Does pacifier use cause ear infections in young children?

A new technology for pacifier weaning: a thematic analysis

Introduction

Babies and toddlers often become accustomed to using baby pacifiers. However, pacifiers may harm children's health and lead to various problems, such as less frequent breastfeeding, shorter breastfeeding duration, dental deformities, tooth decay, recurrent acute otitis media, sleep disorders, and the potential for accidents. This study aims to introduce new technology that may prevent babies from becoming used to a pacifier (patent titled "Prevents Getting Used to Pacifier Baby, Number SA10609, Saudi Authority for Intellectual Property"). This study used a descriptive qualitative design.

Methods

The participants included three pediatricians, three psychologists, three dentists, three family doctors, and three mothers of babies and toddlers, with a mean age of 42.6 years old (SD = 9.51). Semi-structured interviews were used, and thematic analysis was conducted to generate a thematic tree.

Results and Discussion

The thematic analysis resulted in three themes: (1) the disadvantages of pacifier use, (2) the introduction of new technology for the patent, and (3) the expectations for this technology. The results showed that a pacifier might negatively affect the health of babies and toddlers. However, the new technology may prevent children from becoming used to pacifiers and protect them from any possible physical or mental issues.

Control of bacterial biofilms formed on pacifiers by antimicrobial solutions in spray

BACKGROUND

The aim was to evaluate the use of vinegar, hydrogen peroxide and sodium bicarbonate solutions for the disinfection of pacifiers.

DESIGN

Different types and concentrations of the substances were screened in planktonic and biofilm for antimicrobial activity on Streptococcus mutans, Staphylococcus pyogenes, Staphylococcus aureus and Escherichia coli. Also, the effect of the most effective substance was tested against polymicrobial biofilms aiming to mimic the multispecies colonization found in a pacifier.

RESULTS

Based on the agar diffusion test, minimal inhibitory concentration (MIC) and minimal microbicide concentration assays, 70% apple vinegar (70%AV) and 70% hydrogen peroxide (70%HP) were selected (P < 0.05). All tested solutions were able to significantly reduce viable cells of S. pyogenes, S. mutans and E. coli from the biofilms A statistically significant reduction of viable cells in S. aureus biofilms were observed after treatment with 70%AV in comparison to the other treatments. When compared to other microbial species, it was found that 70%HP was particularly effective against E. coli. The solution of 70%HP was able to reduce the viable cells of Enterobacteriaceae/pseudomonas of a polymicrobial biofilm formed from a pacifier. The other solutions were not effective in relation to control group.

CONCLUSION

Solutions of 70% HP showed to be a good alternative for chlorhexidine digluconate for the disinfection of pacifiers.

Pacifier Use and Early Life Weight Outcomes in the Intervention Nurses Start Infants Growing on Healthy Trajectories Study

BACKGROUND

Although widely used by infants, little is known about the long-term effects of pacifiers. We investigated relationships between pacifier use in infancy and appetite, temperament, feeding, and weight outcomes through age 2 years using data from the Intervention Nurses Start Infants Growing on Healthy Trajectories study.

METHODS

Mother-newborn dyads were randomized to a responsive parenting intervention for obesity prevention or a control group. Infants with data on pacifier use (n = 250) were categorized as using a pacifier beyond early infancy (≥4 months of age) or not. Anthropometrics were measured at 6 months, 1, and 2 years with overweight defined as weight-for-length ≥95th percentile at 1 year and BMI ≥85th percentile at 2 years. Mothers completed questionnaires on temperament, appetite, and feeding.

RESULTS

Infants who used a pacifier at 4 months or later (68%) had greater conditional weight gain from birth to 6 months (p = 0.01), weight-for-length z-score at 1 year (p < 0.001), and BMI z-score at 2 years (p < 0.001) than infants who did not. Infants using a pacifier at ≥4 months were more likely to be overweight at ages 1 year (11.7% vs. 1.3%, p = 0.03) and 2 years (20.1% vs. 7.9%, p = 0.03). Pacifier use was associated with shorter breastfeeding duration and less responsive parent feeding styles, but these variables did not mediate the relationship between pacifiers and weight. Parent-reported temperament and appetite were unrelated to pacifier use.

CONCLUSIONS

Pacifier use beyond early infancy is associated with accelerated infant growth and toddler overweight, although the reasons for this relationship are unclear.

Panel 1: Epidemiology, natural history, and risk factors

BACKGROUND

The First International Symposium on Recent Advances in Otitis Media (OM) with Effusion was held in Columbus, Ohio, in 1975. The symposium has been organized in the United States every 4 years since, followed by a research conference to (a) assess major research accomplishments, (b) identify important research questions and opportunities, (c) develop consensus on definitions and terminology, and (d) establish priorities with short- and long-term research goals. One of the principal areas reviewed quadrennially is Epidemiology, Natural History, and Risk Factors.

OBJECTIVE

To provide a review of recent literature on the epidemiology, natural history, and risk factors for OM.

DATA SOURCES AND REVIEW METHODS

A search of OM articles in English published July 2007 to June 2011 was conducted using PubMed and related databases. Those with findings judged of importance for epidemiology, public health, and/or statistical methods were reviewed.

RESULTS

The literature has continued to expand, increasing understanding of the worldwide burden of OM in childhood, complications from treatment failures, and comorbidities. Novel risk factors, including genetic factors, have been examined for OM susceptibility. Population-based studies in Canada, the United States, and other countries confirmed reductions in OM prevalence. Although most studies concentrated on acute OM (AOM) or OM with effusion (OME), a few examined severe chronic suppurative OM (CSOM), a major public health problem in developing countries and for certain indigenous populations around the world.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Recent publications have reinforced earlier epidemiological findings, while extending our knowledge in human population groups with high burden of OM.

Pacifier use: a systematic review of selected parenting web sites

INTRODUCTION

The purpose of this study was to explore and describe content related to pacifier use on parenting Web sites.

METHODS

Sixteen parenting Web sites met the inclusion criteria of the study. Two checklists were used to evaluate and describe different aspects of the Web sites. The first checklist provided a quality assessment of the Web sites. The second checklist was constructed to identify content categories of pacifier use.

RESULTS

The majority of sites met quality assessment criteria. Eleven content categories regarding pacifier use were identified. Nine of the 16 sites contained eight or more of the 11 content areas. The most common types of Web pages containing pacifier information included pacifier specific (articles), questions and answer pages, and related content pages.

DISCUSSION

Most of the parenting Web sites met the quality measures for online information. The content categories reflected the current controversies and information regarding pacifier use found in the expert literature. The findings of this study suggest the need to establish pacifier recommendations in the United States to guide parents and health care providers with decision making.

Pacifiers: A microbial reservoir

The permanent contact between the nipple part of pacifiers and the oral microflora offers ideal conditions for the development of biofilms. This study assessed the microbial contamination on the surface of 25 used pacifier nipples provided by day-care centers. Nine were made of silicone and 16 were made of latex. The biofilm was quantified using direct staining and microscopic observations followed by scraping and microorganism counting. The presence of a biofilm was confirmed on 80% of the pacifier nipples studied. This biofilm was mature for 36% of them. Latex pacifier nipples were more contaminated than silicone ones. The two main genera isolated were Staphylococcus and Candida. Our results confirm that nipples can be seen as potential reservoirs of infections. However, pacifiers do have some advantages; in particular, the potential protection they afford against sudden infant death syndrome. Strict rules of hygiene and an efficient antibiofilm cleaning protocol should be established to answer the worries of parents concerning the safety of pacifiers.

Does the use of pacifiers shorten breastfeeding duration in infants?

Breastfeeding has a number of benefits for both mother and baby, which appear to increase with longer duration of breastfeeding. The use of pacifiers has been negatively associated with shortened breastfeeding duration. The aim of this review was to determine whether the use of pacifiers actually shortens breastfeeding duration in infants. The Cochrane library, Medline, CINAHL and Embase databases were searched for systematic reviews, randomized controlled trials and cohort studies examining the effect of pacifier use on breastfeeding duration. After applying appropriate inclusion criteria only two cohort studies were identified. In one the overall breastfeeding duration was longer in non pacifier-using infants compared to those given pacifiers (10 months vs. 7.5 months). The mean breastfeeding duration in children who were given pacifiers before 6 weeks of age was 168.5 days compared to 196.0 days for children who had a pacifier introduced later or never. However, there is no evidence to suggest any effect from occasional pacifier use, and it remains unclear whether pacifiers are an independent causal factor for reducing breastfeeding duration in infants.

Humidification in the long-term ventilated patient; a systematic review

This review aims to identify which method of humidification is most effective in Intensive Care patients intubated and ventilated for longer than 48hours with regard to the prevention of tracheal tube occlusion and the incidence of ventilator associated pneumonia (VAP). The Cochrane Library, Medline, CINAHL and Embase databases were searched for randomised controlled trials (RCTs) that compared any type of heated water humidifier with any type of heat moisture exchange (HME) filter. Two prospective RCTs met the inclusion criteria and were available to include in the main body of the review. These studies showed no difference in the rate of tracheal tube occlusion between devices but a significantly higher level of VAP with the heated humidifier. However, many potential studies were excluded from the review due to insufficient data within the published articles, and both included studies were undertaken in USA and excluded high risk patients. This limits the wide applicability of findings.