Risk factors for infantile recurrent otitis media: Atopy but not type of feeding

Abstract

We followed 183 infants from birth to 2.3 yr of age. Of these infants 28 had recurrent otitis media (ROM), defined as five or more separate episodes of otitis media (OM) during the first 2 yr of life or four such episodes during their 2nd yr. The OM presented during their 1st yr (early-onset ROM) in 12 infants and during their 2nd yr (2nd yr ROM) in 16. Eighty infants had no OM and served as a comparison group. Regarding type of feeding, the infants with early-onset ROM did not differ from their age-matched pairs in the comparison group either 1 month before the first OM or at the time of first episode of OM. Exclusive breast-feeding did not prevent OM and early weaning was not a risk factor for ROM. Atopy was associated with ROM with a relative risk of 1.9 (95% confidence limits 1.2-3.2). It was particularly prevalent among the infants with early-onset ROM, in 67 versus in 25% in the comparison group (p < 0.01). During, the 2nd yr daily contact with five or more children was associated with ROM with a relative risk of 2.1 (1.3-3.3). The infants with 2nd-yr ROM were in daily contact with more children than the comparison group (mean 11 versus 5;p< 0.001). Parental smoking was more frequent among the infants with ROM than in the comparison group (54 versus 33%; p < 0.05). In the infants with early-onset ROM plasma concentration of IgM antibodies to cow’s milk was highest at the age of 9 months, and the concentration of IgE was highest at the ages of 9 and 12 months. In conclusion atopy, not the type of feeding, is a risk factor for early-onset ROM, and daycare outside the home for ROM during the 2nd yr. © 1988 International Pediatric Research Foundation, Inc.