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Ask Dr. Sears: Weaning Off the Pacifier

Q. My son will be turning 3 in a few weeks, and he's still using a pacifier. He loves it so much  -- how can I wean him off of it?

Many infants' desire, and need, for extra sucking continues throughout toddlerhood. Don't consider this a sign of weakness or a psychological problem. In fact, the ability to self-soothe is a normal developmental milestone, and it sounds like your child has found the one that works best for him. In short, prolonged use of pacifiers usually bothers adults more than children.

However, pacifiers can cause dental problems. Check whether your toddler is developing an overbite: Run your finger along the front of his teeth to see if there is a large gap between the upper and lower teeth. Another potential health problem: A recent study showed a higher incidence of ear infections among infants and toddlers who use pacifiers the most. The way a child sucks on a pacifier may cause germs and saliva to travel up the Eustachian tube into the middle ear.

When it comes to weaning from a "paci," the advice I give parents is: "No dental problems, no worry." Your child will eventually give the pacifier up on his own. If he's so attached to it now and you try to take it away, he's likely to suck his thumb, which can put even more pressure on the upper teeth (forceful thumb sucking, especially at night, usually causes the worst overbite). Regardless, if you still feel it's time to wean, try these tricks:

Trade it in. This has proven to be the best binky-losing trick I have advised over the years. First, propose the idea to your child. Then take him to the toy store and let him trade in his pacifier for a favorite toy. When you get to the toy store, share your plan with one of the clerks. (You may be surprised that veteran toy store clerks have been part of this scheme before!) The child picks out what he wants, and the clerk gives him the toy in exchange for the pacifier. This works because the child participates in the choice and gets something in return for what he feels he is giving up.

Offer relaxing subs. Remember, you want your child to grow up with a set of self-soothing tools. If he gives up his favorite one, he will need to learn more dental-friendly alternatives. Teach him to "think happy thoughts" when he feels the urge to suck on something. Talk to him about imagining his favorite activities, such as games he enjoys playing. If he needs something to do with his mouth, teach him to sing songs. Above all, as mentioned above, you don't want him to replace the pacifier with thumb sucking.

Keep a diary. Before you wean him, note the times of the day or circumstances that prompt his use of the pacifier. Note the connections between certain moods or situations and his urge to suck. During these times, intervene with alternative relaxing strategies.

Weaning from an attachment person or attachment object should not mean the loss of a relationship, but a passage from one relationship to another. Anytime you wean your child from any attachment, know that you must always substitute an equally desirable one.