The purpose of the present study was to analyse the incidence of acute and secretory otitis media (OM), and feeding with breast milk, and the use of a grommet in children with a cleft palate (CP/CLP) or cleft lip (CL), compared with controls. A total of 84 children between 6 and 10 years of age were studied. The CP/CLP group consisted of 48 children with an isolated cleft palate (n = 28), or a cleft lip and palate (n = 20). The CL group consisted of 15 children with an isolated cleft lip. The controls were 21 children without clefts. Children with CP/CLP had acute OM significantly more often than children without clefts (43/48 compared with 10/21), and secretory OM (40/48 compared with 4/21), despite the use of grommets. CP/CLP children were breast fed for a mean of 2.8 months (range 0-13), compared with 3.6 months (0-12) for CL, and 7.5 (0-24) months for controls. There was a significant correlation during the first 18 months of life between longer duration of feeding with breast milk and a lower incidence of acute and secretory OM in the three study groups combined. The incidence of otitis media was not affected by care in a day centre, having a sibling attending a day care centre, or by the family's medical history. Despite cleft repair and early treatment with grommets, both secretory and acute OM are common among children with cleft palate, presumably as a result of their eustachian tube dysfunction. The present study suggests that premature cessation of feeding with breast milk may contribute to an increased incidence of acute and secretory OM.
In a retrospective study of 179 otitis-prone children and 305 controls, various possible predisposing factors for acute otitis media (AOM) were compared. The children were matched for age and sex. There were 61% boys and 39% girls in the otitis-prone group and 58% boys and 42% girls among the controls. Eighty-eight (49%) of the otitis-prone children experienced > or = 11 episodes of AOM and 162 (53%) of the controls had none or at the most one episode of AOM. There were no differences between the groups concerning dwelling districts, the size of family, number of siblings or the education and occupation of the parents. In the otitis-prone group there were more fathers who had been otitis-prone as children. This was not seen for the mothers when comparing all the children, but was seen when comparing the most otitis-prone (> or = 11 AOM) with the controls (0-1 AOM). The otitis-prone children more often had siblings who were otitis-prone compared with the controls. There were no differences between the two groups regarding pregnancy, birthweight or duration of breast-feeding. Thus, male gender and heredity for middle-ear problems appeared to be of importance for otitis-proneness.
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