I can't recall a report linking pacifiers to otitis media except with a day
care connection, either, Rob.  In infants with cleft palate, otitis is
linked with poor ventilation of the eustachian tubes (because the Levator
Palatini muscle normally connects with the soft palate and in babies with
clefts it isn't effectively pulling the tubes open with each swallow.)
Anyway, that's how I understand it.

 When I swallow, I hear a little pop in my ears.  According to Brian Palmer,
that is the Levator Palatini firing to briefly open the eustachian tubes. If
babies are sucking on a pacifier or thumb or whatever, they are doing
non-nutritive sucking.  This generally produces some oral secretions to
swallow, and these swallows occur about every 5-6 sucks in NNS.  I don't
know if that is more or less freq. swallowing than would occur with no
object in the mouth and no sucking going on.  But I would think that
anything you suck on which makes you SWALLOW is going to HELP ventilate the
eustachian tubes, so long as it doesn't get up into the tubes.  So I wonder
if the otitis isn't because pacifiers get real dirty falling on the floor,
or other kids or the dog suck on them, and it's the virus or infection that
causes the otitis rather than some mechanical action of using the pacifier
per se.  This is not an apology for pacifiers-- they can sure be overused
and used for the wrong reasons.  Still, they have occasional theraputic
usefulness, and the new SIDS info is provocative, so we ought to try to
understand how they work and what they do.  This is just me thinking outloud
and extrapolating about my observations -- I've seen no direct clinical
evidence to support these ideas.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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