If you haven’t read it yet, be sure to check out the first blog post in this 2-part series, Milestone or Modern Convenience?  – Part I: Overuse of the Sippy Cup and Pacifier, to learn important information about an infant’s need for sucking and the risks involved with overuse of the pacifier and sippy, cup!

Now that you are familiar with the pluses and minuses of pacifier and sippy cup use,  what about when the parents are ready to help baby “give up” the sucking habit?   Again, as the resource for all things infant and toddler, we can suggest the following tried and true strategies.

Strategies for Breaking the Sucking Habit

Cut back – When ready to begin weaning, cut back on the time that the pacifier and/or sippy cup is available to the child. If the pacifier has been available to the child all day, every day suggest cutting back its availability to only nap and bedtime.  As for the sippy cup, cut back its use to only when the family is out and about.  When at home suggest offering the child a straw or open cup in its place.

Go cold turkey…if the child is ready – If going cold turkey is the method of choice pass along this wisdom: if the child is not ready, he may find something else to suck on, like a thumb or fingers.  However, if ready, this method may work just fine.  Suggest that, if going cold turkey, it is a good idea to rid the house (or at least baby’s line of sight) of all pacifiers and/or sippy cups.  If they remain in the cabinet or drawer, baby will know and will want them!

Provide additional comfort – In preparation of weaning a baby from the pacifier and/or sippy cup, provide him with an additional comfort item. If the child’s only “lovey” is the pacifier or sippy cup, having a back up “lovey” will still allow the child a comfort when his first choice is gone.

Understand that routines may change – Warn your families that routines may change when weaning baby from the pacifier and/or sippy cup, especially if it is used as the child’s primary comfort item. When the pacifier/sippy cup is gone, the child may need assistance with calming, temporarily;  swaddling, rocking, singing and some extra cuddles may be necessary until baby learns how to calm himself without the help of his pacifier or sippy cup.

Give the pacifier or sippy away to a new baby – Sometimes parents can convince the child to give up these items with some incentive.  However, it is suggested that the new baby receiving the child’s old pacifiers/sippy cups not live in the same house.  It will be more difficult for the child not to suck on a pacifier if there is one nearby.  Some parents are also able to negotiate a trade with their child:  “If you leave your pacifier under the Christmas tree, Santa will take it with him and leave you a present!”  If the child is ready, this trick is a gem!

Strategies for Parents to Avoid

Some tips to warn parents to not try are:

Never, ever cut the pacifier nipple and give it to the child – Yes, if there is no nipple for the child to latch onto they will be less interested in sucking the pacifier.  However, the risk of choking is too great to ever recommend this as a means of pacifier weaning.  Pacifiers have to pass what is called a “pull test” (PDF, New Window) during manufacturing. A cut nipple would not pass this pull test and would be deemed as unsafe for a child to have.

Do not shame the child for wanting to suck on his pacifier or sippy cup – Toddlers and preschoolers typically do not respond to being shamed into giving up the pacifier or sippy cup.  Telling the child that in order to be a “big kid” he must give up his most prized possession may just make him want it more.  And who can blame him, who really wants to “grow up” anyway?!

Do not recommend putting something that tastes bad on the nipple of the pacifier and/or sippy cup – I have known families to dip the nipple in chili powder to convince their toddler to stop sucking on his pacifier.  One sweet little guy I knew still wanted his pacifier so badly that he licked the chili powder off, little by little, chased it with water and eventually got his paci back.  Again, this is a case of the parent wanting the child to make the decision to give up the comfort item.  Not gonna happen!  Sometimes the parent has to be just that and take control.

So we wish you good luck as you head into the magical world of the paci and sippy cup.  It holds a strong spell on many little ones, but with the right guidance and when our families are ready, we can help them help their children kick the habit!

Do you have any suggested weaning methods to add to this list? 

What would you say to encourage your families to follow through with weaning their child?

Lacy Morise, M.S. CCC/SLP educates families on the risks involved with over-use of the pacifier and sippy as an early intervention speech-language pathologist in the West Virginia Birth to Three Program.  She guiltily confesses to allowing all of her children to abuse the use of the pacifier!  She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY!  Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.

Website:  www.milestonesandmiracles.com

Blog:  www.milestonesandmiraces.com/blog/

Facebook: https://www.facebook.com/milestonesandmiracles

Pinterest: https://www.pinterest.com/milestonesm/

Twitter: https://twitter.com/MilestonesM

YouTube: https://www.youtube.com/watch?v=HmuWPFDcqZ4

The post Milestone or Modern Convenience? – Part II: What to Do When the Convenience Becomes a Hard to Break Habit appeared first on Early Intervention Strategies for Success.

Although shocking to many, the sippy cup is NOT a developmental milestone.  Nor is sucking on a pacifier, for that matter.  But why do we (therapists, parents and caregivers) celebrate these acquired “skills” as developmentally appropriate achievements?  Why do we allow these “skills” to happen for much longer than they should?  Is it just easier to always have a pacifier (aka mute button) in the baby/toddler’s mouth?  Sippy cups are so easy to take along with us everywhere, how can it be harmful if a preschooler continues to exclusively drink from one?

Benefits of the Pacifier and Sippy Cup

The pacifier is a great thing for infants. It meets a physiological need to suck and allows baby a way to comfort himself. It may reduce the risk of SIDS as it appears to allow baby’s airway to remain more open and prevent baby from falling into a deeper sleep. Not to mention the other fringe benefits like quieting rowdy babes, helping them sleep longer and making outings and car rides more enjoyable for all.  It certainly has a “place” in an infant’s world!  And the sippy cup is an awesome convenience must-have.  Drinks can be toted everywhere with baby/toddler and a sippy’s use means less spills to stain the carpet!  Beautiful!

Risks of Over-Use

But aside from these benefits, there are risks associated with the over-use of both.  Pediatricians and family physicians recommend weaning or stopping pacifier use in the second six months of life.  Shocking I know considering how many toddlers we see with pacifiers in their mouths!  The sippy cup can be skipped all together if natural development is occurring with no issue.  Created for convenience, the sippy cup now has an entire market (and aisle in most stores) devoted to it!  However a baby can transition to a straw (as early as 9 months) or open cup just as easily and drinking from both of these IS developmentally appropriate.

Key Points to Keep in Mind

As trusted resources on development, it is our job as early interventionists to inform families of both the positives and negatives of (prolonged) sucking.  Some points to keep in mind as you discuss these “milestones” with parents and caregivers:

Prolonged sucking on a pacifier puts children at (a higher) risk for misaligned teeth. As those tiny white pearls are erupting, the pressure of the nipple of the pacifier can cause teeth to move around and shift. Also, the pressure can cause their hard palate, the roof of their mouth directly behind the front teeth, to change. It can push the palate forward, again changing the position of the teeth. In his research, J. Poyak concludes, “The greater the longevity and duration of pacifier use, the greater the potential for harmful results.”

A sippy often allows access to drinks all day long for a toddler.  Not necessarily a bad thing, depending on what is in the sippy.  If it is a sugary drink, the sugar increases the risk of developing cavities.  The Medline Plus article titled, “Tooth decay – early childhood” states, “When children sleep or walk around with a bottle or sippy cup in their mouth, sugar coats their teeth for longer periods of time, causing teeth to decay more quickly.” Also, if a sippy is the only way a child gets liquids the developmentally appropriate skills of drinking through a straw and open cup are inhibited.

If children are allowed to have a drink (in a sippy or other cup) all the time, they may fill up on liquids and not eat meals as well, negatively impacting their nutrition.

Although inconsistent, research suggests a relationship between prolonged sucking and speech delays.  Barbosa et al. (2009) concluded in their research of 128 Patagonian preschoolers that, “The results suggest extended use of sucking outside of breastfeeding may have detrimental effects on speech development in young children.” When speech sound development is negatively impacted, so is the child’s intelligibility of speech making it difficult for others to understand them.

Sucking on a pacifier increases a child’s risk of developing otitis media (ear infection).  The AAP (American Academy of Pediatrics) and AAFP (American Academy of Family Physicians) advocate for limited to no use of the pacifier in the second six months of the child’s life to decrease this risk.

A pacifier or sippy cup that is always in the mouth of a child, even when the child is walking around, puts him/her at a higher risk for mouth injuries.  A 2012 study by Dr. Sarah Keim of Nationwide Children’s Hospital in Columbus, found that “a young child is rushed to a hospital every four hours in the U.S. due to an injury from a bottle, sippy cup or pacifier.”  When little ones are just learning to walk, doing two things at once requires a bit more coordination than they are capable of!

Besides the physical risks, beyond the age of 1 a stronger emotional attachment to the pacifier (or sippy cup) makes it increasingly difficult for the child to detach. The pacifier/sippy goes from meeting a physiological need during infancy to providing emotional comfort to the toddler when scared, upset or sleepy.

However, it is our job to know and respect the individuality of each child.  Therefore it is best practice to reassure parents that we recognize they know their child best.  We all want our children to be happy and if using a pacifier and/or sippy is what’s best for them and their family, that is okay.  Our job is to inform the families we serve the best we can.  Equipping them with knowledge on why prolonged sucking may be detrimental to their child allows the family to make the final call.  Education and Support, that’s what we are there for.

Have you ever had the “prolonged sucking” discussion with any of the families you serve? 

How might you begin this conversation with a family?

Today’s blog is Part I of a two-part series on prolonged sucking and what we can do to educate families about it.  Stay tuned for “Part II – What to do When the Convenience Becomes a Hard to Break Habit” next week featuring ideas you can share with families who are ready to wean their child off of the pacifier or sippy!

References

Barbosa, Clarita, Sandra Vasquez, Mary Parada, Juan Carlos Velez Gonzalez, Chanaye Jackson, N David Yanez, Bizu Gelaye, and Annette Fitzpatrick. “The Relationship of Bottle Feeding and Other Sucking Behaviors with Speech Disorder in Patagonian Preschoolers.” BMC Pediatrics. N.p., n.d. Web. 20 Mar. 2015. http://www.biomedcentral.com/1471-2431/9/66

EG, Gois, HC Rubeiro-Junior, MP Vale, SM Paiva, JM Serra-Negra, ML Ramos-Jorge, and IA Pordeus. “Influence of Nonnutritive Sucking Habits, Breathing Pattern and Adenoid Size on the Development of Malocclusion.” Angle Orthod.4 (2008): 647-54. Print. http://www.ncbi.nlm.nih.gov/pubmed/18302463

Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents (n.d.): n. pag. Web. 18 Mar. 2015. http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdf (PDF, New Window)

Hauck, Fern R., MD, MS, Olanrewaju O. Omojokun, MD, and Mir S. Siadaty, MD, MS. “Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis.” PEDIATRICS5 (2005): E716-723. Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis. PEDIATRICS. Web. 17 Mar. 2015.  http://pediatrics.aappublications.org/content/116/5/e716

Keim, Sarah A., MA, MS, Erica N. Fletcher, MPH, Megan R.W. Tepoel, MS, and Lara B. McKenzie, PhD, MA. “Injuries Associated With Bottles, Pacifiers, and Sippy Cups in the United States, 1991-2010.” N.p., n.d. Web. 19 Mar. 2015. http://pediatrics.aappublications.org/content/129/6/1104.long

Natale, Ruby, PhD, PsyD. “Risks and Benefits of Pacifiers.” American Family Physician79 (2009): 681-85. – American Family Physician. Web. 18 Mar. 2015. http://www.aafp.org/afp/2009/0415/p681.html

Poyak, J. “Effects of Pacifiers on Early Oral Development.” Int J Orthod Milwaukee4 (2006): 13-6. Print. http://www.ncbi.nlm.nih.gov/pubmed/17256438

Regulatory Summary for Pacifier (n.d.): n. pag. U.S. Consumer Product Safety Commission. Web. 18 Mar. 2015. http://www.cpsc.gov//PageFiles/120645/regsumpacifier.pdf (PDF, New Window)

“Tooth Decay – Early Childhood: MedlinePlus Medical Encyclopedia.” S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 17 Mar. 2015. http://www.nlm.nih.gov/medlineplus/ency/article/002061.htm

Zardetto, CG, CR Rodrigues, and FM Stefani. “Effects of Different Pacifiers on the Primary Dentition and Oral Myofunction Structures of Preschool Children.” Pediatric Dentistry6 (2002): 552-60. Print. http://www.ncbi.nlm.nih.gov/pubmed/12528948

Lacy Morise, M.S. CCC/SLP educates families on the risks involved with over-use of the pacifier and sippy as an early intervention speech-language pathologist in the West Virginia Birth to Three Program.  She guiltily confesses to allowing all of her children to abuse the use of the pacifier!  She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY!  Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.

Website:  www.milestonesandmiracles.com

Blog:  www.milestonesandmiraces.com/blog/

Facebook: https://www.facebook.com/milestonesandmiracles

Pinterest: https://www.pinterest.com/milestonesm/

Twitter: https://twitter.com/MilestonesM

YouTube: https://www.youtube.com/watch?v=HmuWPFDcqZ4

The post Milestone or Modern Convenience? – Part I: Overuse of the Sippy Cup & Pacifier appeared first on Early Intervention Strategies for Success.