Day Care Blamed For Ear Infections Big Increases Cited In Study Covering 1981 To 1988

Recurring middle-ear infections among preschoolers rose sharply during the 1980s, in part because more children were in day-care centers than before, a study suggests.

Also contributing to the problem was a rise in allergies among children under 6, researchers said in a report based on government surveys of parents in 1981 and 1988.

During that period, the rate of recurrent otitis media shot up from 18.7 percent of all preschoolers to 26 percent, said researchers led by Dr. Bruce P. Lanphear, a professor of pediatrics at the University of Rochester School of Medicine and Dentistry.

The number of preschoolers with repeat ear infections rose by 1.8 million in seven years, to 5.9 million in 1988, the latest year for which figures are available, the researchers reported in a study released Monday.

The study appears in the March 3 issue of Pediatrics’ “electronic pages,” an Internet extension of the journal, published by the American Academy of Pediatrics. Experts not associated with the study cautioned that its findings are based solely on information from parents in years when ear infections were getting increasing attention.

“It’s possible that … if you pay more attention to something, it gets diagnosed more often,” said Dr. Alfred O. Berg, a professor of family medicine at the University of Washington at Seattle.

Ear infections are common and painful for children, and repeated episodes raise youngsters’ risk of of speech delays and hearing problems later. Treating ear infections costs $3 billion to $4 billion annually in the United States, Lanphear said.

It is well-established that large day-care centers are linked to a higher risk of ear infections, possibly because day care exposes children to more viruses and bacteria than they would encounter at home, the study’s authors said.

The share of children in day care rose from 11 percent to 21 percent between 1981 and 1988, the authors said.

The prevalence of allergies reported in preschoolers rose from 14 percent to 18 percent, according to the study. Nasal congestion caused by allergies is thought to lead to secretions or blockages that promote ear infections.

Parents can help protect children from ear infections by not smoking in the home, breast-feeding if possible and finding alternatives to large day-care centers, said Dr. Andrew J. Hotaling, a specialist in pediatric ear infections at Loyola University Medical Center.