Whether it's referred to as a soother, dummy, binkie or bo-bo, new parents can feel conflicted over whether using a pacifier is the best thing for baby.
While some moms and dads fall squarely in the no-soother camp — worried their child could become dependent, harm their teeth or delay speech development — other harried new parents find the nippled devices can be sanity-savers when their squalling infant can't be comforted by anything else.
"What we like to tell new moms is the choice is so individual," says Erica Wells, a Vancouver mother of two young children and co-author of "The Survival Guide for Rookie Moms," published in 2009.
"So as a new mom, you're pulling your hair out, you're trying to figure out up from down, left from right. So if you need to use the pacifier because you feel that your baby needs that added soothing, then go ahead."
Krissy Eiben says when her son Maxx was born last August, she didn't want to use a soother in case it interfered with her attempts to establish a breastfeeding routine.
The first-time mother, who was born and raised in Kelowna, B.C., but lives south of the B.C. border in Blaine, Wash., was worried that using a pacifier could cause "nipple confusion" in her infant son.
"A week later, we got home from the hospital and he wouldn't stop crying," Eiben says. "My breastfeeding did not go well ... and the poor child was starving, and he was crying and crying and I was 'I don't know what to do.'
"So we took a soother that somebody had given us as a gift, plugged it in him and never looked back."
UNICEF and the World Health Organization, which recommend that mothers breastfeed exclusively if possible for the first six months, advise parents to “give no artificial teats or pacifiers to breastfeeding infants." Several studies have shown an association between soother use and early weaning.
In its position statement on pacifier use, the Canadian Paediatric Society says that while it's up to parents to decide whether to give their infant a soother, it suggests holding off until breastfeeding is well-established.
"Generally, my approach to this when asked," says Montreal pediatrician Dr. Carl Cummings, "is to say I'm not concerned that babies will confuse the difference between feeding and sucking. And while I certainly don't encourage pacifier use in newborns, I don't discourage it either."
Cummings says he's not sure that plugging a dummy in an infant's mouth will somehow sabotage the ability to breastfeed.
"But I want this baby not to be spending the whole day sucking a pacifier and tiring him or herself out, but spending most of the sucking time at the breast where it's going to be useful to get the breastfeeding going," he says.
"I think the bottom line is that newborns seem to have a need for non-nutritive sucking — in other words, sucking that has nothing to do with eating," adds Cummings, noting that ultrasound images often show fetuses in the womb sucking their thumbs.
"But if you give a baby a pacifier when they're hungry, all they do is cry harder."
Research suggests pacifier use has both potential upsides and downsides.
On the plus-side, children who sleep with a soother appear to have a lower risk of sudden infant death syndrome, although doctors aren't sure why. Soothers may also discourage thumb-sucking, a habit that is harder for a child to break.
Possible negatives linked to pacifiers include the research-based suggestion that the dummy nipples may heighten the risk of the baby developing a middle-ear infection, although the risk is highest with frequent and prolonged use.
Long-term use of soothers — until after a child has developed baby teeth — also has been linked to cavities and bite problems in some children.
Still, the Canadian Dental Association recommends pacifiers over thumb sucking because the former is easier to control. But it warns parents not to coat the soother in sugar, honey or corn syrup, as that could lead to cavities once the baby cuts his or her first teeth. And ideally, a child should be weaned from the device before permanent teeth erupt.
Eiben says she took Maxx, now 20 months old, for his first dental checkup last October and asked the dentist about pacifier use. "I showed him the one we use, and he said 'Go for it.' He did not discourage the use and he said until he's like four or five, I'm not going to worry about it, it's not going to affect his teeth."
But Eiben does wonder if sucking on the soother might be delaying his speech development, a worry often voiced by parents.
"I would like to see him use it less, just because he's a very social little man, he likes to talk, he's got a great smile and a good personality," she says. "So sometimes I feel like if he's running around with the soother in his mouth, he's less likely to chat it up.
"I wonder if he would talk more if I just took that thing out of him."
Wells, whose two children never took to pacifiers — much to her dismay during prolonged crying jags when no amount of feeding, changing and cuddling could comfort them — says she recently saw a boy about age three in her local Vancouver park happily playing, but with a ubiquitous dummy in his mouth.
"So I kind of thought: 'So they're super happy, they're running around. Why do they need the pacifier? ... They weren't screaming in the stroller or trying to get to sleep. I just didn't understand the need for the pacifier at that moment."
Cummings says while he has seen no evidence that pacifier use impedes vocabulary development, he suggests parents should insist their child remove a soother while talking for the sake of speech clarity, if nothing else.
"In my practice, between the nurses and I, we must tell at least one or two parents a week, 'Your child is way too old to have a pacifier,' because they are three or four," he says. "I think that's permissive for no good reason. No child of that age has any physiological need to suck, and it's clearly not good from an orthodontia point of view.
"The longest kids really should have a pacifier is 12 months."
Eiben says she'd like to wean Maxx off his soother, but she won't force it and make him upset.
"Right now, I'm just trying to slowly decrease the amount of time he is depending on it ... He doesn't use it all the time. It's certainly something that we use at bedtime, we use at nap time. If he's grumpy, it's his go-to, but he's not devastated now if he's without it."
While Cummings isn't for or against pacifiers, he does tell parents that getting a child to give up a soother is much easier than breaking a thumb-sucking habit.
"When I want to take away a pacifier, I can do that. When I want to take away a thumb, it's much harder because it follows them everywhere."