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A diatribe on dummies
  1. Denis Gill
  1. Children's Hospital, Temple Street, Dublin 1, Ireland gilld{at}

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One either hates or likes soothers, dummies, or pacifiers. Their use is widespread and seems to have become semi-automatic, semi-epidemic, and semi-prescriptive. A pacifier is defined as a rubber object that a baby is given to suck so that the baby feels comforted and stays quiet. Their manufacture is covered by the British Standard Number BS5239.

I do not like dummies. My objections are on aesthetic grounds: constant dummy use makes infants and toddlers look distant, dull, glazed, sometimes semi-hypnotised; on hygienic grounds: they are associated with mouth infections (I have often seen parents lift a dropped dummy from a dirty floor, lick it, and place it in the toddler's mouth); on orthodontic grounds: their use is a manifest cause of dental malocclusion, overbite, and loss of primary incisors; on freedom of speech grounds: it must surely be easier to babble and jargonise without a foreign body constantly placed in one's mouth; and on the belief that sucking a body appendage, such as finger or thumb, is more likely to provide sensory feedback and to be self limiting. Furthermore, finger sucking frequency is determined by the child, not by some caregiver.

My opinion is that dummies are an unnecessary, unwarranted intrusion in the mouths of babies and toddlers. One wonders: if babies had an opinion about these, what it would be? The continued and constant use of dummies up to age 4 or 5 years is surely infantilising and stultifying. They almost seem a public statement of insecurity. One even occasionally sees toddlers with one dummy stuck in the mouth, one attached to a flex pinned to the clothes, and a third in the hand, sometimes rubbing the toddler's nose. Where did the term “dummy” come from? In North America they tend to be called a pacifier or comforter. Does the term “dummy” describe the dulled, trance like expression on the face of the constant sucker? Is this non-nutritive sucking a symptom of breast milk bankruptcy? Are babies better sucking their own thumbs, fingers, or wrists? The downsides and benefits are listed below.

Downsides of dummies:

  • increased frequency of oral candidiasis1, 2

  • associated with otitis media3

  • cause dental malocclusion4

  • if syruped cause dental caries5

  • pacifiers are associated with decreased breast-feeding duration6

  • usage seems to increase drooling and slobbering

  • cannot be helpful for articulation if constantly between lips.

Benefits of soothers:

  • said to protect against sudden infant death syndrome7, 8

  • ritual use can help to settle infants and toddlers.

The soother industry is a reasonably lucrative one. My local pharmacy appears to do a considerable trade in these foreign bodies. Soothers do not appear to have been used before the twentieth century, presumably as rubber and plastic are products of that century. My observations would suggest that their use is becoming more prevalent in Britain and Ireland.

I have no difficulty with parents who use sucking/soothing to settle infants/toddlers to sleep in the first/second year of life. I have great objection to prolonged daytime dummy use in toddlers who are awake. Indeed, one meets toddlers who seem “addicted” to dummies and who suck simply non-stop. Such toddlers are usually prolonged bottle feeders and likely to be pushed in buggies up to the age of 4 or 5 years. The “experts” (Jolly, Leech, Green, et al) are against dummies in principle, but recognise that in practice they can be soothing. They recommend occasional use and give inconsistent advice on withdrawal.

Are any paediatric colleagues willing to campaign to “Drive out Dummies OK (DODO)” or “Ban Day Oral Pacifiers OK (BDOPO)”? Out of the mouths of babes, remove dummies! (fig 1)

A contrary view is that the dummy is pacifying. It keeps them quiet. It stops them crying. Peaceful, quiet, constant, non-nutritive sucking. What harm does it do? Don't they all grow out of it? Did it do any harm to the other children? Surely don't they like it?

Figure 1

Reproduced with permission from The Spectator.