Infants who can be weaned from continuous pacifier use or avoid it completely are less likely to experience ear infections and, probably, other ill effects as well, according to a recent study.

Pacifier use was found to cause a 40% increased risk of ear infections in infants, as well as higher rates of tooth decay and thrush, according to Dr. Marjo Niemela and associates from the University of Oulu in Finland.

• In an effort to cut down on infant pacifier use, the authors instituted a program of education and support for parents of healthy children under 18 months of age.

• Ear infection rates were then compared between these children and children whose parents received no such counseling.

Although, when the study ended, equal numbers of children in both groups were still using a pacifier, children whose parents received counseling spent 27% less time sucking their pacifiers than did children whose parents did not receive counseling.

• This resulted in a 29% decrease in the rate of ear infections.

• In fact, children who used a pacifier continuously had 33% more ear infections than did infants who never used the pacifier or only used it when falling asleep.

The authors stress the importance of being positive and encouraging when counseling parents to reduce their children's pacifier use. "We think that if information on the right way of using a pacifier is given early enough," they write, "most parents can identify the time when their child's real need for sucking is over."

"Our results strongly suggest that even the restriction of pacifier use to the moments when the infant is falling asleep will reduce the occurrence of (ear infections)," the authors conclude, adding that because ear infection "is such a common disease during childhood, even small changes in children's everyday habits may have major effects on its occurrence."

Pediatrics September, 2000;106:483-488.