الفهرس 
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Abstract
Background: Acute otitis media is the most frequent chief complaint in infants, accounting 80% of children below 3 years old. It is one of the main reasons for primary care physician consultations and antibiotic prescriptions. It has a high economic burden in terms of direct and indirect cost. The aim of the work: The aim of the work is to Estimate prevalence of acute Otitis Media among both exclusively and non-exclusively breastfed infants and Assess risk factors associated with acute otitis media in both groups. Patients: This study was carried out in multiple primary health care centers (PHCs) and unites at Damietta Governorate, Egypt. over a year from March 2019 to March 2020. The study group included 400 infants aged 4 months (266 males and 134 female) attending to the PHCs. Their Parents were briefed about the study and were encouraged to express their experiences. Approval was granted from the University Institutional Review Board. Methods: Data was collected through a self-administered questionnaire which was basically divided into 4 sections including socio-demographic characteristics of the participating infants, infant feeding history in the first 4 months of age, infant medical history related to upper respiratory tract infection and AOM and the possible risk factors for AOM such as pacifier use, cleft palate and etc. Also Family records were used to compare the data in questionnaires. A clinical and physical examination of infants for signs and symptoms of AOM through history taking, general and local examination via otoscope in the family clinic with assistance of a family medicine specialist during their visits to the center. Results& Conclusion: our study demonstrated the statistically significant association between mode of breast feeding in the first four months of age and incidence of acute otitis media as 16.1% of cases with non-exclusive breast feeding had otitis media versus 5% among cases with excusive breastfeeding. Recommendations: Exclusive breastfeeding should be encouraged at least for 4 months to help in preventing acute otitis media in these infants.