Which factor is NOT a risk factor for otitis media in children?

• A. Breast-feeding
• B. Contact with siblings
• C. Day care attendance
• D. Season of the year

Answer: (A)

Breast-feeding actually lowers the risk of otitis media, so it is not a risk factor. The protective effect comes from immune factors in breast milk, including maternal antibodies, which help defend against respiratory infections that can lead to middle-ear inflammation. Exclusive breast-feeding in early life is associated with fewer episodes of acute otitis media.

In contrast, factors like having contact with siblings and attending day care increase exposure to respiratory pathogens, raising the chance of infections that can spread to the middle ear. The season of the year also matters, with winter months typically seeing more upper respiratory infections and, therefore, more otitis media cases.

So the option that is not a risk factor is breast-feeding, because it reduces the likelihood of developing otitis media rather than increasing it.