The sight of a baby sucking a dummy will often prompt unsolicited commentary and opinion surrounding what the lasting effects may be. These thoughts are generally related to speech development and oral health, but in many cases parents will still resort to dummies as a means of pacifying and settling their young ones. So, what effect, if any, does a dummy have on your child’s development?
In this article, I will tackle this question from a speech pathologists’ point of view by looking at key speech development milestones, and weighing up the pros and cons of dummy use.
Speech Development Milestones
It is without doubt that children vary in their development, and this is certainly the case when it comes to speech and language skills. However, many children will follow a natural progression for mastering the skills of language, and these milestones can help us to identify areas of challenge and when a child may need additional support. Speech Pathology Australia has developed several resources and guides relating to communication skills across the early years of childhood. These guides, including the Communication Milestones Kit, provides information on specific skills that your child may achieve at certain ages ranging from 12 months to five years. By understanding these milestones, we can better assess the potential impact of items like a dummy.
There is an idea that excessive and prolonged dummy use impacts the development of babbling and specific sounds. According to a research article called The Impact of Prolonged (meaning beyond 18 months) Pacifier Use on Speech Articulation, long term use can distort the development of ‘s,z,sh,ch,t,d,n’ sounds eg ‘sun’ might sound like ‘thun’. This is because the dummy encourages the forward-backward movement of a baby’s tongue which results in these sounds being pushed forward.
However, considering that clear production of the ‘sh’ sound, for example, isn’t really demonstrated until around the age of four, is it better for you to play it safe, and limit dummy use to no more than 12 months? It is questions like this that make the dummy debate volatile, yet pertinent, so let’s break this down further by looking at the actual evidence so far.
The Benefits and Risks of Dummy Use
Despite decades of expert opinion, research and conjecture, the bases for any pro or con argument relating to the use of dummies and speech development are often contradictory, confusing and even alarmist. With this in mind, I’d like to provide an overview of what the evidence tells us so far:
Study Finds No Link Between Dummy Use and Majority of Speech Problems
In October 2018, the University of Sydney published an article that discussed a study that assessed the sucking behaviours of 199 Australian pre-schoolers, and in short, found that bottles, dummies, and thumb sucking in the early years of life do not cause or worsen phonological impairment, the most common type of speech disorder in children.
Dummies May Help Infants Settle
Low level studies, expert opinions, and the experience of tired parents suggests that dummies are a great tool for settling infants, and can help transition children through developmental challenges including separation from parents.
Reduce Risk of Sudden Infant Death Syndrome
Multiple case-controlled studies suggest that dummy use at last sleep may materially reduce the risk of Sudden Infant Death Syndrome.
Other Potential Benefits
In addition to the above, dummies may have other benefits such as helping premature babies develop sucking skills and reducing pain during medical procedures.
The Flip Side
Some controlled studies, as well as expert opinion, suggest there is an increased risk of acute otitis media (middle ear infection) with dummy use, and speech problems could develop because of this. It is important to note, however, that the link between otitis media and long term speech and language outcomes is just as unclear and controversial as the studies and discussions around dummy use.
There are also some anecdotal studies that connect dummy use to ‘open bite’ malocclusion in infants which may require orthodontic work down the track. It is also thought that sucking for long periods of time i.e. overnight could impact overall dental development if dummy use continues beyond 2 – 3 years of age.
So Where Does This Leave Us?
From a speech pathologist’s perspective, while the link between dummy use and common speech disorders (including phonological impairment) has essentially been ruled out, more research is required to determine further relationships between sucking for prolonged periods and other speech problems like a lisp.
As for parents, the dummy debate will always be fuelled with conjecture and opinion, and it is because of this that you really need to feel confident in deciding what works for your child. But remember, too much of a good thing is rarely a good idea. If your baby seeks the sensory comfort of a dummy, try to the limit the use, arm yourself with knowledge regarding the milestones, and seek assistance from a speech pathologist if you notice any signs of delay or communication challenges.