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Dr. Sarah (00:02):

Ever wonder what psychologist moms talk about when we get together, whether we’re consulting one another about a challenging case or one of our own kids, or just leaning on each other when parenting feels hard. Because trust me, even when we do this for a living, it’s still hard. Joining me each week in these special Thursday shows are two of my closest friends, both moms, both psychologists, they’re the people I call when I need a sounding board. These are our unfiltered answers to your parenting questions. We’re letting you in on the conversations the three of us usually have behind closed doors. This is Securely Attached: Beyond the Sessions.

(00:44):

Hello. Welcome everybody to our very first Securely Attached: Beyond the Sessions episode. I am so excited to be bringing you this new series every Thursday to answer your questions with two of my closest friends who also happen to be psychologists and moms, Dr. Emily Upshur and Dr. Rebecca Hershberg. Emily is a voice that those of you who have been listening to the podcast will know well. Emily is the co-founder of our group practice, Upshur Bren Psychology Group, in Westchester, New York, and she’s a mom of three. And Rebecca is a clinical psychologist mom to two boys and the author of the book, The Tantrum Survival Guide, and just frankly, a brilliant clinician and mom.

(01:28):

So to kick us off, we’re starting with a question that was submitted from a listener named Jill who writes: “My daughter’s 18 months. I think it’s time to take away the passive fire. I’m dreading it. Any tips, Dr. Bren?” So, ugh, I feel this, I had to deal with this with my kiddos too.

(01:47):

Before we get into this, I just want to mention a free resource that might be helpful in relation to this topic. So if you are transitioning out of the pacifier, you might be looking for some new soothing techniques that you can add into your child’s sleep routine. I’m sure we’re going to cover things like this in this talk, but if that’s the case, I want to share my Toddler Sleep Guide, which has seven things that you can try to help you create a more peaceful and easy bedtime routine with your child. So if you want to check that out, just go to drsarahbren.com and click the resources tab. That’s drsarahbren.com/resources, and you can get that Toddler Sleep Guide. That might be helpful.

(02:24):

Okay, so Emily, Rebecca, let’s jump in on a personal note. I totally remember this transition with my own kids. Emily, I know you have three. Rebecca, you have two. Did you guys do this transition? Was it rough? Was it easy?

Dr. Emily (02:42):

When I heard that question, I was like, oh, this is, it’s a little bit tricky to talk about because I’m not really dogmatic about taking away pacifiers at 18 months, for example. There’s no age that I think is the time when you should be taking away pacifiers. I had one child who really relied on it for self-regulation and I was okay with that, and he was more like three when we decided that maybe that was about time. So that’s sort of where I first go to on all that is who’s your kid? What do they rely on for self-regulation? I love your point of you might need to replace some of that if you take away the pacifier. So yeah, I think I had very three very different experiences, but I have three very different children. So I think that’s sort of where that begins.

Dr. Rebecca (03:33):

I think that’s so important though because I have a lot of clients who come to me saying that the dentist said it. Yes. And I’m always clear I’m not a dentist, and I think children’s minds and hearts are generally much more complicated than their teeth. And I think most dentists would agree with all due respect to dentists. And I just think it may be that there’s one way to go as a dentist, but there’s a lot of different ways you can go as an early childhood psychologist. And again, each kid is different. And I think there’s also a lot of gray area between kind of use, we talk about using and not using, but there’s also using only at night or using only in the crib or my first child was tremendously reliant on a pacifier lamy because it was one of the UB ones that had the lamb hanging down and we took the pacifier away and then a week later he got the flu and we had been told Under no circumstances do you give it back.

(04:47):

And there’s just certain hard and fast rules. And I would, same again. He’s gotten this far, we, and then this poor kid had 103 fever, and here I am, early childhood psychologist being like, I’m sorry, I’m giving it back. He has a few. And to me it was such a helpful learning experience because then we stopped using it a couple months later and that was fine. I could have easily seen myself forcing myself to stick with it and hearing him shriek and cry and be miserable, but just be like, I read somewhere. You can’t give it back. You can’t give it. And I’m so glad that I wasn’t that way and I would just encourage other parents. We can absolutely talk about how to do it and how to make it easier. And as you said, Sarah, the things that you can replace it with and the dogma I think is really misplaced. Again, unless there’s some horrific dental concern, I just think being hard and fast about it and thinking there’s any one right way to go for all kids is just as usual a real oversimplification.

Dr. Emily (05:54):

I think that’s such a great point. I totally forgot, and that’s exactly what it was, that there’s a lot of dental pressure, but there’s just a lot of pressure by age two, you shouldn’t have a pass. There’s sort of these outside pressures that I think we just need to take pause and make sure that they fit with what we want to do and not be pressured. And I think that’s really, really critical. Print. Both of two of my three children’s teeth were totally messed up, just to be clear and resolved completely on their own after I took away the pacifier at a late age for both of them. So I think that’s the other piece is not getting too swept up into the permanency of all these things and there’s no permanent damage. A lot of these things, and I had this distinct memory, Rebecca, when you were mentioning that, the dental stuff of saying, my husband’s kind of getting really worried about are they going to have an overbite or so, and I was like, nah, they’re going to get braces at some point. Their sooth self soothing at this stage seems way more important than that. I can live with that. It’s exactly what my thought was.

Dr. Rebecca (07:06):

The other piece I think is important, and I was going to say I’m playing devil’s advocate, but I don’t actually think, I just think it’s another point, and I know it comes up on this podcast all the time, is the idea of distress tolerance and the idea of, because I’ve also worked with parents who on the one hand kind of want to take the pacifier away, and on the other hand, when their child starts to cry, even the littlest bit because they’re distressed or frustrated, they run for the pacifier and there’s an age at which that becomes no longer healthy for your child. It’s not three months, it’s not six months. Again, I don’t think it’s any hard and fast cutoff, but around let’s say between two and a half and four, generally with the understanding that’s a wide age range, you as a parent need to become comfortable with the idea that your child’s discomfort is really developmentally appropriate and and helpful and part of growth. And so being aware as a parent of where your own anxiety is coming into this process and at what point is it about your not being able to tolerate seeing your child uncomfortable, which your child needs to be in order to gain coping skills such as no longer needing a pacifier. So it’s always that dance, I think.

Dr. Emily (08:29):

I love that. Yes. Cause I think the other thing that I would just add is the thing you said earlier, getting away from this black and white thinking about this, I’m my children’s pacifiers really, aside from infancy and very early childhood, never left their beds. And that was one way that I talk. It was just a narrative in our family, oh, the Passy stays in the bed, say bye to the Passy. And then that, Rebecca, to your point, I think builds distress tolerance in other areas and not necessarily going quickly to that. So I think there’s many ways you can do this. If you’re at that, there’s no shame. If you’re at that phase where your child needs this, you’re passing a lot and it’s traveling and it’s going, and maybe you start by refining it to home or the bed or the car seat, I think that that can help the dance of trying to make sure you both feel okay and committed to whatever choices you’re making.

Dr. Sarah (09:29):

And I think you bring up a good point, which is that it’s not all or nothing. You don’t can pull the paci cold Turkey, but you also can phase it out. And that’s totally fine to do. And it also helps to give a child some practice at being uncomfortable in an sort of titrated way, not all once, all the time. So that’s, I think a good strategy. But I think another thing to think about, so what I think we, we’ve sort of danced around is the function of the pacifier. It varies then, but typically it’s starts out, it’s a mechanism for soothing. Kids have a sucking reflex, it’s regulating to suck when they’re born. And we use a lot of times the pacifier in infancy sometimes as a helpful tool for our own regulation, kind of what Rebecca was talking about. If my child is crying and it’s hard for me to tolerate this sound and this distress in my child, if I put the pacifier in their mouth, they calm down.

(10:41):

It’s a tool. It’s one of many tools that we want to be using in the aggregate to support our child’s  ability to soothe themselves and learn regulation skills. But it’s not the only piece to that. I do think it’s important kind of what you were alluding to, Rebecca, is not to go all paci all the time for every single thing at the beginning, but use it as a tool. And then of course then as they get older, there starts to become more of, it can be a transitional object, it could be something that they have an attachment to as part of their, not just their soothing, but their kind of bigger structure of things that help them feel comforted. Not just soothing the regulation system but soothing in a more emotional way. And you see this with love or pacifiers or other types of things. If your child is using something as a soothing mechanism or as a comfort item and you want to help them transition out of reliance on that item, and you need to figure out a way to replace that function for them.

(11:57):

And that’s I think what we’re talking about, distress tolerance, but also what else could be something that your child can use instead? And can you perhaps build up their skill in using that item or that tool or that skill outside of the pacifier before you take the pacifier away? You want to shore up their other tools in their toolbox. And so that I just think is important to note. And I think that can help parents sort of answer that question for their kid. What else does my kid already gravitate to soothe themselves? Are there things that I can, if they don’t have something else that they sleep with or that they use to help comfort them, can we introduce something and help create some sort of thing that they’re going to then be able to then use and lean on more once we take away the pacifier? Is that making sense?

Dr. Rebecca (12:53):

Yeah, for sure. No, and I think there’s, again, there’s different things for different kids, but as you said, it could be a lovey, it could be certain physical comfort. I’ve known families that a child that they stop using the pacifier at night, they hold mom’s hand falling asleep and then they break up that it’s sort of a stepwise thing. I mean, I think one thing that’s so important when we talk about function is the timing of when to take it away. And I’m always really clear with families that it is a soothing object in whatever way, and it’s stressful to take that away. And so just to be aware of what the other stressors are at play. So again, not necessarily taking it away after there’s a new sibling or a move or the week that a child’s starting, a new daycare or preschool or anything that’s already going to be challenging. Your child’s emotional capacity is not the time to then also take away the pacifier. And I think regardless of whether you’re going cold Turkey or cutting back or just considering any of these issues, I think the timing is one of the most critical factors to take into consideration.

Dr. Emily (14:10):

Absolutely.

Dr. Sarah (14:12):

Yeah, I agree that that’s because with my daughter, so my son, he liked the paci and then he kind of just lost interest in it on his own. But my daughter was really attached to it and she’s also, I ner my son also sort of self weaned at 11 months. He just was like, I’m done. And I was like, oh, I’m so sad about that, but I’m okay, whatever. You can leave me like that. But then my daughter, she did not self wean, and so she was very interested in the pacifier and I nursed her till she was two and a half. And I remember being like, okay, I’m ready. I think she’s ready. It’s time for me. I don’t want to breastfeed anymore. I’m done. And I was very actually dependent on the pacifier to wean her from nursing. And then we did the pacifier after that.

(15:08):

But I spread those things out a bit. And I remember being the order of operations here is important because my husband and I were talking about, okay, we got to kind of think about a game plan here. And at first we were thinking, okay, let’s cut the pacifier. It was pacifier, weaning and potty training we’re all kind of things that were, they were all needing to be kind of addressed at that similar time in her development because she was really ready for all three of them. But I was like, we need to do them in a particular order. And hence, so we chose first we’re going to wean from breastfeeding, then we’re going to give it some breathing room, then we’re going to wean from the paci, we’re going to give it some breathing room, and then we’re going to work on really consistently learning how to use the bathroom.

(15:53):

And that took a while. And I remember her preschool teacher being, when is she, she seems really ready to potty train. When are we going to work on that diaper stuff? And I was like, we’re taking our time because we have other things that we have to do first. And I knew that I didn’t want to do ’em all at the same time. So I think to your point, there’s you there. You can do a lot of different ways, but think about it. Think about it in terms of what works for you, what works for your kid and what other changes are happening, what other different things might be stressors and space them out

Dr. Rebecca (16:29):

And know that there’s always going to be a limit to your planning, which goes back to my flu example. We planned and chose the perfect time based on other stressors that we knew about, but we didn’t count on his getting the flu, which it turns out was a tremendous stressor. And whoops, again, we gave it back. There’s things you can plan around and there’s things you can, and just knowing the function of the pacifier, which is that my child really at this particular stage needs this to feel comfortable and safe and to soothe, once you’re clear on that function, it helps you plan more accordingly.

Dr. Sarah (17:05):

Yeah, I’m also thinking, I’m sure parents are listening to this. Yeah, but if we’re going to do it, how do we do it? What do we actually do if we’re going to do it and when we’re ready to do it? And I think there’s a million different ways you can do this. I probably don’t think we’ll go over every possible one, but I do think there’s a little bit of broad strokes thought processes you want to take into account when you’re making your plan. One is like you want to prepare your child. You want to let them know what’s going to happen ahead of time so they can prepare for it. You want to help them understand they might have mixed feelings about this or they might feel excited that this is a big kid kind of thing to do. They also might really miss it when it’s time when their body’s wanting it or when they’re wishing they had it.

(17:49):

It’s not going to be around anymore. So helping them kind of prepare and cope ahead is a good strategy. I also think us understanding that it is a bit of a loss and our kids actually do need to be able to grieve and process my grief a little bit. It’s not nothing, but also to communicate to them and reflect back to them, our confidence that they can handle this might feel hard sometimes. And we know that you can handle hard things and we’ll be here for you when it feels hard. Any other thoughts on what to do, what not to do and why not?

Dr. Emily (18:31):

I think that it’s so important to be flexible, and I think that that’s really, I say that first, but then I say I also think it’s important to be pretty committed. And so I think having, to your point, preparing them, I love to have a calendar and then I really do like to, when possible, not have temptation all around. So go through your house to gather up the pass that you can find, put them away and really get rid of them because that both is a process for you but also for them with the clarity of the boundaries. Of course there’s always going to be times Rebecca’s flu case where you have to be flexible around that. But I think the more committed you are and the more you feel that you’ve walked through some of the troubleshooting, how they might react and how they might feel, and you still sort of feel that confidence, that’s probably the most critical piece of that.

Dr. Rebecca (19:26):

And I think as far as the what not to do also, and I know there’s going to be listeners that have done this with their older child or they have a friend who did this, and I don’t want to disparage it because it’s a fairly common thing and it’s not the equivalent of locking your child in the closet. It’s okay, but there’s a whole movement to poke a hole in the tip of the pacifier or cut the tip off. The idea being that you make it so that it doesn’t actually have the same physical comfort or physiological ability to be sucked on, if that makes sense, without telling your child that you’re doing that. And that has always struck me as just a very kind of deceptive and very sort of not trusting that your child can actually handle it, not bringing your child in.

(20:20):

I mean, there’s just not the way that I parent. I think it’s not the way that any of the three of us would recommend parenting. Again, if you know someone who who’s done it or if you’ve done it, I get it. It’s not this horrible, horrible thing. But generally it just doesn’t fit with any of the guidelines that we’ve recommended. It’s not helping your child process, it’s not helping your child know that you’re on their team. It’s confusing. It would potentially have your child feel like they’re all alone in this experiences, which is the exact type of thing we, in our philosophies and parenting work avoid at almost all costs. So it’s a pretty hard no for me.

Dr. Sarah (21:02):

And I do think, for me, the reason why I would dissuade parents from doing the poking the hole or the cutting is because like you said, it’s really confusing for this thing to sort of stop working. And we want our children to be able to make sense of this experience as much as possible and trusting that they can be frustrated and handle this, I want this and I can’t have it versus us. The implication being you can still have it, but it doesn’t really work anymore. And I’m not explaining why behind that or you, it just, it’s a little bit, it could feel both confusing and also very disappointing and dissatisfying. And also it, there’s a lot of, it just feels very strange to a child for that experience to happen without it making sense.

Dr. Rebecca (21:57):

I think it’s so to use a total inside baseball clinical terms, which is parallel process, both you and I, Sarah, as we were talking about that experience and what it’s like for kids, we couldn’t come up with the words and we’re shaking our heads and we’re clearly feeling a little bit dysregulated even trying to explain, which is just so interesting because I really do think that’s mirroring how a child feels like, wait, what? What’s up? So I just struck by that.

Dr. Emily (22:25):

Yeah, that was exactly what I was thinking. And as I was hearing you guys talk about this, I was thinking it’s about what message are we sending? It’s a very confusing message and we want to send a clear message of you’ve the, we know it’s hard, but you’ve got this and we’re confident you can do it. Otherwise, it’s a confusing message. And so thinking about the message we’re sending, I think is a way to think about those things.

Dr. Sarah (22:50):

And again, I feel very strongly in saying, if you’ve done this, do not beat yourself up. There’s lots of opportunities for you to make less confusing messages to your kids later in other ways. And even if they’re older, you can go back and be like, you know what? I’m sorry I did that. It didn’t feel good. And if I don’t want you to feel confused about why something is not there anymore. And repair is always an option, always no matter what, as you learn new things about parenting and child development, you just take it in and you move forward. So I just feel like that’s an important piece. Cause I don’t want people to feel bad if they’ve done it. Cause it’s like you don’t know what you don’t know, and now you do, all good.

Dr. Rebecca (23:34):

But isn’t that Maya Angelou quote? Or I did the best that I could with the information that I had, something like that.

Dr. Sarah (23:42):

Yes. And that’s so important in parenting because that’s how we keep tough stuff from becoming tougher stuff. Love it. Thanks so much. I feel like if people have more questions about these things or in general, they want Rebecca or Emily and me to get together and share our different viewpoints on it, because there really isn’t a lot of right and wrong in our opinions on things. Clearly we will answer them. So send them in. And I will, we’ll talk to you all soon.

(24:13):Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced and it’s complicated. So I really hope that this series where we’re answering your questions really helps you to cut through some of the noise and find out what works best for you and your unique child. If you have a burning parenting question, something you’re struggling to navigate, or a topic you really want us to shed light on or share research about, we want to know, go to drsarahbren.com/question to send in anything that you want, Rebecca, Emily, and me to answer in this new series, Securely Attached: Beyond the Sessions. That’s drsarahbren.com/question. And check back for a brand new securely attached next Tuesday. And until then, don’t be a stranger.


✨We want to hear from you! Go to https://drsarahbren.com/question to send us a question or a topic you want to hear us answer on Securely Attached – Beyond the Sessions! ✨

109. BTS: When and how should we pull the pacifier?

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