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Otitis media is the most common bacterial infection in young children. The Greater Boston Study 1 showed that, by 1 year of age, >60% of the children had had ≥1 episode of acute otitis media (AOM) and, by 3 years of age, >80% had had AOM and >40% had experienced ≥3 episodes. Acute otitis media is the most common single cause of antimicrobial therapy in children. In many children the effusion stays in the middle ear for weeks or months after the acute infection, thereby necessitating long term follow-up and possibly surgical procedures. It is well-known that otitis media comprises a major health care problem. Several risk factors have been associated with otitis media. Most studies have shown that young age, passive smoking and attendance at day-care centers significantly increase the risk for AOM
Ruuskanen et al. (1994) studied this question.