link btw ear infections and infant pacifier use

The sucking motion of a pacifier has managed to soothe many a distraught little soul. In fact, up to 85% of children in western countries have habitually used a pacifier.

But doctors may soon be discouraging the constant use of pacifiers. Dentists have long warned that the pacifier may not be good for the teeth. Now Finnish researchers are linking pacifier use to the frequent occurrence of ear infections, particularly in children over six months of age.

Children who use the pacifier regularly are 30% more likely to suffer from otitis media, a common and painful ear infection, according to the researchers at the University of Oulu in Oulu, Finland.

Researchers and clinicians are stumped as to why some children suffer repeated ear infections, and the surgery of inserting tubes in the ears to lessen the problem has become almost commonplace.

“Both for medical treatment and surgical treatment, it (ear infections) is probably the most common problem that children have,” says Dr. Anthony Magit, a pediatric otolaryngologist specializing in the treatment of the head and neck, at the Children’s Hospital San Diego. According to Magit, surgery to treat chronic ear infections is now the most common operation in the United States.

In the Finnish study, researchers managed to significantly reduce the incidence of ear infections by counseling parents about restricting the use of the pacifier in their young children, or limiting use to bedtime alone.

The researchers did not identify how the pacifier increased the occurrence of ear infections, but speculate that there is an alteration in the equilibrium of the ear caused by the sucking that impairs functioning of the ear’s inner tube.

There is another reason why cutting back on pacifier use may be a good idea, Magit says. “Babies have a lot of reasons why they’re uncomfortable and irritable,” he notes. Parents should “not just rely on something like a pacifier but still investigate what’s going on with their child otherwise.” While most parents can tell when their child is truly distressed, it’s always a good idea to see if there is any reason for the crying that can easily be identified and remedied, he says.

However, a very young child may enjoy the pacifier, and the pacifier may even provide some beneficial effects, Magit notes. “The child needs to exercise their sucking reflex and develop good oral motor control. I think that this has to be weighed against the risk of potentially more ear infections, [and] potentially more dental problems.”

Since the Finnish study focused on children older than six months of age, it may be at this point that the pacifier should be phased out, he suggests.

Magit realizes that many infants have great difficulty parting from their binky or soother, as pacifiers are commonly known. The use could be moderated, or phased out over a period of several months, he suggests. There are various tips on how to wean a child from a pacifier, including trying to find a replacement ‘comfort’ object.

In the Finnish study, very few children were in daycare, and so the incidence may vary from what the results would be if the study were conducted here, Magit notes.

However, since pacifier use may increase the risk of ear infections, “it’s something to keep in mind and something that may need to be addressed to hopefully reduce the risk of ear infections. I think you have to see how dependent your child is on the pacifier and sort of make your own decision [as to] the pros and cons of not getting your child to use the pacifier anymore.”

The idea that letting children use pacifiers could increase the risk of ear infections is unsettling for Claudia Erickson, a San Diego mother with a two-year old son. “I think that’s a scary prospect because everybody worries about ear infections.”

Erickson tried not to give her son, Leif, a pacifier as an infant, but he would cry from four in the afternoon until eleven at night, and finally she relented and let him use one. “We were pretty relieved. He was comforted and it was quiet.”

Erickson would advise other moms to avoid going the pacifier route, but notes that she wouldn’t judge someone else who tried everything else and finally gave their child a soother. “We certainly have said we’re not going to go this route again, but you [should] never say never.”