For such a small and simple object, dummies cause a lot of controversy. Are they lifesavers - both metaphorically for harassed parents, and literally, according to recent research - or are they damaging to a child's development? While the Department of Health is now backing their use for helping to prevent cot death (see box), other professionals warn that dummies can harm children's speech, teeth and hearing.
'There is some argument for the use of dummies with babies, for example the link with preventing cot death, but there are also many negative associations,' says Gila Falkus, a manager for early years speech and language in west London. 'Of course it is better to give a child a dummy than to have a totally distraught parent. We need to be careful not to be too fingerwagging and to help parents to understand the difficulties associated with an over-use of dummies and to suggest important strategies for helping their child to give up.'
Research has found that young children talk more often and more clearly when they haven't been sucking on a dummy. While not all children who use dummies have problems making speech sounds, there is an increased risk. Kate Freeman, I CAN speech therapist and consultant, explains, 'Young babies copy sounds, practise sounds, feel around with their tongues to the roof of the mouth and lips, feel the sensations and practise noises. If they have something stuck in their mouth, the child is less likely to make these sounds and therefore less likely to get a reaction from the caregiver to the noises.
'If parents react to the noises their child makes, then the child realises that if they make a sound they get a response, and this is the first stage of turn taking. Parents then translate sounds, such as "da da da" as being daddy and point to him - that's how language develops. If children are not making these sounds, then their language will not develop as it should.
'Speech is also affected if a child is not used to making sounds at the front of their mouth, such as "tu" and "du", often resulting in them saying, for example, "cac" instead of "cat".'
Dummies may stop a child's teeth from forming properly. They may grow with an arch in the front which can impact on speech or cause a lisp. But it has been suggested that using a dummy with a flat teat rather than a 'cherry' teat can have less of an effect on teeth development.
Frequent dummy use can also lead to infections of the middle ear (otitis media) because the constant sucking makes the Eustachian tube more open. And ear infections can affect a child's ability to hear, which has a knock-on impact on their speech development.
Lost interactions
There are also concerns that children who are constantly being given a dummy are not being spoken to and listened to enough. Ms Falkus warns that dummies should not be used as a 'plug'. She says, 'Dummies are often a short-term solution and can stop parents and carers from exploring other ways to distract a child or finding out what the matter is and why they are crying. Parents' interaction with young children affects their brain development - and it's certainly vital for the development of their communication skills.'
Pat Wills, a parenting co-ordinator in Blackpool, corroborates this. 'Often, in goes the dummy as soon as there is even the slightest whimper,' she says. 'Americans do not call them dummies but pacifiers, which says a lot.
'The scary thing is the sheer numbers of children with a dummy. I went around Ikea recently and saw the vast majority of under-school-age children all had dummies. The old interaction between parents and children has been lost - even children making a noise has been lost.'
Immature articulation of sounds and communication problems can then cause a child to experience social delay. 'It can impact on the ways the child forms friendship bonds, such as being able to parallel- play,' says Ms Wills. 'This can be restricted because children can be intolerant of those who cannot communicate with them,'
'Children can also become frustrated if they can't make their wishes known - if they want the yellow spade it can be easier to grab it rather than ask, and the child can then get labelled as having behavioural problems. Once a child is able verbalise their feelings, they are more likely to be able to cope with a variety of situations.'
Calling time
Long before such social situations, babies who use a dummy may spend less time breastfeeding, because it reduces the baby's desire to suck. Weaning may also occur earlier than if a dummy was not used. Paediatricians often advise that an infant should be at least a month old and that breastfeeding is well established before carers introduce a dummy. It is also strongly advised that parents limit the amount of time that a child is allowed a dummy each day - preferably, it's only used for settling a child to sleep.
Gila Falkus says, 'Parents need to know that after the age of one, their child needs to get rid of the dummy. This is when the child's sucking phase of development should be at an end.
'Of course, if they don't use a dummy in the first place, then they won't have the problem of how to stop it.'
RISKS ASSOCIATED WITH DUMMY USE
- Increased risk of speech and language problems
- Fewer opportunities to communicate with parents through 'babble'
- Gastro-intestinal infections because the dummy is dirty
- An increased risk of suffering oral thrush
- One study says using a dummy may lead to persistent tongue thrust
- Increased risk of dental malocclusion of the jaw, where the 'bite' is not in the correct place
- An increased risk of glue ear and other ear infections
- Children drinking saliva for longer
- Developing a habitual open mouth posture, rather than closed mouth
- Delay in the eruption of milk teeth and misalignment of milk teeth
- Increased risk of dental caries (tooth decay), especially if the dummy is dipped in honey or sugary drinks
- Problems with breastfeeding and weaning may occur earlier
CAN DUMMIES PREVENT COT DEATH?
Settling a baby to sleep with a dummy can reduce the risk of cot death, according to a review of current evidence by the American Academy of Paediatrics.
It found that dummies halved the risk of sudden infant death syndrome (SIDS), although there is no clear reason why. The department of Health has included the new advice in leaflets for parents on preventing cot death, published jointly with the Foundation for the Study of Infant Deaths (FSIDS).
'This is something that can be recommended to every parent to make a difference,' says Dr Richard Wilson, FSID trustee and honourary consultant paediatrician in Kingston, Surrey. 'The type of dummy does not make a difference and it makes no difference if the dummy stays in while the child is asleep. The dummy just needs to be put in as part of the going to sleep routine, once breastfeeding has been established. We are recommending them just to be used as part of this routine, not babies spending all day with dummies in their mouths. If a baby wakes in the night, then utilise a dunny at that point, but if the baby is asleep then the parent does not need to put the dummy back in.
He believes the first six months are particularly important because most cot deaths occur in that time. 'The child should be weaned off the dummy when they are a year old,' he adds. 'Medical problems associated with dummies only start after this age, and then if the dummy use goes on for several years.'
- The Last Noo-noo by Jill Murphy (Walker Books) is a children's book telling the story of a monster struggling to give up his dummy
- Reducing the Risk of Cot Death can be downloaded at www.fsid.org.uk.
