controversial: feed on demand or feed on a schedule, breastfeed or bottle-feed, circumcision or no circumcision, vaccines or no vaccines. Now, parents are getting mixed messages about a once-universal baby accessory that no one thought twice about, and it affects emotional health more than physical health. Pacifiers have been linked to emotional problems for boys later in life, according to a new study.

The study, conducted by psychologists at the University of Wisconsin, included three separate investigations that evaluated pacifier use and emotional health. For the first study, parents of 106 first- and second-grade children in France completed a questionnaire about their child’s pacifier use and thumb-sucking as babies and infants. The children were independently asked to watch a video of different emotions and mimic those expressions. (Facial mimicry is a component of emotional development.) For the second and third studies, college students from across the United States and France were asked to self-report pacifier use and thumb-sucking during their own childhoods, as well as complete surveys of emotional intelligence and reactivity and attachment to other people.

Each investigation led to the same conclusion: boys who used pacifiers frequently had lower emotional competence than other groups. According to the authors, boys who used a pacifier during the day had a difficult time mimicking the facial expressions and emotions of others, which makes it harder to express their own emotions.

While the study cannot draw definite cause-and-effects conclusions, the authors do report that the results remained consistent, regardless of other factors such as demographics, education levels, personalities and temperaments, and environment. Across all the investigations, a longer duration of pacifier use was associated with a greater degree of emotional incompetence. Thumb-sucking did not lead to the same effects, nor did girls who used a pacifier show emotional deficits. Night-time only pacifier use was not associated with negative consequences, either.

Pacifier use is controversial, with different organizations making different recommendations. The World Health Organization recommends limiting the use of pacifiers to reduce dental abnormalities and the incidence of ear infections. But, the American Academy of Pediatrics recommends pacifiers as a protective measure against Sudden Infant Death Syndrome for children under one year old. However, pacifiers have proven beneficial in analgesia for newborns and infants and reducing hospitalizations in preterm infants.

The study, published in Basic and Applied Social Psychology, cautions parents to consider limiting pacifier use in order to encourage emotional health. Many parents (and children) are reluctant to take away a pacifier, relying on it for comfort, security, and a little bit of quiet. Like everything else in parenthood, the decision to use a pacifier is a balancing act. Parents should consider the risks and benefits of a pacifier with their child’s physician and dentist and limit its use when the time is right.

References

Hauck FR, Omojokun OO, & Siadaty MS (2005). Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics, 116 (5) PMID: 16216900

Keim SA, Fletcher EN, TePoel MR, & McKenzie LB (2012). Injuries associated with bottles, pacifiers, and sippy cups in the United States, 1991-2010. Pediatrics, 129 (6), 1104-10 PMID: 22585773

Niedenthal PM, Augustinova M, Rychlowska M, et al. Negative relations between pacifier use and emotional competence. Basic and Applied Social Psychology. 2012; 34:387-394. DOI: 10.1080/01973533.2012.712019

Sexton S, & Natale R (2009). Risks and benefits of pacifiers. American family physician, 79 (8), 681-5 PMID: 19405412

Soxman JA (2007). Non-nutritive sucking with a pacifier: pros and cons. General dentistry, 55 (1) PMID: 17333970

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