By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. We have a very bright, active and affectionate 3-and-1/2-year-old boy, who is wonderful in every way.

My question concerns the use of a pacifier. Our child still sleeps with one, and occasionally (rarely) asks for it “to calm down.” It is something he uses only at home. The dilemma is that our pediatrician, who is a wonderful child advocate, says it is fine and that we should let him give it up when he is ready.

My dentist (who has not yet examined the child), however, says in no uncertain terms that will deform his palate and we should take it away.

We’ve decided not to nag him about it, but think we should make a decision about it soon. I myself sucked my thumb until I started school.

A. Does your child use the pacifier just to soothe himself to sleep at bedtime, or does he suck on it all night long? If he only uses it briefly as he falls asleep and occasionally “to calm down”: for short periods, then trying to take it away may not be worth the struggle. If he uses it more often than this, he’s even less likely to give into nagging.

Either way, attempts to stop thumb sucking or pacifier use are bound to backfire unless the child is offered and successfully learns alternative strategies for self-calming. Without other ways to relax and calm down, a child will cling to a pacifier even harder when a parent tries to interfere with its use, since this struggle creates a new source of stress while threatening to take away a major way of handling it.

Instead, without ever mentioning the long-term goal of replacing the pacifier, watch your child for other things he does to calm himself down. Does he talk or sing to himself, squeeze a teddy bear, curl up under the covers, or come to you for a hug, a lullaby, or reassurance?

Whenever he does use his pacifier, encourage him to fall back on one of his other ways of soothing himself too. You can also introduce new ones. If he has a favorite (small) stuffed animal, doll, or toy, offer it to him when he is upset, and ask him to stroke and hug it until he’s feeling better again. Take it with you wherever you go as you do the pacifier, so that you can offer both.

Little by little he’ll learn to feel nearly the same comfort from his specially treasured toy or doll as he has from the pacifier, and will begin to let go of the latter – when he is ready.

The key is to keep any sense of urgency to yourself, for this will only make him anxious, and more in need of his pacifier. Let him lose interest in the pacifier, at his own pace. Sooner or later he will. As may have been true for you when you stopped sucking your thumb as you began school, many children make up their minds to give these soothers up when being accepted by their peers becomes even more important.

Strategies that simply stop pacifier use or thumb sucking in the short term may come at some cost. For example, simply taking away something this important to a child may lead some children to feel less secure, and some to become more focused on seeking comfort by putting things in their mouths, fingers, thumbs, other objects, or more food than is healthy.

Turning the pacifier into a negative experience, for example, by scolding or mocking the child when he uses it, or punishing him when he does, may stop the behavior in the short term, but there may also be a price later to pay for it.

Unfortunately, too many sources of information for parents try to reduce child rearing into a few quick tips and simple steps. Although some of these may “just work” in the here and now, they may not be good for a child’s future development. To raise a child is not always simple or easy. It wouldn’t be as rewarding as it usually is if it were. Often parents are caught between conflicting recommendations from professionals. Perhaps you might ask your pediatrician and dentist to talk with each other. If they do decide together to recommend stopping the pacifier, it is reasonable to expect that they would also help you figure out how to do it. Just ordering parents to make a child change a hard-to-change behavior without any other help won’t do.

Perhaps our readers can help too.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Before Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at

Reprinted with permission from the authors.