title: The effect of breastfeeding and its duration on acute otitis media in children in Brno, Czech Republic.
abstract: OBJECTIVE
  We designed this study to assess the effect of breastfeeding and its duration on acute otitis media (AOM) in children of our geographical region. Our main aim was to determine the period of breastfeeding, necessary to achieve optimal preventive results against AOM.
  
  
  METHODS
  The children that, according to the questionnaire, had suffered AOM infections in the past were used as the study group with the rest of the children used as control. The duration of breastfeeding was divided into months and the odds ratios for the occurrence of AOM were calculated for the children breastfed for more than or equal to a certain period, compared to the children breastfed for less than that period. This was repeated for each month separately and the results plotted on a graph of the confidence interval (CI) for the odds ratio values, against months of breastfeeding.
  
  
  RESULTS
  The results of our study show that breastfeeding for a period of up to 11 months can play a significant preventive role against AOM (odds ratio and lower 90% CI > 1). Breastfeeding for longer periods of time is also beneficial, with breastfeeding up to 18 months being associated with some preventive effect against the disease (odds ratio > 1), but the reduction in the incidence of AOM is not statistically significant after the 11th month. Furthermore, there are marked differences in the importance of breastfeeding during the first 11 months, with a vital protective effect during the first 4 months of life which, however, drops by the 5th month and then rises again from the beginning of the 6th to the end of the 8th month. The protective effect then drops once more, although it remains positive and statistically significant until the 11th month of life and positive, but not statistically significant, until the 18th.
  
  
  CONCLUSIONS
  Our study has revealed that for an optimal preventive effect to be achieved, the child should be breastfed for at least the first 11 months of its life. Continuing after this for up to the 18th month shows some preventive effect, which however is not statistically significant. Our results support the hypothesis that the importance of breastfeeding varies with the development of the child, its changing environment and to the new immunological challenges this brings.
authors.affiliation: Department of Paediatric Otorhinolaryngology, University Hospital, Brno, Czech Republic.
authors.forename: Ermis
authors.initials: E
authors.lastname: Vogazianos
authors.forename: Paris
authors.initials: P
authors.lastname: Vogazianos
authors.forename: Jindrich
authors.initials: J
authors.lastname: Fiala
authors.forename: Dalibor
authors.initials: D
authors.lastname: Janecek
authors.forename: Ivo
authors.initials: I
authors.lastname: Slapák
mesh_terms: D000208:Acute Disease; D001942:Breast Feeding; D016022:Case-Control Studies; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D010033:Otitis Media / Q000453:epidemiology* / Q000517:prevention & control; D013997:Time Factors