Babies are born with the need to suckle, and a pacifier can help fill that need. But will using a pacifier have long-term effects for your toddler if he continues to use one?

Recent headlines linking ear infections to pacifier use might cause concern for some parents. The September issue of "Pediatrics," the scientific journal of the American Academy of Pediatrics (AAP), reported a study that followed pacifier use and the incidence of ear infections among two groups of Finnish children younger than 18 months of age. In the group where pacifier use was decreased by 21 percent, ear infections were 29 percent lower than the group in which children used a pacifier continuously.

Does that mean that you should wean your child away from pacifiers?

"It's my feeling that a child who has a greater amount of pacifier use is more likely to get an ear infection. But that doesn't mean that you can't use a pacifier some of the time," says Dr. Ronald Eriksen, a Carol Stream, Ill. pediatrician. "Sometimes, it can be helpful to both a toddler and his or her parents. If you're just finishing making dinner and you're holding off crying for 15 minutes, there's no problem with giving a child a pacifier. But, I do encourage parents to wean their children off a pacifier by about 18 months of age."

Orthodontist John Murphy of Glen Ellyn, Ill. recommends that parents give their child an orthodontic pacifier.

"Nature is very forgiving up to a certain age," Murphy says. "An orthodontically correct pacifier, like Nuk, will allow a baby or toddler to replicate the suckling response. These pacifiers can be used as old as age 2 without creating a detrimental environment for tooth development. A thumb can be worse than a pacifier over the longer term. But, even after age 5, orthodontics can do a lot to correct problems. If a child needs a pacifier for support, and an orthodontic one like Nuk is used, parents should feel comfortable in using it with their child."

If your toddler still needs a pacifier, here are some guidelines from the American Academy of Pediatrics regarding the type of pacifier to use:

• Look for a one-piece model that has a soft nipple (some models can break into two pieces).
• The shield should be at least 1 1/2 inches across, so a child cannot put the entire pacifier into his or her mouth. Also, the shield should be made of firm plastic with air holes.
• Make sure the pacifier is dishwasher safe. If your baby is older than six months, you can wash the pacifier with soap and rinse it in clear water.
• Pacifiers come in two sizes, one for the first six months and another for children after that age. For your child's comfort, make sure the pacifier is the right size.
• You also will find a variety of nipple shapes, from square "orthodontic" versions to the standard bottle type. Try different shapes until you find the one your child prefers.
• Buy some extras. Pacifiers have a way of getting lost or falling on the floor or street when you need them most.
• Never tie a pacifier around your child's neck or hand, or to your child's crib. The danger of serious injury or even death is too great.
• Do not use the nipple from a baby bottle as a pacifier. If the baby sucks hard, the nipple may pop out of the ring and choke him or her.
• Pacifiers fall apart over time. Inspect them every once in a while to see whether the rubber has changed color or torn. If so, replace them.

Helping Your Child to Stop Using a Pacifier
U's child, Laura, was very attached to her pacifier as a toddler and young preschooler.

"Laura had her 'binky' until she was about 4 and 'somehow' it started to disintegrate until there was nothing left to suck on," U. says. "I had talked to my pediatrician much earlier and he felt it would be too traumatic to try to take it from her at the time. She never really asked for another, but continued to sleep holding the damaged one. One thing I know about my daughter is that change doesn't come easy for her."

Eriksen says sometimes when a pacifier gets a hole in it, a child doesn't want it any longer. As a child matures, AAP recommends ignoring your child's sucking habits as a first step. If that doesn't work, the recommendation is to try diverting your child's attention with activities that he or she finds fun.

AAP also recommends that parents praise and reward their child when he or she does not suck his or her thumb or use a pacifier. Star charts, daily rewards and gentle reminders, especially during the daytime hours, are also very helpful.

If your child is one who can't seem to stop, peer pressure will probably do the trick. However, AAP states putting too much pressure on your child to stop this type of behavior may cause more harm that good, and eventually most children will stop the habit on their own.