Abstract
Dr. Bland found an increase in otitis media in bottle-fed versus breast-fed infants. He speculates that this may be due to transfer of IgA in breast milk. Another possibility is that the increased incidence of otitis is due to positional differences between bottle- and breast-feeding. Bottle babies are often fed in the recumbent position which promotes entry of milk into the eustachian tubes and the middle ear, whereas the anatomy of the maternal breast requires that the infant's head be vertical during feeding. This concept of positional otitis has been recently reviewed.
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