Abnormal tympanography after supine bottle feeding.

Abstract

To determine whether bottle feeding with the infant in the supine position is related to entry of milk into the middle ear, thereby predisposing the infant to otitis media. Ninety children, aged 7 to 24 months, who were free of respiratory infection and had normal tympanograms initially, were bottle fed in either the supine or the semiupright position, and tympanography was repeated immediately afterward. Thirty-four (59.6%) of the 57 infants fed in the supine position had abnormal postfeeding tympanographic results compared with only five (15%) of the 33 infants fed in the semiupright position (p < 0.005). In addition, when the infants with abnormal tympanograms were placed in semiupright or prone positions for 15 minutes after feeding, the majority of tympanograms returned to normal. These data suggest that supine bottle feeding has a significant effect on middle-ear pressure dynamics, probably caused by the aspiration of milk into the ear. The results also suggest that repositioning infants after feeding may mitigate the effects of supine feeding, at least in healthy children. Although this study did not demonstrate that tympanographic abnormality definitely predisposes to otitis media, it provides more evidence to encourage the practice of feeding infants in a semiupright position.