Breast-feeding, nasopharyngeal colonization and otitis media

Abstract: This thesis analyzed the relationship between breastfeeding, nasopharyngeal colonization and acute otitis media (AOM) in children. Nasopharyngeal cultures were collected from 400 children and milk samples from their mothers in connection with the scheduled visits to well baby clinics at 1-3, 4-7 and 8-12 months of age, and episodes of AOM and URI were documented. The nasopharyngeal flora was acquired more slowly by Swedish infants than in developing countries. The carriage increased with the number of siblings and day care center. (Aniansson et al. J Infect Dis. 1992;165:38-42). Breast-feeding was associated with a reduced frequency of AOM and URI, but the frequencies were higher in children with day-care contact and siblings. The nasopharyngeal bacterial carriage was higher in children with AOM. (Aniansson et al .Pediatr Infect Dis. J 1994;13:83-188). The pneumococcal anti-capsular antibody activity, in milk samples collected from the nursing mothers, was low or absent in >90% of the milk samples. In contrast anti-phosphorylcholine and anti-cell wall polysaccharide antibody activity was common. The frequency of AOM did not vary with the milk antibody activity (Andersson v Rosen et al. Pediatr Infect Dis J. 1996;15:498-507). The pneumococcal isolates were tested for adherence to human respiratory tract epithelial cells. Adhesive capacity was found in virtually all isolates. Anti-adhesive activity was found in 98.8% of the individual milk samples and it increased with age (Aniansson et al. Submitted). Children with a cleft palate were investigated between 6 and 10 years of age. Despite surgical repair and early treatment with a tympanic membrane tube, AOM and secretory otitis media were common, presumably due to Eustachian tube dysfunction and premature cessation of breast-feeding (Aniansson et al. Submitted).