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Does pacifier use cause ear infections in young children?
Sinéad Hanafin1, Peter Griffiths
1Health Research Board, Ireland.
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.
Abstract:
The aim of this review was to identify whether, in children under 2 years of age, pacifier (dummy) use results in an increased risk of ear infection (acute otitis media). The Cochrane Library, Medline, CINAHL and Embase databases were searched for cohort studies and randomised controlled trials that compared infants who used pacifiers with those who didn't or examined the effect of reducing pacifier use in a group of infants. One cluster randomised trial and two cohort studies met the review criteria and were available to be included in the body of the review. These studies show a clear increase in risk of ear infection to be associated with use of a pacifier that may well be causal. The risk of ear infections is up to three times higher in those who use a pacifier and there does appear to be a 'dose response' with continual users more at risk than occasional users. However, this relationship may be confounded by socio-demographic factors. Rather than advising a parent not to use a pacifier for fear of causing otitis media, advice in relation to this issue might best be restricted to pacifier users suffering from the problem in order to reduce the chances of recurrence.