Exclusive Breast-Feeding for at Least 4 Months Protects Against Otitis Media
1 From the Department of Pediatrics, Steele Memorial Children's Research Center, and The Respiratory Sciences Center of the University of Arizona Health Sciences Center, Tucson
Objective. This study was designed to assess the relation of exclusive breast-feeding, independent of recognized risk factors, to acute and recurrent otitis media in the first 12 months of life.
Methods. Records of 1220 infants who used a health maintenance organization and who were followed during their first year of life as part of the Tucson Children's Respiratory Study were reviewed. Detailed prospective information about the duration and exclusiveness of breast-feeding was obtained, as was information relative to potential risk factors (socioeconomic status, gender, number of siblings, use of day care, maternal smoking, and family history of allergy). Acute otitis media and recurrent otitis media, defined as three or more episodes of acute otitis media in a 6-month period or four episodes in 12 months, were the outcome variables.
Results. Of the 1013 infants followed for their entire first year, 476 (47%) had at least one episode of otitis and 169 (17%) had recurrent otitis media. Infants exclusively breast-fed for 4 or more months had half the mean number of acute otitis media episodes as did those not breast-fed at all and 40% less than those infants whose diets were supplemented with other foods prior to 4 months. The recurrent otitis media rate in infants exclusively breast-fed for 6 months or more was 10% and was 20.5% in those infants who breast-fed for less than 4 months. This protection was independent of the risk factors considered.
Conclusion. These findings suggest that exclusive breast-feeding of 4 or more months protected infants from single and recurrent episodes of otitis media.
Key Words: breast-feeding otitis media infant
Submitted on June 25, 1992
Accepted on November 24, 1992
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||||
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||||
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||||
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||||
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||||
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||||
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||||
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||||
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||||
![]() |
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||||
![]() |
P. D. Scariati, L. M. Grummer-Strawn, and S. B. Fein A Longitudinal Analysis of Infant Morbidity and the Extent of Breastfeeding in the United States Pediatrics, June 1, 1997; 99(6): e5 - e5. [Abstract] [Full Text] [PDF] |
||||
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P. J. Byrns, J. Bondy, J. E. Glazner, and S. Berman Utilization of Services for Otitis Media by Children Enrolled in Medicaid Arch Pediatr Adolesc Med, April 1, 1997; 151(4): 407 - 413. [Abstract] [PDF] |
||||
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||||
![]() |
S. C. Fuchs, C. G. Victora, and J. Martines Case-control study of risk of dehydrating diarrhoea in infants in vulnerable period after full weaning BMJ, August 17, 1996; 313(7054): 391 - 394. [Abstract] [Full Text] |
||||
![]() |
B. M. Hartley and M. E. O'Connor Evaluation of the 'Best Start' Breast-feeding Education Program Arch Pediatr Adolesc Med, August 1, 1996; 150(8): 868 - 871. [Abstract] [PDF] |
||||
![]() |
C. L. Wagner, D. M. Anderson, and W. B. Pittard Special Properties of Human Milk Clinical Pediatrics, June 1, 1996; 35(6): 283 - 293. [Abstract] [PDF] |
||||
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A. L. Wright, C. J. Holberg, L. M. Taussig, and F. D. Martinez Relationship of Infant Feeding to Recurrent Wheezing at Age 6 Years Arch Pediatr Adolesc Med, July 1, 1995; 149(7): 758 - 763. [Abstract] [PDF] |
||||
![]() |
BREASTFEEDING PREVENTS OTITIS MEDIA Journal Watch (General), May 14, 1993; 1993(514): 2 - 2. [Full Text] |
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