Can lying down to nurse cause ear infections?

My 18 week old has an ear infection. The first thing my doctor asked was if my son nurses lying down. He sleeps in our bed and I do nurse him on and off throughout the night. Could my nighttime feeds have caused his ear infection?

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Kathy Kuhn

Kathy Kuhn is a registered nurse who has been working with breastfeeding families since 1981. She has been an International Board Certified... Read more

Nighttime breastfeedings do not increase the risk for ear infections. Night nursings help foster the breastfeeding relationship, which will reduce the baby's risk for an ear infection.

It is well established, through scientific research, that breastfed babies are less likely to have ear infections than their formula fed counterparts. (Riordan, & Auerbach 1998) There are several factors that help protect the breastfed baby from ear infection.

Most important for the breastfed baby are the wonderful antibodies and immune system boosters provided by breastmilk that discourage the growth of bacteria in the mouth, nose and ears. (Harabuchi et al 1994). The mechanics of breastfeeding inhibit the flow of milk into the Eustachian tubes (tubes connecting the nose and mouth with the middle ear). In breastfeeding, the milk only flows when the baby sucks. The suck is usually followed by a swallow and this greatly reduces the risk that milk will pool in the baby's mouth and enter the Eustachian tubes.

With bottle feeding, the formula can flow even when the baby is not sucking and swallowing, leading to milk pooling in the mouth and increasing the risk that formula will enter the ears. This is one reason that bottles should never be propped-up for the baby. Even when babies are held during a bottle feeding it is possible for milk to enter the Eustachian tubes because babies are usually fed on their back. (Lawrence 1994)

Breastfed babies are usually on their side, or with their head slightly elevated during feedings. Breastfeeding at night can not be compared to bottle propping because of the mechanics involved as well as the immune factors. Formula is much more irritating if it gets into the ear. Remember, it is a foreign substance, unlike breastmilk. Additionally the antibodies in breastmilk would tend to discourage the growth of bacteria, if it did get into the middle ear, unlike formula that has no antibodies.

I encourage you to continue breastfeeding, especially through this illness, as your body will be producing antibodies specific to the bacteria that caused your baby's infection. These antibodies can help him fight off the infection and help him to feel better, faster.

It sounds to me that the doctor may be applying bottle feeding knowledge and theories to breastfeeding. Breastfed babies may have fewer ear infections, but this does not mean they never get them.

Other things that can increase the baby's risk of ear infections, in addition to formula feeding are; exposure to cigarette smoke, being in a day care environment, using a pacifier, allergies and having older siblings.

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