Zein Syamsurizal
Olivia Anggreyni


Acute Otitis Media (AOM) represents a common childhood ailment with significant implications for pediatric health. While breastfeeding has long been purported to confer protection against AOM, the precise nature of this relationship and underlying mechanisms remain incompletely understood. This research aimed to elucidate the relationship between breastfeeding practices and AOM incidence in children, as well as to explore potential mechanisms underlying this association. A comprehensive review of existing literature was conducted, encompassing systematic reviews, meta-analyses, longitudinal cohort studies, and mechanistic investigations. Studies investigating the incidence of AOM in relation to breastfeeding practices, as well as mechanistic pathways such as maternal antibodies, antimicrobial factors, anti-inflammatory properties, and microbiota modulation, were synthesized to provide a comprehensive understanding of the topic. The synthesis of existing evidence revealed a consistent and robust association between breastfeeding practices and reduced AOM incidence in children. Meta-analyses demonstrated a lower AOM risk among breastfed infants compared to non-breastfed counterparts, with exclusive breastfeeding yielding the greatest risk reduction. Longitudinal cohort studies further elucidated a dose-response relationship between breastfeeding duration and AOM risk, underscoring the protective effect of prolonged breastfeeding. Mechanistic investigations highlighted the role of maternal antibodies, antimicrobial factors, anti-inflammatory properties, and microbiota modulation in mediating breastfeeding's protective effect against AOM.


How to Cite
Syamsurizal , Z., & Anggreyni, O. (2024). Exploring the Relationship between Breastfeeding Practices and Acute Otitis Media Incidence in Children: Mechanisms and Implications. International Journal on Health and Medical Sciences, 2(2), 63–71. Retrieved from http://journals.iarn.or.id/index.php/HealMed/article/view/263
Abrahams, S. W., & Labbok, M. H. (2011). Breastfeeding and otitis media: a review of recent evidence. Current Allergy and Asthma Reports, 11, 508–512.
Ambikapathi, R., Kosek, M. N., Lee, G. O., Mahopo, C., Patil, C. L., Maciel, B. L., Turab, A., Islam, M. M., Ulak, M., & Bose, A. (2016). How multiple episodes of exclusive breastfeeding impact estimates of exclusive breastfeeding duration: report from the eight‐site MAL‐ED birth cohort study. Maternal & Child Nutrition, 12(4), 740–756.
Ancel, P.-Y., Goffinet, F., Kuhn, P., Langer, B., Matis, J., Hernandorena, X., Chabanier, P., Joly-Pedespan, L., Lecomte, B., & Vendittelli, F. (2015). Survival and morbidity of preterm children born at 22 through 34 weeks’ gestation in France in 2011: results of the EPIPAGE-2 cohort study. JAMA Pediatrics, 169(3), 230–238.
Bowatte, G., Tham, R., Allen, K. J., Tan, D. J., Lau, M. X. Z., Dai, X., & Lodge, C. J. (2015). Breastfeeding and childhood acute otitis media: a systematic review and meta‐analysis. Acta Paediatrica, 104, 85–95.
Cheng, H.-Y., Ning, M.-X., Chen, D.-K., & Ma, W.-T. (2019). Interactions between the gut microbiota and the host innate immune response against pathogens. Frontiers in Immunology, 10, 439915.
Dewey, K. G., Heinig, M. J., & Nommsen-Rivers, L. A. (1995). Differences in morbidity between breast-fed and formula-fed infants. The Journal of Pediatrics, 126(5), 696–702.
Hoffman, H. J., Daly, K. A., Bainbridge, K. E., Casselbrant, M. L., Homøe, P., Kvestad, E., Kvaerner, K. J., & Vernacchio, L. (2013). Panel 1: Epidemiology, natural history, and risk factors. Otolaryngology–Head and Neck Surgery, 148, E1–E25.
Homøe, P., Kværner, K., Casey, J. R., Damoiseaux, R. A. M. J., van Dongen, T. M. A., Gunasekera, H., Jensen, R. G., Kvestad, E., Morris, P. S., & Weinreich, H. M. (2017). Panel 1: epidemiology and diagnosis. Otolaryngology–Head and Neck Surgery, 156(4_suppl), S1–S21.
Klein, J. O., Chonmaitree, T., Loosmore, S., Marchant, C. D., Ruuskanen, O., & Shinefield, H. R. (2001). Otitis media: a preventable disease? Proceedings of an International Symposium organized by the Marcel Mérieux Foundation, Veyrier-du-Lac, France, February 13 to 16, 2000. The Pediatric Infectious Disease Journal, 20(5), 473–481.
Kumar, M., Singh, P., Murugesan, S., Vetizou, M., McCulloch, J., Badger, J. H., Trinchieri, G., & Al Khodor, S. (2020). Microbiome as an immunological modifier. Biomarkers for Immunotherapy of Cancer: Methods and Protocols, 595–638.
Law, J. (2000). The politics of breastfeeding: Assessing risk, dividing labor. Signs: Journal of Women in Culture and Society, 25(2), 407–450.
Lim, D. J. (2005). Recent advances in otitis media: report of the eighth research conference. The Annals of Otology, Rhinology & Laryngology, 114(1), 1.
Longo, F., McPherran Lombardi, C., & Dearing, E. (2017). Family investments in low-income children’s achievement and socioemotional functioning. Developmental Psychology, 53(12), 2273.
Nettleton, S. (2020). The sociology of health and illness. John Wiley & Sons.
Organization, W. H. (2004). Chronic suppurative otitis media: burden of illness and management options.
Reitz, S. M., Scaffa, M. E., & Dorsey, J. (2020). Occupational Therapy in the Promotion of Health and Well-Being. American Journal of Occupational Therapy, 74(3).
Rosenfeld, R. M., Schwartz, S. R., Pynnonen, M. A., Tunkel, D. E., Hussey, H. M., Fichera, J. S., Grimes, A. M., Hackell, J. M., Harrison, M. F., & Haskell, H. (2013). Clinical practice guideline: tympanostomy tubes in children. Otolaryngology—Head and Neck Surgery, 149(1_suppl), S1–S35.
Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., Hoelting, D., Hunter, L. L., Kummer, A. W., & Payne, S. C. (2016). Clinical practice guideline: otitis media with effusion (update). Otolaryngology–Head and Neck Surgery, 154(1_suppl), S1–S41.
Stockwell, D. C., & Kane-Gill, S. L. (2010). Developing a patient safety surveillance system to identify adverse events in the intensive care unit. Critical Care Medicine, 38, S117–S125.
Stone, R. (2014). Breastfeeding in the Psychoanalytic Imagination. Adelphi University, The Institute of Advanced Psychological Studies.
Story, L., & Perish, T. (2008). Breastfeeding helps prevent two major infant illnesses. Internet Journal of Allied Health Sciences and Practice, 6(3), 10.
Thabane, L., Mbuagbaw, L., Zhang, S., Samaan, Z., Marcucci, M., Ye, C., Thabane, M., Giangregorio, L., Dennis, B., & Kosa, D. (2013). A tutorial on sensitivity analyses in clinical trials: the what, why, when and how. BMC Medical Research Methodology, 13, 1–12.
Tregoning, J. S., & Schwarze, J. (2010). Respiratory viral infections in infants: causes, clinical symptoms, virology, and immunology. Clinical Microbiology Reviews, 23(1), 74–98.
Trevisi, E., Moscati, L., & Amadori, M. (2016). Disease-predicting and prognostic potential of innate immune responses to noninfectious stressors: human and animal models. In The Innate Immune Response to Noninfectious Stressors (pp. 209–235). Elsevier.
Van Belkum, M., Mendoza Alvarez, L., & Neu, J. (2020). Preterm neonatal immunology at the intestinal interface. Cellular and Molecular Life Sciences, 77, 1209–1227.
Vedal, S. (1997). Ambient particles and health: lines that divide. Journal of the Air & Waste Management Association, 47(5), 551–581.
Vlastarakos, P. V, Nikolopoulos, T. P., Manolopoulos, L., Ferekidis, E., & Kreatsas, G. (2008). Treating common ear problems in pregnancy: what is safe? European Archives of Oto-Rhino-Laryngology, 265, 139–145.
Williams, T. A., Gruber, D. A., Sutcliffe, K. M., Shepherd, D. A., & Zhao, E. Y. (2017). Organizational response to adversity: Fusing crisis management and resilience research streams. Academy of Management Annals, 11(2), 733–769.