AOM is far less common in breastfed infants than in formula-fed infants, and the greatest protection is associated with exclusive breastfeeding (no formula use) for the first six months of life. A longer duration of breastfeeding is correlated with a longer protective effect. Pneumococcal conjugate vaccines (PCV) in early infancy decrease the risk of acute<unk>  in healthy infants. PCV is recommended for all children, and, if implemented broadly, PCV would have a significant public health benefit. Influenza vaccination in children appears to reduce rates of AOM by 4% and the use of antibiotics by 11% over 6 months. However, the vaccine resulted in increased adverse-effects such as fever and runny nose. The small reduction in AOM may not justify the side effects and inconvenience of influenza vaccination every year for this purpose alone. PCV does not appear to decrease the risk of<unk>  when given to high-risk infants or for older children who have previously experienced<unk> . Risk factors such as season, allergy predisposition and presence of older siblings are known to be determinants of recurrent<unk>  and persistent middle-ear effusions (MEE). History of recurrence, environmental exposure to tobacco smoke, use of daycare, and lack of breastfeeding have all been associated with increased risk of development, recurrence, and persistent MEE. Pacifier use has been associated with more frequent episodes of AOM. Long-term antibiotics, while they decrease rates of infection during treatment, have an unknown effect on long-term outcomes such as hearing loss. This method of prevention has been associated with emergence of antibiotic-resistant otitic bacteria. They are thus not recommended. There is moderate evidence that the sugar substitute xylitol may reduce infection rates in those who go to daycare. Evidence does not support zinc supplementation as an effort to reduce otitis rates except maybe in those with severe malnutrition such as marasmus. Probiotics do not show evidence of preventing acute<unk>  in children.
Otitis media
Chorditis
Rhinitis medicamentosa
Aerosinusitis
Fungal sinusitis
Otitis externa
Rhinosinusitis
Streptococcal pharyngitis