Prolonged use of the pacifier, sippy cup or bottle in children may cause an orofacial myofunctional disorder as well as set your child up for delays in speech and eating. For very young children, education to monitor the frequency, intensity, and duration of pacifiers should begin as soon as the child is born and well-child visits are conducted. As parents you should be made aware of the recommendation from the American Academy of Family Physicians and the American Academy of Pediatrics which states that pacifiers should be weaned after six months of age.
After six months of age and beyond 10 months of age, there is a correlation with an increased incidence of otitis media, oral candida, malocclusion, and dental caries. Furthermore, the behavior becomes habitual after 6-10 months of age. The earlier the pacifier is replaced after 6 months of age the better the child is able to develop feeding and speech skills on time. The pacifier should be replaced with age appropriate items for the infant to chew, help with oral explorations and to soothe the infant. Alternatives to pacifiers for assisting with calming include infant massage, swaddling, rocking, and singing.
Another preventative method to help minimize orofacial myology problems is to avoid using sippy cups or prolonged bottle feeding. Instead it is encouraged to begin straw drinking and open cup drinking as soon as developmentally appropriate. Sippy cups, much like prolonged pacifier use, tend to place the spout or nipple over the front third of the tongue. A prolonged use of the pacifier, sippy cup, or bottle prevent the tongue from elevating. The inability for the tongue tip to elevate during this crucial developmental time impedes the natural progression to a mature swallowing pattern. As a result of the low and forward resting tongue position past the age of 6 to 12 months, there is interference with the advancement of the child’s speech and language skills.
This low and forward tongue position causes open mouth breathing, as the child does not learn how to use good nasal breathing. As a result, facial development is affected which increases the incidence of malocclusions and high palatal vaulting due to the tongue not resting inside the palate. The resultant high and narrow palatal vaulting or ‘V-shape’, interferes with the development and accommodation of the permanent teeth. As predominantly oral breathing continues due to the low and forward tongue position, there is likely an impact on the overall health of the child. Oral breathing does not allow the body to utilize the nasal turbinates to assist in filtering the air of pollens, dust and bacteria. Oral breathing allows the dirty air to be drawn into the child’s respiratory system. This likely increases illnesses over time and may possibly increase asthmatic illness.
Preventing the prolonged use of pacifiers and bottle feeding, and encouraging straw drinking and open cup drinking all assist in developing normal speech and eating. They are also important for the overall health and well-being of the child.
Hanson, Marvin L. & Mason, Robert M. Orofacial Myology: International Perspectives (Vol. 2nd). Springfield, IL. Charles. C. Thomas Publisher. 2003. Print.
Sexton, S. & Natale, R. “Risks and Benefits of Pacifiers”. American Family Physician. Volume 79, Number 8. April 15, 2009.Print.