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Family Practice Advance Access originally published online on June 17, 2008
Family Practice 2008 25(4):233-236; doi:10.1093/fampra/cmn030
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Is pacifier use a risk factor for acute otitis media? A dynamic cohort study

Maroeska M Roversa,b, Mattijs E Numansa,c, Esther Langenbacha, Diederick E Grobbeea,c, Theo JM Verheija,c and Anne GM Schilderb

a Julius Center for Health Sciences and Primary Care
b Department of Otorhinolaryngology, University Medical Center Utrecht, Utrecht, The Netherlands
c The Utrecht Health Project, University Medical Center Utrecht, Utrecht, The Netherlands

Correspondence to Maroeska M Rovers, Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Stratenum 6.131, PO Box 85060, 3508 AB Utrecht, The Netherlands; Email: m.rovers{at}umcutrecht.nl

Received 28 April 2008; Accepted 18 May 2008.


   Abstract

Background. Recently, the use of a pacifier has been identified as a risk factor for acute otitis media (AOM). The studies performed so far, however, suffer from methodological limitations.

Objective. To study whether pacifier use increases the risk of AOM.

Methods. Four hundred and ninety-five children between the ages of 0 and 4 years followed from 2000 to 2005 in a dynamic population study in the Leidsche Rijn residential area in Utrecht, The Netherlands. At baseline, the parents of these children filled out a questionnaire regarding pacifier use and potential confounders. AOM was diagnosed by GPs according to the International Classification of Primary Care coding system. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

Results. Of the 216 children that used a pacifier at baseline, 76 (35%) developed at least one episode of AOM, and of the 260 children that did not use a pacifier, 82 (32%) developed at least one AOM episode; for recurrent AOM, these figures were 33 (16%) versus 27 (11%), respectively. The adjusted ORs for pacifier use and AOM and recurrent AOM were 1.3 (95% CI 0.9–1.9) and 1.9 (95% CI 1.1–3.2), respectively.

Conclusion. Pacifier use appears to be a risk factor for recurrent AOM. Parents should be informed about the possible negative effects of using a pacifier once their child has been diagnosed with AOM to avoid recurrent episodes.

Keywords. Acute otitis media, children, pacifier, risk factor.


Rovers MM, Numans ME, Langenbach E, Grobbee DE, Verheij TJM and Schilder AGM. Is pacifier use a risk factor for acute otitis media? A dynamic cohort study. Family Practice 2008; 25: 233–236.


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