Some call it a "pacee," a "binky, a "ninny" and even a "dummy." No matter its moniker, the pacifier means comfort to babies and peacefulness for parents. And like all creatures of comfort, babies can have a hard time breaking the rubber nipple habit.

"The pacifier has no major health benefits, but it often plays an important role in making a child and a family more comfortable," says Dr. Ross Black, a family physician and clinical professor of family medicine at the Northeastern Ohio Universities College of Medicine. "Clearly some children like to use pacifiers because they need them for comfort. It's more of a social thing."

Natural Born Suckers
As a family physician, Dr. Black has seen many parents come through his office door who were anxious about the topic of their child's pacifier use. He explains that it is natural for babies, especially during their first six months, to have the suck reflex that pacifiers so conveniently satisfy. "In terms of feeding issues, neurologically, young babies still want to suck," says Dr. Black, an active member of the American Academy of Family Physicians. "For example, a 4- to 6-month-old who can't eat solid foods will naturally need to suck. This basic neurology need can be easily satisfied, as many different pacifiers have been developed in different sizes for different ages."

A recent study by the Department of Pediatrics at the Medical College of Georgia in Augusta confirms this natural tendency for babies to go gaga over pacifiers. According to the study, 75 to 85 percent of American children use pacifiers, most in their first few weeks. Medical College of Georgia researchers also found that the later in life a child is given a pacifier, the more it is used.

"When we first became parents, we said we weren't going to give our boys pacifiers," says Megan Espich, an Indiana mother of a 16-month-old and a 4-year-old. "With Cameron, our first child, it wasn't much of an issue. But with our second son, Nolan, he really needed a pacifier to calm down, pretty much as soon as he was born."

The American Academy of Pediatrics (AAP) agrees with Dr. Black in that the suck reflex is present in all infants and that parents shouldn't stress too much about offering pacifiers. The AAP says the habit typically does not cause the problems often associated with thumb or finger sucking, and is much easier to wean children from since a pacifier can simply be thrown out if needed. Or, in the Espich family's case, added to Santa's annual collection of used pacifiers.

"This past Christmas, we asked Nolan to leave his ninny out for Santa Claus with the milk and cookies," she says. "We did have to give it to him on Christmas Day so he would really sleep, but other than that he has done really well. He has always known that he could only have his ninny at naptime, bedtime or while riding in the car, so he did not become so attached to it."

Just Saying No
When it comes to diminishing a child's pacifier attachment, Dr. Black says providing encouragement and a sense of independence for children is most effective. "Let's give children the decision to stop using a pacifier, just like you may give them the choice to wear the blue shirt, green shirt or yellow shirt when they are learning to dress themselves," he says. "You always want to use positive language to help build a child's self-esteem, and you don't want to have a negative effect by saying things like, 'You don't want to be a little baby with a pacifier do you?' This gives children the wrong connotation and they may think that when they were babies, you loved them more. If we want them to feel confident about growing up, we need to teach them the decision-making process. We must help them grow up by themselves."

For many parents, helping their children realize they no longer need the comfort of a pacifier can be the most difficult stage of the weaning process. Although Dr. Black does not pinpoint a certain age at which a child should stop using a pacifier, he does warn of the sociological issues that are often involved. "If a child is over the age of 1 1/2 to 2 years, using a pacifier in public can carry with it a negative impact," he says. "We don't know why people have such negative feelings about older children with pacifiers, but it is an issue that can be brought up by other family members or even complete strangers. In that case, it's never good to negatively confront an individual who has reacted in some way in front of your child. You can approach the situation with your child by saying, 'Some people won't like you using your pacifier in public, so maybe we can try to go out without it.' This allows the child to stop using a pacifier by method of trial and error. It's not always scientific; it's about decisions."

Mom Knows Best
Not only are there sociological effects that can arise from prolonged pacifier use, there are also developmental considerations. Remember Mom's advice to not talk with your mouth full? That not only makes polite sense at the dinner table, but it also applies to pacifier-toting toddlers who are learning to talk.

"It is possible that the longer a child keeps a pacifier, the longer it may delay their speech development," says Dr. Black. "Although the subject has not been studied enough to say whether or not there are clear negative effects on speech development, I would say it may affect how they communicate. If a child is over the age of 1 1/2 to 2 years and always using a pacifier, there is often little communication coming from the child."

Dental problems may also cause concern for parents of older children with the pacifier habit. The AAP warns that sucking on pacifiers, fingers or thumbs as permanent teeth are coming in may cause teeth to slant or the upper and lower jaws to misalign. However, these conditions are most common in children who suck fingers or thumbs, as opposed to strictly pacifier usage. "In terms of dental problems and pacifiers, there is nothing too detrimental," Dr. Black says. "Sucking thumbs causes more dental problems, as you'll see more pulling of the teeth forward." To prevent tooth decay, pediatricians and dentists advise against dipping a pacifier in sugary liquids before offering it to a child. Also, parents should not place honey on pacifiers, as this common teething remedy can cause a bad case of botulism.

Whether it's called a pacee or a ninny, the rubber-nipple pacifier has a universal calming effect that is a saving grace for many babies and parents. Let's hope breaking the habit in a year or two comes with at least a taste of that treasured peace and quiet.

Want to see more?

• Pacifiers: Love 'Em or Lose 'Em?
• A Hard Habit to Break Part One: Bring on the Cup
• A Hard Habit to Break Part Two: From Diaper Donned to Toilet Trained
• Talk about it!