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Pacifiers may boost ear infection risk

Introduction

Research suggests that using a pacifier may increase your child’s risk of developing ear infections…

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23/06/2008
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Paci pain…

European researchers have found that recurrent ear infections occur nearly twice as frequently in babies and young children who use a pacifier. A five-year study of 495 children aged from birth to 4 years showed that 35% of the 216 who were using a pacifier at the start of the study had at least one episode of acute otitis media (AOM) –middle ear infection – while 33% had recurrent AOM. Among the 260 children who didn’t use a pacifier, 82% had at least one episode of AOM, while 27% had recurrent AOM.


The researchers concluded that pacifier use appears to be a risk factor for recurrent AOM and have suggested that pedatricians tell parents of children with recurring AOM about the likelihood of it recurring more often if they allow their child to use a pacifier.

“Paediatricians and GPs can use this information in their daily practice,” says lead author Dr Maroeska Rovers, of the Julius Center for Health Science and Primary Care, University Medical Center Utrecht. “They can dissuade parents from using a pacifier once their child has been diagnosed with acute otitis media, to avoid recurrent episodes.”

Common in kids

Ear infections are the most common illness in babies and young children. Their Eustachian tubes, which connect the ears with the back of the throat, are very short and this makes it easier for bacteria to travel from the throat to the ears and harder for any fluid build-up – from a cold, for example, which is the main underlying cause of a middle ear infection – to drain. They’re narrow too, meaning that any inflammation can cause them to swell up, which also contributes to fluid being trapped in the middle ear. The resultant infections can be very painful and, if recurrent, can affect a young child’s hearing.

Boys tend to suffer more from ear infections than girls do; kids are also more at risk if they were premature, bottlefed, or have siblings who can pass on cold viruses. While the new research suggests pacifier use might also increase risk, there’s no evidence that thumbsucking does. Exposure to secondhand cigarette smoke can also be a factor.

What are the symptoms?

If your baby has a near infection she’ll likely be cranky, may tug at her ear and may run a fever. Older children too will be irritable and may complain of pain or a blocked up or ‘full’ sensation in their ear. You may also notice pus or brownish fluid coming from their ear.

Relieving the discomfort

While it used to be routine for children with ear infections to be prescribed antibiotics, there’s evidence that it doesn’t clear the infection any more rapidly than the wait-and-see approach. There’s evidence that up to 80% of middle ear infections clear up without the use of antibiotics and a review of studies by the American Academy of Pediatrics indicated there was no difference in relief of after 24 hours between children who took antibiotics and children who didn’t. However, if your child is under 6 moths of age or is suffering from recurrent infections, your pediatrician may prescribe antibiotics.

Over-the-counter pain relievers will help ease your child’s discomfort (don’t give your child aspirin, however, as it has been linked with a life-threatening condition called Reyes syndrome). An older child can also lie down with the affected ear resting on a well-wrapped hot-water bottle. Your pediatrician may also prescribe ear drops that numb the ear canal.

The study was published in Family Practice, June 17.


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