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A pacifier increases the risk of recurrent acute otitis media in children in day care centers.

Abstract

OBJECTIVE

To follow up a previous retrospective analysis in which we found the use of a pacifier to be a risk factor for recurrent acute otitis media (AOM).

METHOD

In the present prospective study, the occurrence of AOM and the use of a pacifier were recorded in 845 children attending day care centers during a 15-month period.

RESULTS

More than three attacks of AOM occurred in 29.5% of the children younger than 2 years using pacifiers and in 20.6% of those not doing so (relative risk, 1.6; 95% confidence interval [CI], 0.6, 4.1); in children 2 to 3 years of age, the figures were 30.6% and 13.2%, respectively (relative risk, 2.9; 95% CI, 1.2, 7.3). Logistic modeling with adjustment for age and the duration of monitoring showed the occurrence of AOM to be associated with the time during which a pacifier was used. The use of a pacifier increased the annual incidence of AOM from 3.6 (95% CI, 2.5, 4.9) to 5.4 episodes (4.4, 6.6) in children younger than 2 years and from 1.9 (1.4, 2.5) to 2.7 (2.2, 3.3) in children 2 to 3 years of age. The population-attributable risk of AOM attacks due to the use of a pacifier was 176 attacks, ie, 459 to 635 attacks per year, in the youngest children and 69 attacks, ie, from 264 to 333 attacks per year, in those 2 to 3 years of age. It can be calculated that the use of a pacifier was responsible for 25% of the attacks in children younger than 3 years. Breastfeeding, parental smoking, thumb sucking, using a nursing bottle, and the social class of the family failed to show such strong associations with the occurrence of AOM.

CONCLUSION

We conclude that the use of a pacifier is a significant risk factor for recurrent AOM and suggest that pacifiers should be used only during the first 10 months of life, when need for sucking is strongest, and AOM is uncommon.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Pediatrics, University of Oulu, Finland.

    ,

    Source

    Pediatrics 96:5 Pt 1 1995 Nov pg 884-8

    MeSH

    Acute Disease
    Child
    Child Day Care Centers
    Child, Preschool
    Female
    Finland
    Humans
    Incidence
    Infant
    Infant Care
    Male
    Otitis Media
    Prospective Studies
    Recurrence
    Risk Factors
    Social Class

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    7478830

    Citation

    Niemelä, M, et al. "A Pacifier Increases the Risk of Recurrent Acute Otitis Media in Children in Day Care Centers." Pediatrics, vol. 96, no. 5 Pt 1, 1995, pp. 884-8.
    Niemelä M, Uhari M, Möttönen M. A pacifier increases the risk of recurrent acute otitis media in children in day care centers. Pediatrics. 1995;96(5 Pt 1):884-8.
    Niemelä, M., Uhari, M., & Möttönen, M. (1995). A pacifier increases the risk of recurrent acute otitis media in children in day care centers. Pediatrics, 96(5 Pt 1), pp. 884-8.
    Niemelä M, Uhari M, Möttönen M. A Pacifier Increases the Risk of Recurrent Acute Otitis Media in Children in Day Care Centers. Pediatrics. 1995;96(5 Pt 1):884-8. PubMed PMID: 7478830.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A pacifier increases the risk of recurrent acute otitis media in children in day care centers. AU - Niemelä,M, AU - Uhari,M, AU - Möttönen,M, PY - 1995/11/1/pubmed PY - 1995/11/1/medline PY - 1995/11/1/entrez SP - 884 EP - 8 JF - Pediatrics JO - Pediatrics VL - 96 IS - 5 Pt 1 N2 - OBJECTIVE: To follow up a previous retrospective analysis in which we found the use of a pacifier to be a risk factor for recurrent acute otitis media (AOM). METHOD: In the present prospective study, the occurrence of AOM and the use of a pacifier were recorded in 845 children attending day care centers during a 15-month period. RESULTS: More than three attacks of AOM occurred in 29.5% of the children younger than 2 years using pacifiers and in 20.6% of those not doing so (relative risk, 1.6; 95% confidence interval [CI], 0.6, 4.1); in children 2 to 3 years of age, the figures were 30.6% and 13.2%, respectively (relative risk, 2.9; 95% CI, 1.2, 7.3). Logistic modeling with adjustment for age and the duration of monitoring showed the occurrence of AOM to be associated with the time during which a pacifier was used. The use of a pacifier increased the annual incidence of AOM from 3.6 (95% CI, 2.5, 4.9) to 5.4 episodes (4.4, 6.6) in children younger than 2 years and from 1.9 (1.4, 2.5) to 2.7 (2.2, 3.3) in children 2 to 3 years of age. The population-attributable risk of AOM attacks due to the use of a pacifier was 176 attacks, ie, 459 to 635 attacks per year, in the youngest children and 69 attacks, ie, from 264 to 333 attacks per year, in those 2 to 3 years of age. It can be calculated that the use of a pacifier was responsible for 25% of the attacks in children younger than 3 years. Breastfeeding, parental smoking, thumb sucking, using a nursing bottle, and the social class of the family failed to show such strong associations with the occurrence of AOM. CONCLUSION: We conclude that the use of a pacifier is a significant risk factor for recurrent AOM and suggest that pacifiers should be used only during the first 10 months of life, when need for sucking is strongest, and AOM is uncommon. SN - 0031-4005 UR - https://www.unboundmedicine.com/medline/citation/7478830/A_pacifier_increases_the_risk_of_recurrent_acute_otitis_media_in_children_in_day_care_centers_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=7478830 DB - PRIME DP - Unbound Medicine ER -