Should you use a baby dummy?

To spit the dummy?

The dummy, or the “pacifier” as it known in other countries, is considered by many  to be an essential shopping-list item to welcome your newborn into the world. A cursory search online about whether we should, or should not, be using a dummy provides conflicting and emotionally charged viewpoints on the subject. 

Historically, dummies have been around for centuries. Some tombs dating back to 3000 years ago had clay objects with one end having a hole for honey to pacify the newborn. Since then various materials were used, including a piece of fabric padded with food inside or alcohol (brandy). The alcohol-laced dummy was promoted as a way to calm a restless infant and help them sleep! Interestingly, dummies were banned by the French in 1926 as they were perceived to be dangerous and unhygienic. 

The modern-day dummy

The first modern-day dummy is commonly accepted to have been invented by Christian W. Meinecke. Christian, a Manhattan pharmacist, patented the modern-day dummy using rubber. For the unfortunate infants of the time, they had to endure the smell of foul-smelling sulphur. The shields were made of aluminium, ivory or bone. Some dummies were coated with white, lead-containing paint.

This article is intended to separate fact from fiction and provide you with a proper understanding of the baby dummy, should you choose to use it for your newborn or toddler.

Dummies and SIDS

Whether you grew up with a dummy in your mouth or a silver spoon, we can all make an impact on our current and future generation of young stars by getting them off to a better start in life.

One online resource, suggests that after 4 weeks of life there is a reduced risk of SIDS (Sudden Infant Death Syndrome) when dummies are used during times of rest. This was also confirmed by the 2012 NHMRC Australian report. The reasons are not clear as to how a pacifier reduces this risk. My own cranial-dental viewpoint is that breathing during sleep is impaired as the muscles maintaining a proper airway begin to relax.

An “oral” appliance may improve breathing if it increases the vertical height of the oral cavity. In addition, the sucking reflex stimulates the “pumping” of cerebrospinal fluid (CSF fluid) around the spinal cord. Our central nervous system lacks a lymphatic drainage system, and neuroscientists have been intrigued for many years as to how the body flushes out the toxins. Recent findings suggest that it is only during deep sleep that this flushing out of toxins occurs. For those interested, watch neuroscientist Jeff Illif discuss these fascinating findings.

Dummies as pacifiers

Pacifiers are known to have a calming effect on infants particularly for those under 6 months of age for pain relief when undergoing minor hospital procedures. Both natural sugars found in breast milk, or a small amount of sucrose on a dummy within a few minutes of a hospital procedure has analgesic effects.

The surgical procedure of tongue-tie release in babies unable to breastfeed (from restricted tongue movement) is routinely performed now in Australia. Interestingly, mothers can usually settle their babies quickly just with breastmilk alone.

The 2012 NHMRC report titled Infant Feeding Guidelines performed a systematic review and implicated that if  a dummy was to be used, it may have the following negative effects:

1) Interference with the natural process of breastfeeding: The infant sucking capacity is diminished, the breast-milk stimulation is decreased and a there is a reduced duration of breastfeeding in general.

2) An infant learning to breastfeed for the first time may suffer with “nipple confusion” as the natural reflex of suckling for milk is substituted for a synthetic “non-nutritive” alternative.

Dummy concerns

Other concerns from the usage of dummies include:

1) A higher rate of middle ear infections (otitis media). This may be from the reflux of nasal passage secretions. Alternatively, germs from the dummy may be entering the eustachian tube (that leads into the middle ear).

2) A higher rate of fungal overgrowth and tooth-decay causing bacteria. This is especially true if mothers have been in the habit of placing it in their own mouth first or dipping the teat in any sugary substance.

3) Dental and oral deformity: One little known fact is that breastfeeding for the first 12 months (if possible) helps mould and develop the upper jaw correctly. Early work by Weston A. Price, clearly demonstrated the clear advantage to an infants facial and dental development from adopting a more “natural diet”.

Baby sucking on breast
Proper tongue position when breastfeeding

A cursory search online about whether we should, or should not, be using a dummy provides conflicting and emotionally charged viewpoints on the subject.

Without entering into a debate of bottle vs breastfeeding, a few general things are universally accepted. One of these is bottle feeding or dummy usage till 3 or 4 years of age is more likely to create misshapen upper jaw bones and a dental “malocclusion”. If we back up even before this age, a posterior dental cross bite can often be seen as early as the age of 2 from a narrowing of the upper arch. 

The long-term usage of the dummy creates weak oral muscles and encourages the tongue to remain low in the mouth. There is a tendency for a proper lip seal at rest, which encourages mouth breathing, to be lost. Some of the “functional” consequences of prolonged dummy use may include a “reverse swallow” or tongue thrust when swallowing, narrow protruding upper teeth and a lack of cheek bone development.

Baby being bottle fed

Impact on emotional development

On another note, research on infants, particularly boys, found that prolonged dummy usage was linked with impaired emotional development. An infant’s ability to mimic, communicate and develop facial expressions consistent with their emotional state is stunted by the dummy. Unfortunately, it is not just the caregivers that are left clueless as to their emotional needs. The newborn grows up with a reduced tendency for empathy and emotional intelligence.

Silver spoon advice

In conclusion, based on the current available evidence it would be strongly advisable to:

1) Only introduce the dummy after 4 weeks of age if you are breastfeeding.

2) Avoid contaminating the dummy with your own mouth and use a dummy cover when not in use.

3) There may be some benefits to dummy usage during sleep and reducing the risk of SIDS in their first year.

4) Wean the dummy away from your child by 12 − 18 months to decrease orthodontic problems later in life.

Whether you grew up with a dummy in your mouth or a silver spoon, we can all make an impact on our current and future generation of young stars by getting them off to a better start in life. As American poet, T. S. Eliot once said:

For last year’s words belong to last year’s language
And next year’s words await another voice.
And to make an end is to make a beginning.”


Dr Nader Malik

Dr Nader Malik

Dr Nader Malik is a cosmetic and integrative dentist whose core treatment philosophy is to make a visible difference to the lives of his patients so that they can be inspired to laugh, smile and share the same experience with others! As a whole-body dentist, he focuses on understanding and treating the strong links between the teeth and the rest of the body. He also enjoys working with medical doctors and allied health professionals to ensure the best outcomes for his patients. Dr Malik practises at Our Medical Dental in Penrith, NSW Australia.

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