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A prospective cohort study on breast-feeding and otitis media in Swedish infants
G Aniansson1, B Alm, B Andersson
1Department of Medical Microbiology, Lund University, Sweden.
Insights
Breast-feeding significantly reduces acute otitis media (AOM) frequency in infants. Early weaning before six months was linked to earlier AOM onset, highlighting breastfeeding
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Acute otitis media (AOM) is a common childhood infection.
- Breastfeeding is recognized for its health benefits, but its specific impact on AOM requires further elucidation.
- Understanding risk factors for AOM is crucial for prevention strategies.
Purpose of the Study:
- To investigate the association between breastfeeding and the incidence of acute otitis media in infants.
- To determine if breastfeeding duration or timing influences AOM frequency.
- To explore the role of specific pathogens and environmental factors in AOM development.
Main Methods:
- Prospective cohort study involving 400 infants followed from birth.
- Data collection included infant age, feeding patterns (breast-fed vs. non-breast-fed), and documented episodes of acute otitis media.
- Nasopharyngeal cultures were obtained at 2, 6, and 10 months to identify common respiratory pathogens.
Main Results:
- Infants who were breast-fed exhibited a significantly lower frequency of AOM compared to non-breast-fed infants across all age groups.
- Children weaned before 6 months experienced their first AOM episode significantly earlier than those breast-fed longer.
- Higher frequencies of nasopharyngeal Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae were observed in infants with AOM.
- Day-care contact and presence of siblings increased AOM frequency, particularly in older infants.
- Breastfeeding was associated with a reduced frequency of upper respiratory tract infections.
Conclusions:
- Breastfeeding is a protective factor against acute otitis media in infants.
- Early cessation of breastfeeding, particularly before 6 months, is associated with an increased risk and earlier onset of AOM.
- Pathogenic bacteria like H. influenzae, M. catarrhalis, and S. pneumoniae play a significant role in AOM.
- Environmental factors such as day-care and siblings contribute to AOM risk, but breastfeeding appears to mitigate some of these effects.
Abstract:
This study analyzed the effect of breast-feeding on the frequency of acute otitis media. The protocol was designed to examine each child at 2, 6 and 10 months of age. At each visit nasopharyngeal cultures were obtained, the feeding pattern was recorded and the acute otitis media (AOM) episodes were documented. The analysis was based on 400 children from whom complete information was obtained. They represented 83% of the newborns in the study areas. By 1 year of age 85 (21%) children had experienced 111 AOM episodes; 63 (16%) had 1 and 22 (6%) had 2 or more episodes. The AOM frequency was significantly lower in the breast-fed than in the non-breast-fed children in each age group (P < 0.05). The first AOM episode occurred significantly earlier in children who were weaned before 6 months of age than in the remaining groups. The frequency of nasopharyngeal cultures positive for Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae was significantly higher in children with AOM. At 4 to 7 and 8 to 12 months of age, the AOM frequency was significantly higher in children with day-care contact and siblings (P < 0.05 and < 0.01, respectively). The frequency of upper respiratory tract infections was increased in children with AOM but significantly reduced in the breast-fed group.