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

AimTo synthesise the evidence on the association between duration and exclusivity of breastfeeding and the risk of acute otitis media (AOM). MethodsSystematic review and meta-analysis following searching of PubMed, CINAHL and EMBASE electronic databases. ResultsTwenty-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 2years of life. Exclusive breastfeeding for the first 6months 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). ConclusionThis systematic review and meta-analysis provides evidence that breastfeeding protects against AOM until 2years of age, but protection is greater for exclusive breastfeeding and breastfeeding of longer duration. Exclusive breastfeeding during the first 6months was associated with around a 43% reduction in ever having AOM in the first 2years of life. After 2years of age, there is no evidence that breastfeeding protects against AOM; however, there were few studies and the evidence quality was low.