As a speech pathologist, I've had people ask what I thought about pacifiers. I have always been somewhat hesitant about giving them the green light. I've seen kids that had them way way way past when they should be using them and I always fear if you say they are okay, that they will end up as a 4 year old with a pacifier.
When I was making my registry, I put pacifiers on the registry to have as a 'just in case'. Luckily, I did. My second night home with baby, I was at my wits end. I had run through the list of things: hunger, wet diaper, cold, swaddle; nothing was working! In a hysterical fit I screamed
"Alright FINE! Just go get the pacifier!" It was still in the packaging.
When I popped it in his mouth, I heard silence for the first time in what seemed like hours
(but it was realistically about 30 minutes).
Ah. Pacifier, I do love you after all!
After that, the pacifier was never too far from us. But I have since limited its use.
Here are my rules:
1. We use the pacifier only when nothing else works to calm baby
2. We remove pacifier when baby is calm (most of the time)
3. Begin setting limits that pacifier is only for bedtime soothing (around 3 months)
4. Wean off pacifier by 5 months of age
5. Replace pacifier with age appropriate mouthing toys
Why are these my rules?
You should never just trust someone because they say it should be a certain way. You have to do your research and you have to do what works for your family.
That being said, these rules are really only my rules. You will notice if you research this topic, different people will say different things. Dr. Harvey Karp from the uber popular book Happiest Baby on the Block says at 4-5 months to wean. I have heard some SLPs say to wean at 6-10 months. 10 months is also the time that research tells us correlates to an increase in ear infections in babies that are not weaned by that time. I chose 5 months because that is when baby is starting to make more babbling sounds. When baby has a pacifier in their mouth, they are not making those sounds.
No pacifier = an opportunity to make a sound
I also wanted the pacifier out by the time teeth start to emerge, which can be as early as 8 months.
Also, since nothing really goes as smoothly as you would like, if you start around 5-6 months but don't make the mark, it's not the end of the world. I undershoot so there's wiggle room. I really don't want it used at all as we near 12 months because that's when baby should be starting to make their first words.
the types of pacifiers
If you search pacifiers on Amazon, you will see there's endless options, different shapes and sizes. How will you know which one baby will like? Are you just supposed to buy them all?
You might be intrigued by the 'Orthodontic Pacifier' in hopes that your child won't need Orthodontic work in the future. That is unfortunately not the case. Orthodeontic is a term used because the jaw is not out of alignment when baby is using it. It does NOT help your baby's palate form. That is done by baby's tongue (assuming there are no tongue ties affecting tongue mobility) and mother's breast and there are NO pacifiers that can replicate that process exactly.
I registered for the Avent Soothie because the shape is most conducive to the 'cupping' action the tongue needs to make to suck from the breast. I was also recommended the MAM pacifier by a friend who said it was the only pacifier her baby liked.
The type of pacifier you purchase also depends on your baby's mouth and preference. I first tried the Soothie, which at first didn't work. I can now see why because my baby had trouble cupping the breast, so cupping the Soothie nipple was just as challenging. If you are breastfeeding, you want a nipple with that cylindrical shape like the Soothie. After baby had his tongue and lip ties released, we started working towards success with the Soothie. Each day we had more and more success and it has aligned with his progress in breastfeeding as well.
The MAM worked like a charm from day one and seemed easier for baby to use.
I wouldn't assume that if baby spits out the Soothie that they have a tongue tie. If there are other symptoms then it's worth investigating, but that alone was not a determining factor in the tongue tie.
The material that it is made of was important too. I choose silicone over latex to avoid any potential allergy risk. Ideally, I would have liked baby to take to the natural rubber option Natursutten, but it wasn't in the cards for us.
What's the big deal?: The cons
So why is it controversial anyway? It keeps baby happy and a happy baby means happy parents. No one agrees with you more! As evidenced by my story above, I was so relieved to have that pacifier!
Well, there are quite a few reasons you want to limit it's use, despite the love we have for it.
what are the benefits?: the pros
Pacifiers can come under fire, but they shouldn't be completely dismissed! Like everything in life, the pacifier has it's place and some pros that come with it.
Babies are really programmed to suckle from the womb. If you don't want to use a pacifier at all, you can try guiding baby to bring their hands to the mouth to suck on their fingers. I personally don't love this because of germs and I feel like they can develop a habit that can extend well beyond the recommended 10-12 months we spoke of earlier. It's just a harder habit to break in my opinion.
You can throw out a pacifier, but baby will always have their hands!
Another option are mouthing toys/objects. Babies cannot independently use these right away though. It requires hand to mouth coordination and doesn't satisfy the needs for sucking. I will get into mouthing toys in another post.
Some might be offended that I am using the word 'survived.' Sorry, but that's how I feel! I didn't think I would make it without having to use formula. I didn't think our routines would survive, because it wasn't sustainable. Turns out, only some people are able to have a tongue and lip tie release and then be perfectly fine. Most people need additional training and help. We were in the latter group. Here are some key things I learned:
It is soo so so so important to make sure all of these steps are completed, even if you think things are fine after a release, I would make sure you checked all these boxes. The consequences of not doing so are far-reaching and surprising. Even things like crowding of teeth and a child's future of dentition are affected. Children can become picky eaters, have articulation and speech issues, can develop sleep apnea resulting in poor sleep quality, which can affect how they learn and attend during the day. It snowballs slowly over time.
The earlier these things are fixed, the better the outcome for the child will be. The tissues in the palate are not yet formed, so it is easiest to mold the palate now before those bones fuse together.
how i am surviving
This is my feeding station. I don't go here to feed exclusively every single time, but it is often. It's a hot mess. I'll explain a few of the things I have here and why.
Mentally and emotionally I was drained. Picture this: Baby is screaming and flailing their little body, sliding off the breast. You know they are hungry and are ready to serve, you shove the breast into their mouth, making sure you do the thing where you line the nipple to the nose, you pull them in quick. CHIN FIRST (I hear in my head). The latch isn't good- and it hurts! So, you try again. You unlatch, then re-latch. Same problem. Now he's on and he's eating... for about 15 seconds. The baby is screaming again and you are screaming too. "IT'S HERE! IT'S IN YOUR MOUTH! WHY AREN'T YOU EATING?!" Also you're tired and hungry. Did I drink enough water today? This was my reality for awhile. It's heartbreaking to watch, but it's so much harder when it's you. Your baby is struggling to eat and it's your job and your job alone to provide them with that food, and you feel like you're doing a bad job. In tears I would say, "I get why people give up and bottle feed, this is so hard!" ..."But he is gaining weight!" people would say. I was relieved at that, but you just know in your gut when something isn't right. I needed help. Fast.
SURVIVING is as easy as 1, 2, 3:
I agree with the controversy and I will say I always try breast first, then if I need to add the shield I do. If I can remove the shield partway through feeding, I do. That being said, I think it is absolutely necessary and would not have made it this far without it.
Click Here to read Part 3 of my breastfeeding journey !
Most people won't socialize or 'bring baby out' until they get their shots. During a pandemic, that period lasts a lot longer. Can this be detrimental for baby?
Socialization at this age is mainly with their parents and sometimes grandparents. Babies are studying facial expressions, tone of voice, and around 3 months they are recognizing people and voices in their lives, but don't feel like you need to expose baby to other people and children physically right away.
what can i do to help baby socialize under lockdown?
Under lockdown, what we have done is use video chatting a lot. Baby is fascinated by people's faces and this has been no different. It has been a great way to keep in contact with grandparents and friends safely. Baby gets the benefit of seeing people, but without the worry.
Make sure babies and meeting their milestones, basically the opposite of the red flags! If they are not, you should reach out to your county's Early Intervention program for an evaluation.
I wanted to write about my journey through breastfeeding thus far . It's something I always knew I wanted to do, but I wasn't determined or passionate about it until I watched 'The Milky Way' You HAVE to watch this. Your boss needs to watch this, your husband, your mother- just watch it! I didn't really understand the importance of breastfeeding until I watched this video.
Here's some things you should know about breastfeeding:
After learning these facts, I just had to do it. I insisted not a drop of formula would grace my son's lips. What I didn't know was how hard it would be to maintain this dream.
from the start
With my baby, I waited for the breast crawl and was not disappointed! It really did happen! He latched immediately and there was no pain. My doula casually said in passing "I think he has a lip tie". I brushed it off because he latched no problem, no pain. My baby was perfect and a rockstar breastfeeder. No intervention necessary, I read books people!
Well... if you are able to infer by the title of this post, it wasn't exactly all sunshine and roses.
That was the first and last pain free latch I would experience for weeks. Now I had heard a few things about breastfeeding, like how it hurts initially really badly but then it gets better. Your nipples have to 'toughen up' essentially. This turns out to not be true! There shouldn't be pain when you breastfeed!
I asked the nurses and went to the hospital's breastfeeding class. I asked for the lactation consultant to come to my room to observe my feeding, but apparently she was only there for a couple hours and had a lot of people to see, so I had to go to the class (this was a baby friendly hospital too...). A little put off, I went because I was in pain and I was wondering if there was any way to make this easier. I learned about the football hold. She observed the latch and said he had a great latch, despite the pain I was in. I trusted her. After all, she had been doing this for 30 years.
After discharge, it wasn't getting easier. In fact, I was now crying in pain with every feed because we were feeding so often I didn't have time to recover in the interim between feeds. I was tired, so very very tired, and in excruciating pain. I was lathering coconut oil and nipple cream on to try to get relief.
This was exhausting and upsetting. I felt so defeated. One week in I had my doula come by. She weighed him before and after and he took in so much milk! She adjusted the latch and it did help. She gave me some tips on how to ease the raw feeling after a feed. Did you know a hairdryer on your nipples can help?! Also rubbing breastmilk on them can help too! I felt so much better that she saw me! I felt a renewed sense of ease. Everything would be fine now.
Despite a slight improvement, most of the feedings were still painful, but we pushed through. Something just felt wrong. It shouldn't be this hard I kept thinking. I started researching. What my doula had said at his birth stuck in my head and I went off on a tangent researching lip and tongue ties. As an SLP, I feel like I should know about this! Why were we not taught about it in grad school?!
So now here I am bleary eyed and sore and researching at all hours what could be wrong with my baby- or with me. I had enough information to suspect that this tie was the issue. I sent my doula a video and photos of his mouth. She quickly said he had a moderate lip tie and posterior tongue tie. FINALLY AN ANSWER!!
I immediately sought out a highly recommended surgeon to check him out. We had an appointment the next day, despite the craziness of the corona virus! Sure enough, he did have a tongue and lip tie.
This was right before the laser tongue and lip tie revision. Baby gets goggles to protect their eyes as well as anyone present in the room. The actual procedure was about 30 seconds in total. There was crying, of course, but we breastfed right after. The next two days baby was uncomfortable and would cry more frequently. Homeopathic medicine Camilia (used during teething traditionally) has been helpful.
so why am i still in pain?
A few days later, I felt there was no progress. I think it actually felt worse. Baby was trying to latch, then arching back and screaming as if nothing was in there. So I tried pumping and got almost nothing after a half hour. Holy crap where was my supply?! Something was wrong. I reached out to a IBCLC lactation consultant. These are the top experts certified to know about how to help you breastfeed...But it was a teletherapy session because of the Corona virus. I got some great tips. Like for example, she knew his cries were gassy cries (how did she hear that I don't know) she told me not to have Fenugreek because it makes babies really gassy, and I should avoid dairy and chocolate and caffeine. Ah! gas! That's going to solve everything!! Finally!
So now I'm not eating dairy, or chocolate, not using fenugreek supplements..... and I'm still in pain! He is screaming and thrashing his body and I just want to cry and give up.
The person who was not going to allow a drop of formula to touch my son's lips was thinking of giving up?! I felt so horrible. Now I know why people give up. I was so quick to judge before. I would think, "Don't they know how great this is for the baby? Have they not seen the documentary? Are people just selfish?" Now I understood. The pain, the screaming...it wears people down! You're so tired and vulnerable and it's SO EASY to say "I GIVE UP!"
but i refuse!: continuing my education
I started finding courses online about breastfeeding and tongue ties. No one can come over physically because of the Corona Virus, so I felt it was up to me to figure out how to make this work. This was my last effort.
I found a great website that IBCLCs watch to learn and continue their education. I spent about 20 hours learning in between feedings. I watched lectures from IBCLCs, Dentists, Surgeons, Speech Pathologists (yes! some are great with this niche population), Chiropractors, Occupational Therapists, and Pediatricians.
I was determined to become an expert in this!
After many many hours of learning,I finally knew what I had to do... and there was SO MUCH to do!
Click here to read what happened in part 2!