Hi Barb

> I read somewhere that pacifiers (as well as bottles) can cause otitis
> media.   I am aware of two b/f babies, who both have dummies, that have
had
> repeated otitis media and have had grommets put in.   What is the
mechanism
> behind the dummy (SA term - Yuck) use and otitis media?

I just happen to have this stuff on my desk!  Yes, dummy (pacifier) use is a
significant risk factor for otitis media.  Two studies that support this
(one retrospective and one prospective):

Niemela M, Uhari M, Hannulesela A:  Pacifiers and dental structure as risk
dactors for otitis media.  Int J Peidatr Otoshinolaryngol 1994;  29: 121-127

Niemela M, Uhari M, Mottonen M:  A pacifier increases the risk of recurrent
acute otitis media in children in daycare centres.  Pediatrics  1995;  96:
884-888

According to two older studies (Bluestone, Wittenborg - refs if you want),
frequent sucking on a dummy could be harmful for the functioning of the
Eustachian tube.  The pressure equilibrium between the middle ear and the
nasopharynx, which is maintained by active and passive  opening of the
Eustachian tube is important for protecting the middle ear from infection.
This proper funcioning also protects the middle ear from reflux of secretion
from the nasopharynx.

Regards
Jean Ridler  RN  RM  IBCLC
Cape Town, South Africa
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