Although shocking to many, the sippy cup is NOT a developmental milestone.\u00a0 Nor is sucking on a pacifier, for that matter.\u00a0 But why do we (therapists,![\"Baby](\"https:\/\/www.veipd.org\/earlyintervention\/wp-content\/uploads\/2015\/05\/DSC05445-300x225.jpg\")
parents and caregivers) celebrate these acquired \u201cskills\u201d as developmentally appropriate achievements?\u00a0 Why do we allow these \u201cskills\u201d to happen for much longer than they should?\u00a0 Is it just easier to always have a pacifier (aka mute button) in the baby\/toddler\u2019s mouth?\u00a0 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?<\/p>\n
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<\/a> as it appears to allow baby\u2019s 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.\u00a0 It certainly has a \u201cplace\u201d in an infant\u2019s world!\u00a0 And the sippy cup is an awesome convenience must-have.\u00a0 Drinks can be toted everywhere with baby\/toddler and a sippy\u2019s use means less spills to stain the carpet!\u00a0 Beautiful!<\/p>\n But aside from these benefits, there are risks associated with the over-use of both.\u00a0 Pediatricians and family physicians recommend weaning or stopping pacifier use<\/a> in the second six months of life.\u00a0 Shocking I know considering how many toddlers we see with pacifiers in their mouths!\u00a0 The sippy cup can be skipped all together if natural development is occurring with no issue.\u00a0 Created for convenience, the sippy cup now has an entire market (and aisle in most stores) devoted to it!\u00a0 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.<\/p>\n As trusted resources on development, it is our job as early interventionists to inform families of both the positives and negatives of (prolonged) sucking.\u00a0 Some points to keep in mind as you discuss these \u201cmilestones\u201d with parents and caregivers:<\/p>\n Prolonged sucking on a pacifier puts children at (a higher) risk for misaligned teeth.<\/strong> 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<\/a>, J. Poyak concludes, \u201cThe greater the longevity and duration of pacifier use, the greater the potential for harmful results.\u201d<\/p>\n A sippy often allows access to drinks all day long for a toddler.\u00a0<\/strong> Not necessarily a bad thing, depending on what is in the sippy.\u00a0 If it is a sugary drink, the sugar increases the risk of developing cavities. \u00a0The Medline Plus article\u00a0titled, \u201cTooth decay \u2013 early childhood\u201d<\/a> states, \u201cWhen 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.\u201d 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.<\/p>\n 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.<\/strong><\/p>\n Although inconsistent, research suggests a relationship between prolonged sucking and speech delays.<\/strong>\u00a0 Barbosa et al. (2009) <\/a>concluded in their research of 128 Patagonian preschoolers that, \u201cThe results suggest extended use of sucking outside of breastfeeding may have detrimental effects on speech development in young children.\u201d When speech sound development is negatively impacted, so is the child\u2019s intelligibility of speech making it difficult for others to understand them.<\/p>\n Sucking on a pacifier increases a child\u2019s risk of developing otitis media (ear infection).\u00a0<\/strong> The AAP (American Academy of Pediatrics) and AAFP (American Academy of Family Physicians)<\/a>\u00a0advocate for limited to no use of the pacifier in the second six months of the child\u2019s life to decrease this risk.<\/p>\n 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.<\/strong>\u00a0 A 2012 study<\/a> by Dr. Sarah Keim of Nationwide Children\u2019s Hospital in Columbus, found that \u201ca 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.\u201d\u00a0 When little ones are just learning to walk, doing two things at once requires a bit more coordination than they are capable of!<\/p>\n 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.<\/strong> The pacifier\/sippy goes from meeting a physiological need during infancy to providing emotional comfort to the toddler when scared, upset or sleepy.<\/p>\n However, it is our job to know and respect the individuality of each child.\u00a0 Therefore it is best practice to reassure parents that we recognize they know their child best.\u00a0 We all want our children to be happy and if using a pacifier and\/or sippy is what\u2019s best for them and their family, that is okay.\u00a0 Our job is to inform the families we serve the best we can.\u00a0 Equipping them with knowledge on why prolonged sucking may be detrimental to their child allows the family to make the final call.\u00a0 Education and Support, that\u2019s what we are there for.<\/p>\n Have you ever had the \u201cprolonged sucking\u201d discussion with any of the families you serve?\u00a0 <\/strong><\/p>\n How might you begin this conversation with a family?<\/strong><\/p>\n Today\u2019s blog is Part I of a two-part series on prolonged sucking and what we can do to educate families about it.\u00a0 Stay tuned for \u201cPart II \u2013 What to do When the Convenience Becomes a Hard to Break Habit\u201d next week featuring\u00a0ideas you can share with families who are ready to wean their child off of the pacifier or sippy!<\/p>\n References<\/strong><\/p>\n 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<\/em>. N.p., n.d. Web. 20 Mar. 2015. http:\/\/www.biomedcentral.com\/1471-2431\/9\/66<\/a><\/p>\n 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.<\/em>4 (2008): 647-54. Print. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18302463<\/a><\/p>\n Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance\/Counseling, and Oral Treatment for Infants, Children, and Adolescents<\/em> (n.d.): n. pag. Web. 18 Mar. 2015. http:\/\/www.aapd.org\/media\/Policies_Guidelines\/G_Periodicity.pdf<\/a> (PDF, New Window)<\/p>\n 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.” PEDIATRICS<\/em>5 (2005): E716-723. Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis<\/em>. PEDIATRICS. Web. 17 Mar. 2015.\u00a0 http:\/\/pediatrics.aappublications.org\/content\/116\/5\/e716<\/a><\/p>\n 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<\/a><\/p>\n Natale, Ruby, PhD, PsyD. “Risks and Benefits of Pacifiers.” American Family Physician<\/em>79 (2009): 681-85. – American Family Physician<\/em>. Web. 18 Mar. 2015. http:\/\/www.aafp.org\/afp\/2009\/0415\/p681.html<\/a><\/p>\n Poyak, J. “Effects of Pacifiers on Early Oral Development.” Int J Orthod Milwaukee<\/em>4 (2006): 13-6. Print. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17256438<\/a><\/p>\n Regulatory Summary for Pacifier<\/em> (n.d.): n. pag. U.S. Consumer Product Safety Commission. Web. 18 Mar. 2015. http:\/\/www.cpsc.gov\/\/PageFiles\/120645\/regsumpacifier.pdf<\/a> (PDF, New Window)<\/p>\n “Tooth Decay – Early Childhood: MedlinePlus Medical Encyclopedia.” S National Library of Medicine<\/em>. U.S. National Library of Medicine, n.d. Web. 17 Mar. 2015.\u00a0http:\/\/www.nlm.nih.gov\/medlineplus\/ency\/article\/002061.htm<\/a><\/p>\n Zardetto, CG, CR Rodrigues, and FM Stefani. “Effects of Different Pacifiers on the Primary Dentition and Oral Myofunction Structures of Preschool Children.” Pediatric Dentistry<\/em>6 (2002): 552-60. Print.\u00a0http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12528948<\/a><\/p>\n 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.\u00a0 She guiltily confesses to allowing all of her children to abuse the use of the pacifier!\u00a0 She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY!\u00a0 Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.<\/p>\n Website:\u00a0 www.milestonesandmiracles.com<\/a><\/p>\n Blog:\u00a0 www.milestonesandmiraces.com\/blog\/<\/a><\/p>\n Facebook: https:\/\/www.facebook.com\/milestonesandmiracles<\/a><\/p>\n Pinterest: https:\/\/www.pinterest.com\/milestonesm\/<\/a><\/p>\nRisks of Over-Use<\/h2>\n
Key Points to Keep in Mind<\/h2>\n
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