EVIDENCE THAT BREAST MILK PROTECTS AGAINST OTITIS PAMEDIA WITH EFFUSION (OME) IN INFANTS WITH CLEFT PALATE

Abstract

In a prospective study of nutrition and middle-ear disease in 252 infants with cleft palate, entailing frequent standardized pneumatic otoscopic examination, we encountered sporadic infants with one or both ears effusion-free on one or more occasions. Each was additionally unusual in having been fed breast milk. We therefore reviewed the prospectively obtained feeding histories of all subjects in relation to the recorded presence or absence of OME at each examination, excepting examinations subsequent to myringotomy if performed.Of the 252 infants enrolled in an 8-yr. period, 231 (91.7%) were ≤ 2 mos. of age at entry. Two hundred twenty-two (88.1%) received cow milk or soy formulas with no reported admixture of breast milk; 30 (11.9%) received breast milk exclusively or in part for varying periods, in virtually all instances expressed by the mother and provided via artificial feeder. In none of the 222 infants fed only formula was either ear effusion-free at any examination during the first 18 mos. of life, whereas in 11 (37%) of the 30 infants fed breast milk, one or both ears were effusion-free at one or more examinations (P < 0.0001). Freedom from OME was found across categories of cleft type, race, sex, SES, and birth order.These findings provide evidence (1) that in infants with cleft palate, impaired Eustachian tube function is not the sole factor in the pathogenesis of OME, and (2) that breast milk protects against the development of otitis media in infancy.