How Bad Are Pacifiers?


We are looking at direct and indirect connections between pacifier use and obesity. This was hard to untangle for years. While researchers were chasing down threats like crooked teeth, “nipple confusion,” and germs, nobody was thinking about what kind of unholy laboratory-concocted materials the objects that babies put in their mouths were made of.

“Intervention Nurses Start Infants Growing on Healthy Trajectories” is a longitudinal study with what seems like a needlessly ungainly title, until you realize that the first letters spell out INSIGHT. One thing it wants insight into is the relationship between infant pacifier use and weight, along with appetite, temperament, and feeding habits.

Early infancy is defined as up until four months of age, and apparently,

Pacifier use beyond early infancy is associated with accelerated infant growth and toddler overweight, although the reasons for this relationship are unclear.

The study seems grounded in the regrettable habit that many parents have of responding to any distress or unease by automatically sticking something in the baby’s mouth. Rather than immediately answer an unhappy baby with the opportunity for either nutritive or non-nutritive sucking, the researchers urge parents to figure out some other way to ease the distress.

The bottom line is that feeding should not be the default response. Parents will misguidedly encourage a child to eat by “offering preferred foods, promoting intake in the absence of hunger, offering large portions, coercing children to eat beyond satiety, and providing palatable, preferred foods.” Each of those strategies is an inadequate substitute for finding out what’s really going and addressing that problem instead.

Pacifiers blamed for emotional problems in boys

A University of Wisconsin study based on three separate trials determined that pacifier use is detrimental to baby boys, because it stops them from experimenting with facial expressions, and thus impedes their emotional development. Here are the words of lead author Paula Niedenthal:

By reflecting what another person is doing, you create some part of the feeling yourself. That’s one of the ways we understand what someone is feeling — especially if they seem angry, but they’re saying they’re not; or they’re smiling, but the context isn’t right for happiness.

This calls to mind the folk wisdom that smiling can actually cultivate the feeling of happiness. We won’t go into it here, but scientists have discovered clues that the muscular activity of forming a smile can actually influence the brain and the emotions. In any case, mimicry is a vital learning activity for any baby. A grownup with a certain kind of psychological awareness and sensitivity can make a strong case against pacifiers by comparing them to gags, handcuffs, straitjackets, and other hostile forms of restraint.

Botox is used in adults to erase the marks of aging, by paralyzing certain facial muscles. According to some reports, these patients lose some of their ability to decode the expressions of others. They risk losing a certain amount of emotional intelligence. Now consider the growing incidence of autism, and how that condition seems to cripple the ability to receive and comprehend social cues.

What about the fact that a pacifier pretty much looks like a weird and embarrassing facial deformity? Does that count for anything? This is a murky area, where lots of work remains to be done. How much does it matter, in terms of obesity prevention? If emotional problems can cause or exacerbate obesity, it could matter a lot. Does a baby really need a plastic gadget that potentially interferes with his emotional development by immobilizing part of his face?

Your responses and feedback are welcome!

Source: “Pacifier Use and Early Life Weight Outcomes in the Intervention Nurses Start Infants Growing on Healthy Trajectories Study,”, 01/01/18
Source: “Pacifier Use Can Lead To Emotional Problems In Boys,”, 09/19/12
Photo credit: Quinn Dombrowski (quinn.anya) on Visualhunt/CC BY-SA

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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