Pacifier as a risk factor for acute otitis media: a randomized, controlled trial of parental counseling.

Objectives. To evaluate the association between pacifier use and the increased occurrence of acute otitis media (AOM) in an intervention trial. Methods. Fourteen well-baby clinics were selected to participate in an open, controlled cohort study. These clinics were paired according to the number of children and the social classes of the parents they served. One clinic in each pair was randomly allocated for an intervention, while the other served as a control. The nurses at the intervention clinics were trained to instruct the parents of children Results. After the intervention, a 21% decrease was achieved in continuous pacifier use at the age of 7 to 18 months (P = .0001), and the occurrence of AOM per person-months at risk was 29% lower among children at the intervention clinics. The children who did not use a pacifier continuously in either of the clinics had 33% fewer AOM episodes than the children who did. Conclusion. Pacifier use appeared to be a preventable risk factor for AOM in children. Its restriction to the moments when the child was falling asleep effectively prevented episodes of AOM.