Otitis media risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.; Hardik Patel, M.D.


The most potent risk factor for otitis media is age, specifically being younger than 5 years old. Other common risk factors include exposure to smoke and air pollution, malnutrition, lack of breastfeeding, enrollment in daycare, allergies or recurrent upper respiratory infections, living in cold climates or climates subject to sudden changes, being a male younger than 20 months old, and being of Caucasian, Greenlandic, Southeast Asian, or Sub-Saharan West African descent.

Risk Factors

  • Being a child under 5 years old.[1]
  • Smoking, or exposure to secondhand smoke.
  • Exposure to air pollution
  • Suffering from malnutrition
  • Being born in the winter or spring.[2]
    • Exclusively applies to first 12 months of life.
  • Not being breastfed
  • Being a child in daycare.[3]
  • Family history of ear infections.
  • Living in cold climates or experiencing sudden changes in climate.
  • Being Caucasian, Southeast Asian, Greenlandic or Sub-Saharan West African.[4]
  • Being a male below 20 months old.
  • Being immunocompromised.
  • Recurrent upper respiratory infections for chronic suppurative otitis media.[5]
  • Experiencing allergies.


  1. Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, Grasso D, Barbiero C, Tamburlini G (2012). "Burden of disease caused by otitis media: systematic review and global estimates". PLoS ONE. 7 (4): e36226. doi:10.1371/journal.pone.0036226. PMC 3340347. PMID 22558393.
  2. Macintyre EA, Karr CJ, Koehoorn M, Demers P, Tamburic L, Lencar C, Brauer M (2010). "Otitis media incidence and risk factors in a population-based birth cohort". Paediatr Child Health. 15 (7): 437–42. PMC 2948776. PMID 21886448.
  3. "Ear infection - acute: MedlinePlus Medical Encyclopedia".
  4. Lowy, Franklin D.; Zhang, Yan; Xu, Min; Zhang, Jin; Zeng, Lingxia; Wang, Yanfei; Zheng, Qing Yin (2014). "Risk Factors for Chronic and Recurrent Otitis Media–A Meta-Analysis". PLoS ONE. 9 (1): e86397. doi:10.1371/journal.pone.0086397. ISSN 1932-6203.
  5. Acuin J (2007). "Chronic suppurative otitis media". BMJ Clin Evid. 2007. PMC 2943814. PMID 19454051.

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