Background
Methods
Design
Participants
Inclusion criteria
Exclusion criteria
Sample size
Data collection procedure
Study tool
Demographic data
Feeding data
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Artificial feeding: Infants are fed only using a breast milk substitute [11].
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Breast milk substitute: Any food being marketed or otherwise represented as a partial or total replacement for breast milk, regardless of whether it is suitable for that purpose [12]
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Breastfeeding: The child has received breast milk directly from the breast or milk that was expressed [13]
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Exclusive breastfeeding: No other food or drink, not even water, except breast milk (including expressed milk or milk from a wet nurse) for the first 6 months of life, but the infant is allowed to receive ORS, drops and syrups (vitamins, minerals and medicines) [14]
AOM data
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The researcher visited the General Pediatric Clinic to review medical records from 1/1/2017 to 31/12/2020, and then we collected cases who were diagnosed with AOM when they were less than 2 years old. Additionally, we collected controls after reviewing their records, which showed no evidence of previous AOM episodes during the first 2 years of life. We conduct our study based on the definition of AOM [15] and we depend on reviewing the cases with documented bulging and redness of tympanic membrane along with acute onset of fever in addition to the presence otitis media with effusion using an objective test which is the tympanometry.In the analysis, the following conditions were used to diagnose OM (AOM and OME):
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AOM: eardrum inflammation with anabrupt onset of symptoms (fever, irritability, or earache) and signs (fluid level, bubbles, hypervascularity, withdrawn tympanic membrane) as documented by pneumatic otoscopy and/or tympanometry [15].
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Acute otitis media (AOM): Rapid onset of signs and symptoms of inflammation in the middle ear [16].
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Recurrent AOM: Three or more well-documented and separate AOM episodes in the preceding 6 months, or four or more episodes in the preceding 12 months with more than one episode in the past 6 months [16]
Statistical analysis
Results
Sociodemographic characteristics
Variable | Level | Cases | Controls | p- value |
---|---|---|---|---|
*Sex | Female | 36(36.7) | 49(50) | 0.061 |
Male | 62(63.3) | 49(50) | ||
**Age (months) | 21.26 ± 4.3 | 19.35 ± 4.75 | 0.04 | |
*Level of Education | Preparatory | 6(6.1) | 5(5.1) | 0.004 |
High school | 24(24.5) | 6(6.1) | ||
University college | 11(11.2) | 12(12.2) | ||
Bachelor’s | 50(51) | 59(60.2) | ||
Postgraduate | 7(7.1) | 16(16.3) |
Types of feeding among the study participants
Variable | Level | Cases | Controls | p- value |
---|---|---|---|---|
Type of feeding | Nonexclusive | 40 (40.8) | 23 (23.5) | 0.000 |
Artificially Fed | 23 (23.5) | 17 (17.3) | ||
Exclusively breastfed-3 months | 22 (22.4) | 17 (17.3) | ||
Exclusively breastfed -6 months | 13 (13.3) | 41 (41.9) |
Association between the type of feedings and the development of acute otitis media (AOM)
Type of Feeding | Cases | Controls | Chi-Square | P value | Odds Ratio (OR) |
---|---|---|---|---|---|
Artificially Fed | 23 (23.5) | 17 (17.3) | 20.647 | 0.000 | |
Nonexclusively Breastfed | 40 (40.8) | 23 (23.5) | 0.234 | ||
Exclusively Breastfed-3 months | 22 (22.4) | 17 (17.3) | 0.182 | ||
Exclusively Breastfed -6 months | 13 (13.3) | 41 (41.9) | 0.245 | ||
Total | 98 | 98 |
Association between the duration of breastfeeding and the development of Acute Otitis Media (AOM)
Type of Feeding | Cases | Controls | Chi-Square | P value | Odds Ratio (OR) |
---|---|---|---|---|---|
Exclusively Breastfed-3 months | 22 (62.9) | 17 (29.3) | 10.088 | 0.001 | 1.7 |
Exclusively Breastfed -6 months | 13 (37.1) | 41 (70.7) | |||
Total | 35 (37.6%) | 58 (62.4%) |
Association between pumped breast milk and the development of acute otitis media (AOM)
Receiving pumped breast milk | Cases | Controls | Chi-Square | p value | Odds Ratio (OR) |
---|---|---|---|---|---|
No | 45(62.5) | 69(90.8) | 16.721 | 0.00 | 5.91 |
Yes | 27(37.5) | 7(9.2) | |||
Total | 72 | 76 |