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Study links ear infections to pacifier use


CHICAGO (CNN) -- Results of a new study suggest that heavy pacifier use by infants may contribute to an increased risk of ear infection.

Reporting in the journal Pediatrics, researchers in Finland found that children who stopped using pacifiers regularly after 6 months of age had more than a third fewer ear infections than those who continued to use them.

"The method by which pacifier use increases susceptibility ... is not known," lead study author Dr. Marjo Niemela of the University of Oulu wrote. "It is reasonable to assume that the effect may lie in an alteration in the pressure equilibrium between the middle ear cavity and the nasopharynx, which apparently impairs the functioning of the Eustachian tube."

The Eustachian tube is a passage that connects the middle ear to the cavity at the back of the nose and mouth. It acts as a drain for the middle ear and equalizes air pressure between the inner and outer surfaces of the eardrum. Blockage of the Eustachian tube can result in infection.

"Over half of children will have at least one ear infection by the first year of life," said Dr. Jeffrey Keller, an ear, nose and throat specialist at New York Presbyterian Hospital. "So perhaps a small intervention like removing or eliminating pacifier use could have significant impact in terms of decreasing the tendency for ear infections."

Keller, who also is an adjunct assistant professor of otorhinolaryngology at the New York Weill Cornell Center, called the Finnish study "interesting" and "compelling" as well as one that "offers parents some hope that they have some control over a variable that potentially could reduce the tendency of ear infections in their children."

Still, the group studied was small -- just 484 children at 14 well-baby clinics. Data were collected for three to six months, according to the study.

In order to make a comparison, nurses at some clinics advised parents to restrict pacifier use to bedtime only after the age of 6 months because of such increased health risks. Parents also were told that pacifiers should not be given to infants older than 10 months of age. Other parents in the study were not advised on pacifier use either way.

Until now, pacifier use had been associated with a temporary effect on tooth and bite development. But the Finnish study authors also suggest repeated pacifier use also could contribute to increased oral fungal infection and tooth decay. And doctors advise that pacifiers can spread germs if children share them.

Keller said pacifier use by older children -- those past infancy -- "is kind of a learned behavior." If the pattern can be disrupted, he said, dependence on its use can be lessened.

CNN Parenting Correspondent Pat Etheridge and Reuters contributed to this report.

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New York Presbyterian Hospital
American Academy of Pediatrics
Journal of Pediatrics
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