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Otitis media and feeding with breast milk of children with cleft palate
Gustaf Aniansson1, Henry Svensson, Magnus Becker
1Department of Plastic and Reconstructive Surgery, Malmö University Hospital, SE 205 02 Malmö, Sweden.
Insights
Children with cleft palate experience more ear infections (otitis media) despite grommet use. Longer breastfeeding duration correlates with fewer infections, suggesting premature cessation may increase otitis media incidence.
Area of Science:
- Pediatric Otolaryngology
- Craniofacial Anomalies
- Infectious Disease Epidemiology
Background:
- Otitis media (OM) is a common childhood illness, particularly in children with cleft palate (CP/CLP).
- Eustachian tube dysfunction is a known complication in CP/CLP, increasing OM risk.
- Grommets are used to manage recurrent OM, but their effectiveness in CP/CLP requires further investigation.
Purpose of the Study:
- To analyze the incidence of acute and secretory otitis media (OM) in children with cleft palate (CP/CLP) or cleft lip (CL) compared to controls.
- To investigate the impact of breastfeeding duration and grommet use on OM incidence in these groups.
- To identify factors influencing OM in children with clefts.
Main Methods:
- A comparative study of 84 children aged 6-10 years.
- Groups included CP/CLP (n=48), CL (n=15), and controls (n=21).
- Data collected on OM incidence, breastfeeding duration, and grommet use.
Main Results:
- Children with CP/CLP had significantly higher rates of acute and secretory OM compared to controls, even with grommet use.
- A significant inverse correlation was found between breastfeeding duration (first 18 months) and OM incidence across all groups.
- OM incidence was not affected by daycare attendance or family medical history.
Conclusions:
- Despite surgical repair and grommet treatment, otitis media remains highly prevalent in children with cleft palate, likely due to persistent eustachian tube dysfunction.
- Premature cessation of breastfeeding may contribute to an increased incidence of acute and secretory OM.
- Promoting longer breastfeeding durations could be a strategy to reduce OM in at-risk populations.
Abstract:
The purpose of the present study was to analyse the incidence of acute and secretory otitis media (OM), and feeding with breast milk, and the use of a grommet in children with a cleft palate (CP/CLP) or cleft lip (CL), compared with controls. A total of 84 children between 6 and 10 years of age were studied. The CP/CLP group consisted of 48 children with an isolated cleft palate (n = 28), or a cleft lip and palate (n = 20). The CL group consisted of 15 children with an isolated cleft lip. The controls were 21 children without clefts. Children with CP/CLP had acute OM significantly more often than children without clefts (43/48 compared with 10/21), and secretory OM (40/48 compared with 4/21), despite the use of grommets. CP/CLP children were breast fed for a mean of 2.8 months (range 0-13), compared with 3.6 months (0-12) for CL, and 7.5 (0-24) months for controls. There was a significant correlation during the first 18 months of life between longer duration of feeding with breast milk and a lower incidence of acute and secretory OM in the three study groups combined. The incidence of otitis media was not affected by care in a day centre, having a sibling attending a day care centre, or by the family's medical history. Despite cleft repair and early treatment with grommets, both secretory and acute OM are common among children with cleft palate, presumably as a result of their eustachian tube dysfunction. The present study suggests that premature cessation of feeding with breast milk may contribute to an increased incidence of acute and secretory OM.
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