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    Continuous Pacifier Use Linked to Ear Infections

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    Niemelä tells WebMD she isn't advocating restricting all pacifier use. For example, among babies "six months old or younger, continuous use of a pacifier is not harmful." Therefore, she doesn't recommend advising parents of newborns to limit pacifier use.

    Although makers of pacifiers often tout one design over another, Niemelä says she can't comment on the sales pitch. She says, "We didn't study pacifier design to determine if risk increased depending upon type of pacifier."

    Many parents think the trick to safe pacifier use is cleanliness. Here again, Niemelä says that wasn't a factor in this study. She says it is unlikely that bacteria growing on the pacifier are the reason for the increased number of ear infections, although she says that bacteria do "grow very easily in pacifiers."

    Robert C. Sprecher, MD, chief of the division of otolaryngology at Rainbow Babies and Children's Hospital in Cleveland, tells WebMD he is not convinced that pacifiers increase ear infections. He says, for example, that another likely explanation is that babies who are more susceptible to ear infections are fussier and thus more likely to "have a parent stick a pacifier in their mouths to calm them down. So what comes first? The pacifier or the otitis?"

    Sprecher says that known risk factors for ear infections are "day care and a genetic predisposition. You can't do anything about genetics and it is difficult to keep children out of day care."

    He adds, however, "One thing that can be done is to reduce exposure to secondhand smoke. I do tell parents this all the time: Don't smoke." He says the no smoking message is "probably more important than a warning about pacifier use [in preventing ear infections]."

    Sprecher says that pacifier use is already associated with increased oral infections, and with dental problems. "For those reasons, I think it may be wise to encourage less use of pacifiers," he says. "But I'm not going to tell a mother to get rid of the pacifier to protect against ear infections."

    The American Academy of Pediatrics, in its book for parents Caring for Your Baby and Your Child, Birth to Age 5, says this about pacifiers: "Pacifiers do not cause any medial or psychological problems. If your baby wants to suck beyond what nursing or bottle-feeding provides, a pacifier will satisfy that need."

    Reviewed by Michael W. Smith, MD, April 2002

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