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At Mazzy's 18 month check-up, her pediatrician gave us a simple directive that every parent dreads: "It's time to get rid of the pacifier."

While Boo (Mazzy's blankie) has always occupied best-friend-status, the pacifier had been more akin to a basic necessity like water. Mazzy sucked on that thing roughly 70% of the time and never went to sleep without it. Plus it was my go-to solution to shut her up in almost any situation. I honestly didn't know who was more unprepared to give it up— Mazzy or myself.

With visions of tantrums in Mel Gibson proportions, I devised a plan involving a transitional period where Mazzy was allowed the pacifier for naptimes and bedtime but denied it while awake. I tried my best to distract Mazzy during the day while I mentally prepared for the battle of a lifetime come 7:30pm.

Then— a weird thing happened. After just ONE AFTERNOON of repeatedly saying "no pacifier", Mazzy didn't even ask for it at bedtime. While reading her a story, I found myself covertly burying the thing under a chair cushion so an accidental viewing wouldn't end her sudden case of baby amnesia.

Once Mazzy went to sleep without the pacifier, that was it. All pacifiers were put in the trash and our only directive was to stick to our guns. Which we did. When Mazzy requested the pacifier the next morning, we told her no and gave her a frozen teething toy to chomp on instead. By the end of the day, she appeared to have forgotten all about it.

It's been about a month now and although, I do find that it is harder to get Mazzy to settle down and go to sleep, she has still not asked for it. In fact, today, an old pacifier fell out of the diaper bag by accident. Mazzy picked it up, stuck it in her mouth, and then promptly handed it back to me.

TASK COMPLETE.

I'm not going to assume that everybody has it this easy. God knows, transitioning from a bottle to a cup was WAY harder. I'm curious about everyone else's experiences— have you tried to get rid of the pacifer yet? Were you successful? Are you as big a fan of "cold turkey" as I am?

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Dr. B (our resident early childhood development specialist) says that once a kid turns two, transitioning off a comfort item "cold turkey" becomes less of an option (which is why you should get rid of the pacifier pronto). Today's question is from the mom of a soon-to-be four-year-old boy who still drinks from a sippy cup and calls it "baba".

Dear Dr. B,

My nearly 4 year-old son often asks for his "baba" — which is basically heated up milk in a sippy cup.  He drinks other things like the occasional juice box and water out of a regular cup, but at least a few times a day, he declares "I want baba" because he finds it soothing.  My question is… I've been telling him we'd be stopping the "baba" when he turns 4, because he'll be a "big boy."  But is it really a problem for him?  Or is the problem just mine? 

— SLW

Dear SLW,

Almost all children rely on comforting items or routines at some point in early development and these behaviors can often turn into habits that are difficult to break. The reliance on comfort items serves an important psychological need of helping them cope with increased independence. The need of a comfort item usually lessens as a child matures, becomes more independent, and develops new ways to self-soothe.

A good rule of thumb is that if the behavior is safe and does not negatively impact a child’s health, development, or social-emotional well-being, then it is often best to wait until your child outgrows the behavior naturally or is motivated to change it.

On the other hand, some behaviors are much easier to change than we think and we make the mistake of setting our child up to think the change is a bigger deal than it needs to be.

9 Strategies to Help Reduce Reliance on Comforting Items or Behaviors:

1) Make the Behavior More Appropriate: Select one aspect of the behavior to change (e.g., the word “baba,” drinking warm milk, or the type of cup). Gradually introduce another more appropriate behavior and prompt your child to use it. If your child asks for “baba” prompt him to say, something more appropriate such as “warm milk.” 

2) Offer Fun Alternatives as Choices: Offer your child a choice between the requested item and a novel item. If your child asks for his baba, give him the choice between his baba and a new drink; or a cool big boy cup with a straw. If he doesn't choose the new item the first time, keep trying. He may change his mind.

3) Purchase New Items as Incentives: Go with your child to purchase a new similar item that is more age appropriate to replace the old item. Find an item that matches your child’s interest such as a cup with their favorite cartoon character on it to replace the baba, an ice pop in their favorite flavor to suck on when they get the urge for their pacifier, or an intricate hands-on toy that your child can play at times when he is more likely to suck his thumb.

4) Teach a New Behavior: It is easier for children to change behaviors, when they know what to do in its place. Teach your child to seek comfort in other ways. You can select things to teach on your own or brainstorm these ideas together. For instance, you can teach him how to seek comfort by asking for a hug, to sit on your lap, or to read a story together. For self-soothing, you may want to identify a special toy he can hold, cuddle, or play with or a soothing song he could listen to.

5) Use Positive Language: For some children, the word “no” is a trigger for challenging behavior. Instead of saying, “no,” use positive language. Respond to your child’s request for a comforting item in a positive way. If your child asks for his “baba,” say, “You want milk. Let’s go get it and put it in your big boy cup.”

6) Encourage Comparison: Help your child to reflect on his habit in a fun way. Talk about special characters that your child likes such as Spiderman or SpongeBob and subtly point out similarities and differences between your child and their favorite characters. Say, “Did you know that Spiderman’s favorite drink is cold milk? I wonder what he puts it in. Do you think he drinks from a baba or a cup?

7) Use Praise and Rewards: Provide praise and encouragement when your child a) uses more age appropriate self-soothing techniques; b) seeks comfort in new ways; c) requests the comfort item but then accepts that it is no longer available; d) chooses to use a new more appropriate item or behavior; and e) does something incompatible with the comforting behavior such as drinking juice or drinking from a cup.

8) Set Limits: Explain that certain items or behaviors are only acceptable at specific time or places. You may decide that drinking from a “baba” is only acceptable at bedtime or when your child is at home. Instead of telling your child they can’t have the item when they ask for it which may trigger a meltdown, tell them when the item will be available.

9) Quit Cold Turkey: Simply taking away the item may be an option for very young children under age 2, for behaviors that are unhealthy and have the potential to impact development, and when other methods have been tried and are unsuccessful. In some cases, gradual weaning can be more difficult for children because they don’t understand the limits being set on the behavior which leads them to become very frustrated more often. By taking the item away entirely, the child is quickly forced to learn how to cope with the loss, as wellas alternative ways to satisfy the same needs. If you use this method, it is important to stick with it and not give in. When you give into a tantrum, the child learns that tantrums are effective in getting what they want and they are more likely to use them.

Finally, children are much more resilient than we often give them credit for and we are often surprised when something we thought would be very challenging for them is forgotten after a few days of a consistent, “No more baba.” Young children are also very intuitive and pick up on very subtle cues from the people they depend on most, their parents. When parents set the tone that change is okay along with positive reassurance that certain items are no longer needed, children are likely to follow their lead with minimal difficulty.

Best of luck,
— Dr. B