To study the natural development of antibodies to pneumococcal capsular polysaccharides of types 1, 6B, 11A, 14, 19F, and 23F and its association with pneumococcal carriage and acute otitis media (AOM), 329 children were followed-up prospectively during their first 2 years of life. Nasopharyngeal carriage was determined by cultures of nasopharyngeal swab samples, and etiology of AOM was determined by cultures of middle ear fluid. Antibodies were measured in serum samples collected at 6, 12, 18, and 24 months by EIA. Antibodies increased modestly but significantly with age. Contact with serotypes 11A and 14 was associated with increased antibody concentration as early as age 6 months. Children with contact with serotypes 6B, 19F, and 23F had antibody levels similar to those in children without contact. Antibodies increased modestly, even in children without known contact with Streptococcus pneumoniae and in children with contact with heterologous serotypes. Antibody concentrations were equal after carriage or AOM.