RELATION OF INFANT-FEEDING PRACTICES, CIGARETTE-SMOKE EXPOSURE, AND GROUP CHILD-CARE TO THE ONSET AND DURATION OF OTITIS-MEDIA WITH EFFUSION IN THE 1ST 2 YEARS OF LIFE

The relation of infant feeding practices, cigarette smoke exposure, an d group child care to the onset and duration of otitis media with effu sion (OME) was evaluated in a cohort of 698 healthy infants prospectiv ely monitored by tympanometry in the home every 2 to 4 weeks until 2 y ears of age. Except for an experimental group of children who were off ered early tube placement, the study children received conventional ca re from their personal physician or clinic. We used LISREL, a structur al equation modeling procedure (computer software), to explore associa tions between environmental variables and OME onset and duration while controlling for interrelations among the variables. Supine feeding po sition and early initiation of group child care were associated with e arlier onset of OME. Shorter duration of breast-feeding, increased pac ks of cigarettes smoked per day in the home, and increased hours per w eek in group child care were associated with an increase in the amount of time with OME during one or more of the age blocks studied (birth to 6, 6 to 12, 12 to 18, and 12 to 24 months). For a decrease in the a mount of time with OME during the first 2 years of life, prolonged bre ast-feeding and upright feeding position should be encouraged, and cig arette smoke exposure should be minimized. Limiting early child care i n large groups might also be advisable.