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My baby doesn't often take a pacifier, but occasionally he will. I've noticed lately that once in a while, putting in the pacifier will trigger his gag reflex and will sometimes even cause him to spit up. I've tried using the "mam" pacifier that we received in the hospital, as well as some Avent ones... he's been using all of these happily until now, although not often. The gagging is a new thing and only occurs sometimes... What could be causing it? Is there anything to do about it?

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Is there any reason to keep giving him a pacifier if he isn't enjoying it? –  HedgeMage Jun 27 '11 at 3:10
    
@HedgeMage +1 for that - I wish we'd toughed it out a bit more in the beginning with baby #1, because in the end it was a tough habit to get him to kick. With #s 2 & 3 on the way, we're doing all we can to avoid pacifiers altogether. If your child doesn't seem to enjoy a pacifier, perfect - skip them. –  Saiboogu Jun 27 '11 at 14:07
    
@HedgeMage - that's why we don't give it to him often. But occasionally he does seem to want it and enjoy it... except lately this gagging thing is getting in the way. Also, he's started to suck his thumb lately, and I'd prefer addiction to a pacifier over addiction to a thumb, considering that you can't take a thumb away :-/ –  babiesRyummy Jun 29 '11 at 6:49
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5 Answers

up vote 2 down vote accepted

We had a similar problem, especially with Avent, and you can just try brands until it works. It may start happening now simply because you baby is sucking more strongly, or the pacifier is getting old and stretchy.

Our daughter seemed to prefer pacifiers that was really wide, but ultimately she rejected the idea of pacifiers altogether. :-)

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I can think of a few possibilities. One is that some babies prefer some brands; mine did not like anything but Nuk brand pacifiers. It surprised me; I know kids learn brands cause they're bombarded by advertising, but I didn't think it started THAT young. Another possibility is that your baby just doesn't like/want pacis. I don't know if I'd push it in that case, unless perhaps you're flying and want the baby to suck on something to help pop his ears.

The other possibility I can think of is that there is some kind of tongue-tie or palate issue. From my experience on blogs and message boards for women who could not breastfeed, I have discovered that problems with the baby's mouth structure are surprisingly under-diagnosed. Here is some info on tongue tie and high palate, although finding info on high palate outside breastfeeding blogs seems to be a bit difficult. I'd bring it up with the baby's pediatrician on the off chance that the baby has some sort of issue with his mouth.

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My oldest son never liked them, he would just spit them out. My youngest loves them, and whenever he can he looks for them, although when he was younger if the pacifier was a little too long it triggered something similar to what you describe. Lennart is right, you just need to try different brands until your child finds one that fits or wait until your child grows a little and the pacifier will probably fit better.

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All pacifiers are not created equal! The design of the nipple either encourages, interferes with or compensates for lack of development of normal oral motor control.

The gag is a protective reflex and is usually triggered by touch to the posterior 1/3 of the tongue. If the pacifier is too long it will naturally elicit a gag in children with normal reflexes. Perhaps your child's sucking reflex is developmentally becoming stronger and therefore he's more sensitive. Enlarged tonsils can cause a gag reflex to be more sensitive also. And some children are less tolerant of oral stimulation.

A broad and flat nipple can slow development of tongue grooving which is an important for controlling a liquid or food bolus for swallowing.

My son gagged on all nipples and meat consistency baby foods. He is 28 and a college graduate and is still a very picky eater that cannot tolerate more textured foods. This is one of the differences that he was born with that makes him unique.

Since you mention that he sometimes spits up, I wonder if reflux episodes could be the reason he is gagging. Perhaps he wants the pacifier because he's experiencing some indigestion and sucking is calming his system, until the reflux surfaces causing the gag and spit up.

Trying shorter or different pacifiers, monitoring for signs/symptoms of reflux, and rule out enlarged tonsils are all reasonable approaches to address this behavior.

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You should ask your pediatrician about gagging. The great news is that while they are a handy invention, babies were fine before pacifiers existed. Suckling instincts can be satisfied by suckling, and they're likely suck a thumb for a while regardless of pacifier use, so that is something you'll have to deal with eventually either way. Listening to the issues of families that used pacifiers (including the children "requiring" it before they are able to return it to the mouth themselves, and later weaning), I'm glad I didn't bother.

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You're not answering the question. –  Torben Gundtofte-Bruun Jun 30 '11 at 8:34
    
Suggesting professional advice and providing an alternative that will prevent gagging (not using a pacifier) are each reasonable answers to the question. –  Peter DeWeese Jun 30 '11 at 14:22
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