We read the article “Burden of acute otitis media on Canadian families,”1 which was published in the January 2011 issue of Canadian Family Physician, with interest. The topic is certainly a valid line of scientific inquiry and the results are of interest to family physicians.
The authors chose to mention primary prevention of acute otitis media (AOM) through immunization and noted that this is an area requiring further study. It was curious that there was no further discussion of the other proven methods of primary prevention of AOM. Breastfeeding, in particular, is extremely well studied and effective. One large meta-analysis showed that the pooled odds ratio was 0.50 (95% confidence interval 0.36 to 0.70) when comparing exclusive breastfeeding with exclusive bottle feeding for more than either 3 or 6 months’ duration.2
Other risk factors for AOM, including second-hand smoke, child care attendance, and pacifier use, were similarly neglected. This oversight, although initially puzzling, was quickly explained in the fine print: “This study was supported by an unrestricted research grant from GlaxoSmithKline.” GlaxoSmithKline is of course, a purveyor of vaccines. We would have expected better from the authors and from this journal.
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