Pacifiers Linked to Ear Infections

ByMelissa Schorr

B O S T O N, Sept. 5, 2000 -- Helping your kid kick the pacifier habit may prevent painful ear infections, one of the most common childhood ailments, a new study says.

Finnish researchers are unsure why, but they found children who continuously sucked on a pacifier had more cases of ear infections than those who didn’t.

The study, led by Dr. Marjo Niemela of the University of Oulu, Finaland, is published in the current issue of Pediatrics.

The study divided 484 children ranging from 7 months to 18 months of age into two groups, asking the parents of one group to restrict the time their child used a pacifier for several months.

These parents were told about some of the drawbacks of using pacifiers, such as a higher risk of tooth misalignment and the possible link to ear infections.

Fewer Infections

The study found that those children who cut back on the use of pacifiers had 33 percent fewer cases of ear infections than those children who didn’t.

The researchers don’t advise banning pacifiers altogether, but say parents should limit pacifier use once the child is past the age of 6 months. At that point, pacifiers should only be used to soothe the child to sleep, and should be discontinued completely after 10 months of age.

This may be of some dismay to many parents, who rely on pacifiers to help their child gratify the sucking instinct between meals and calm them when they are upset.

Addicted to Pacifiers?

“Absolutely, parents get dependent on these pacifiers,” says Dr. Glenn Isaacson, a pediatric otolaryngologist at Temple University in Philadelphia.

Some 75 percent to 85 percent of children in Western countries use pacifiers, the study reports.

The American Academy of Pediatrics currently recommends that pacifiers “do not cause any medical problems” and can be used safely to satisfy a child’s sucking instinct.

The Finnish researchers are unsure why the use of a pacifier might lead to an ear infection, but theorized it may have something to do with the change in pressure equilibrium inside the ear caused by the sucking.

Ear Etiology Ear infections generally occur when the Eustachian tube, which connects the middle ear to the throat and nose, becomes blocked, often from a cold or allergies.

If the fluid-filled tube becomes infected with bacteria, it can lead to swelling and pain in the ear. Ear infections can be treated with antibiotics, but often reoccur.

“Ear infection is the number one reason why a sick child goes to a pediatrician,” says Isaacson. “It’s a $3 billion problem in the United States.”

Previously, he says, researchers had found a higher rate of ear infections among children who used pacifiers and attended day care, attributed to the pacifier getting passed around and becoming more likely to pick up an infection. But it was unclear whether it was the pacifier itself causing the problem.

Evidence Mounting Now, he says, the evidence seems to be implicating the pacifier more directly.

“Based on the previous study, I tell parents, don’t let their kids in day care use a pacifier,” Isaacson says. “Now, I would recommend they don’t use them at all — especially in children prone to ear infections.”

“There are very few things we can do, most parents can’t take kids out of day care, can’t change their family history,” he adds. “But if you can take pacifier away and drop the incidence of ear infections by at third, that’s a good thing.”

Isaacson says the pacifier might act as a receptacle for viruses, or the sucking pressure may bring up bacteria from the throat that could infect the middle ear.

But Dr. Jacqueline Jones of Weil Medical College at Cornell University in New York City says that without an anatomical explanation for how ear infections may be caused by pacifiers, parents should take these findings with a “grain of salt” until further research is done.

There has not been any proven higher rate of pacifier use in the home and ear infections, she says.

Still, she adds, “a pacifier is a difficult thing to break — so if you don’t have to start it, don’t start it.”