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Breastfeeding and childhood acute otitis media: A systematic review and meta-analysis

journal contribution
posted on 2023-05-18, 17:05 authored by Bowatte, G, Tham, R, Allen, KJ, Tan, DJ, Lau, MXZ, Dai, X, Lodge, CJ

Aim: To synthesise the evidence on the association between duration and exclusivity of breastfeeding and the risk of acute otitis media (AOM).

Methods: Systematic review and meta-analysis following searching of PubMed, CINAHL and EMBASE electronic databases.

Results: Twenty-four studies, all from the USA or Europe, met the inclusion criteria. In the pooled analyses, any form of breastfeeding was found to be protective for AOM in the first 2 years of life. Exclusive breastfeeding for the first 6 months was associated with the greatest protection (OR 0.57 95% CI 0.44, 0.75), followed by ‘more vs less’ breastfeeding (OR 0.67; 0.59, 0.76) and ‘ever vs never’ breastfeeding (OR 0.67; 0.56, 0.80).

Conclusion: This systematic review and meta-analysis provides evidence that breastfeeding protects against AOM until 2 years of age, but protection is greater for exclusive breastfeeding and breastfeeding of longer duration. Exclusive breastfeeding during the first 6 months was associated with around a 43% reduction in ever having AOM in the first 2 years of life. After 2 years of age, there is no evidence that breastfeeding protects against AOM; however, there were few studies and the evidence quality was low.


Publication title

Acta Paediatrica








Tasmanian School of Medicine


Taylor & Francis As

Place of publication


Rights statement

©2015 The Authors. Acta Pædiatrica published by John Wiley & Sons Ltd

Repository Status

  • Restricted

Socio-economic Objectives

Neonatal and child health

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