Child care arrangements and repeated ear infections in young children.

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Abstract
OBJECTIVES. The purpose of this study was to assess the association between child care arrangements and repeated ear infections in young children. METHODS. Data on 5818 children younger than 6 years of age were taken from the 1988 National Health Interview Survey of Child Health. RESULTS. Seventeen percent of the children had had repeated ear infections in the year preceding the interview. Multiple logistic regression analysis showed that factors significantly associated with repeated ear infections were age (1 to 2 years), race (White), sex (male), and medical history (repeated tonsillitis, enlarged adenoids, or asthma). When these factors were controlled for, children in a current child care arrangement still had a 50% higher chance of repeated ear infections than did children not in care. Children in day care centers were at higher risk than children cared for in homes. Care in settings with more than six children elevated the risk, but hours per week of care did not. CONCLUSIONS. Decreasing the risk of repeated ear infections in young children in out-of-home child care settings may require smaller group sizes. Given the increasing use of child care, research should continue to identify specific aspects of child care that contribute to this problem.