Does pacifier use cause ear infections in young children?

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Published on: April 19, 2024

Sinéad Hanafin1, Peter Griffiths

  • 1Health Research Board, Ireland.

British Journal of Community Nursing
|April 30, 2002
PubMed

Insights

Pacifier use in infants under two years old significantly increases the risk of ear infections (acute otitis media). This risk can be up to three times higher, with continuous use posing greater danger.

Area of Science:

  • Pediatrics
  • Otolaryngology
  • Epidemiology

Background:

  • Pacifier use is common in infants.
  • Acute otitis media (ear infection) is a frequent childhood illness.
  • The relationship between pacifier use and ear infections requires further clarification.

Purpose of the Study:

  • To determine if pacifier use in children under two years old increases the risk of acute otitis media.
  • To evaluate the evidence for a causal link between pacifier use and ear infections.

Main Methods:

  • Systematic review of cohort studies and randomized controlled trials.
  • Searches conducted in Cochrane Library, Medline, CINAHL, and Embase databases.
  • Inclusion of studies comparing pacifier users with non-users or examining pacifier reduction.

Main Results:

  • Three studies (one cluster randomized trial, two cohort studies) met the review criteria.
  • Pacifier use is associated with a significantly increased risk of ear infections.
  • Risk of ear infections may be up to three times higher in pacifier users.
  • A potential 'dose-response' relationship observed, with higher risk for continuous users.
  • Socio-demographic factors may confound the observed relationship.

Conclusions:

  • Pacifier use is linked to an increased risk of acute otitis media in young children.
  • The association may be causal, with a dose-response effect.
  • Clinical advice should focus on managing recurrent ear infections in pacifier users rather than complete avoidance.
  • Further research may be needed to fully understand confounding factors.

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