In reference to the cases of otitis developing into a serious or fatal illness this may be chicken or egg. Did this children have otitis then become bacteremic or were they bacteremic and deveoped otitis and another focus of infection?
I recently recieved a CME suppliment to one of my peds journals on otitis, listed as risk factors are:
Host Factors
age
early onset of disease
gestation <33wk
BW <1500grams
male sex
race:Native American, Alaskan Eskimo,Australian Aborigines
genetic predispositon
altered host defense

Environmental factors
group day care
environmental allergens and pollutants
exposure to smoke
Not Breast-fed (their hypen not mine)
season:fall,winter,early spring
low socioeconomic status
prone sleep position
use of pacifier

I though it interesting and correct that not breastfeeding be listed as a risk instead of saying breastfeeding is protective. Breastfeeding is the way babies should be fed.
-Rob
 r