When does pacifier use become problematic?

If your child continues to suck strongly on a pacifier beyond the age of 2 to 4 years, this behavior may negatively affect the shape of his mouth, or cause defective alignment of his teeth and result in an abnormal bite. If however your child stops sucking on a pacifier before his permanent front teeth erupt, then the bite will m most likely correct itself.

How can you help your child stop her pacifier use?

This can be tricky. The use of harsh words, teasing, or punishment is not an effective way to get rid of habits; it may actually worsen the problem. A better alternative includes the following:

• Praise and reward your child when he/she does not use the pacifier. Star charts, daily rewards (within limits of course), and gentle reminders, especially during the day, are also very helpful.
• If your child uses sucking out of boredom, keep his/her hands busy or distract her with things he/she enjoys doing, like coloring on a sketch book.
• If you see changes in the roof of your child's mouth (palate) or in the way the teeth are lining up, talk with a pediatric dentist.

Below are suggested plans for pacifier weaning that you may want to follow:

The 3-Day Approach

Day 1: In the morning and at bedtime, tell your child that you can see he/she wants to do lots of things like older people. So agree that in three days it will be time to say goodbye to his/her pacifiers. Reassure him/her that he/she can do it and that you'll work together on it. Continue to talk for about 30 seconds, and Try not to sound as if you're asking permission. If your child responds, reflect back his/her feelings -- "I know you don't want to" -- then move on. Your child will most likely become anxious if given advance warning, but that’s OK.

Day 2: Repeat the same 30-second talk twice daily, only replace "in three days" with "tomorrow." Don't try to sell him/ her on the idea and be firm in your tone and manner.

Day 3: Remind your child that it's day three and time to gather up his/her pacifiers. Act as if you're playing scavenger hunt . Even if your child protests, collect the pacifiers into a bag, and explain that this bag is for "pick-up by the recycling truck." (I hope you do recycle!) because they will be made into new tires or toys. Your child may burst in tears, but you need to maintain your firm attitude while showing empathy. Most children get over losing their pacifiers within 48 hours.

The Gradual Approach

Start by removing the pacifier in "zero-distress" situations, when your child is home, happy, and playing. Once he/she gets accustomed to not having the pacifier at home, stop using it outdoors. Making the final break may be more challenging. You could tell your child that the dentist or doctor collects pacifiers for new babies, and that if she donates hers, she'll get a special toy.

Whatever method you choose, you need to be prepared for one to five nights of crying. Don’t be tempted to give in quickly. Be persistent.