Otitis Media in Young Children in Different Types of Day-care

Abstract

The occurrence of otitis media was studied in 108 Sweden children attending 14 day-care centers and compared with that in 57 children cared for in their own homes (usually with one or no sibling) and with that in 42 children in family day-care homes (where a woman cared for both her own and 1 to 4 other children in her home during the day). The children were 6 months to 2 years old. In the day-care centers 37% of the children had otitis media at least once during 8 months with an average of 2.2 episodes each. Otitis media was more common in 6- to 17-months-old children in the day-care centers than in children of the same age cared for in their own homes. The occurrences of otitis media in the day-care centers and in the family day-care homes were approximately equal. Children attending centers where those with signs of infection were excluded had otitis in about the same frequency as those attending centers where children with infections were accepted.

Racial/ethnic disparities in the diagnosis of otitis media in infancy

“…Breastfeeding was associated with a substantially lower risk of OM in these data, as it has been in almost all studies that have considered breastfeeding during the first 6 to 12 months of life [2,[13][14][15][16][17][18][19][20][21][22][23][24]. Our study confirms the association between out-of-home daycare and OM [8,9,[12][13][14][15][16][17][25][26][27][28][29][30] and also demonstrates a strong ''dose effect'' of the size of the daycare center, such that infants who attended daycare centers with 13 or more children had an almost four-fold greater risk of OM than infants not in daycare. We did not find any independent association between a diagnosis of OM and maternal cigarette smoking, income, number of adults living in the home, or household crowding.…”

Increasing Prevalence of Recurrent Otitis Media Among Children in the United States

“…Several prospective and cross-sectional studies have estimated that the risk of otitis media among children in various types of child care is two times higher than that found among children who are not in child care. 1,[3][4][5][6]14,15 It is not known why there is an increased risk of otitis media associated with child care. One hypothesis is that child care is associated with increased exposure to various viral and bacterial pathogens, resulting in more frequent infections and otitis media.…”

“…1 Among infants, an estimated 17% to 29% have at least one episode of acute otitis media, and 10% of infants experience three or more episodes. [1][2][3][4][5][6][7] In 1990, otitis media was the second most common diagnosis among all age groups in the United States; Ͼ24 million clinic visits were made for otitis media, and medical care was estimated to be $3 billion to $4 billion annually in the United States. 8,9 In addition to the physical discomfort and economic costs associated with otitis media, there also is evidence that children with recurrent otitis media are at risk for both hearing loss and speech delay.…”

Diagnostic accuracy and the observation option in acute otitis media: the Capital Region Otitis Project

“…Child day care is associated with an increased incidence of viral upper respiratory infections, the usual precursor of acute otitis media (AOM) [2][3][4][5][6]. In 1990, there were an estimated 24.5 million office visits for otitis in the United States [1], with an estimated fiscal impact for medical care of between 3 and 4 billion dollars [7].…”