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Question: My 1-year-old won’t go anywhere without her pacifier. Is that okay?

Answer: Don’t stress too much if your baby has a Binky habit: Many 1-year-olds still find pacifiers comforting. And often, toddlers between 12 and 18 months use sucking as a way of self-soothing during peak times of separation anxiety, like when being left with a new babysitter. But, it’s still a good idea to start transitioning her from using a pacifier all the time. Both the American Academy of Pediatrics and the American Academy of Family Physicians recommend parents wean children from using them after the child is 6 months old to help prevent ear infections, even though the link is not strong. The idea is that the sucking could cause fluid to get trapped in the middle ear, leading to infections. I encourage stopping pacifier use completely by 2 years, as it appears that use after that age may result in problematic cosmetic tooth and jaw alignment changes. One thing to remember at any age: avoid letting your child run around with the pacifier in her mouth because she may be more at risk of injury if she falls with something in her mouth. And if the transition away from the pacifier gets tough, you can always try to replace the paci with another soothing “love” object, like a blanket or small stuffed animal.

Lawrence D. Rosen, M.D., is the founder of the Whole Child Center in Oradell, New Jersey, one of the first green, integrative primary care practices in the U.S.

Have a question for Dr. Rosen? 
E-mail him at drrosen@kiwimagonline.com.

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