Infant Otitis Media & Bottle Feeding

Otitis media, more commonly known as a middle ear infection, is a condition that affects all ages but especially children -- and especially children under 5 2. A middle ear infection happens when the canal that connects the middle of each ear to the back of the throat becomes infected. This canal is called the Eustachian tube. When debris, mucous and fluids block this canal, it can become infected. Bottle-fed infants are especially vulnerable to middle ear infections.

Angle of Eustachian Tube

The angle of the infant's Eustachian tube leads to higher rates of ear infection in infants. In an infant, the Eustachian tube between the throat and middle ear lies on a horizontal plane. This horizontal angle enables foreign material to enter the canal and the middle ear more easily than if the angle were more vertical. The horizontal angle of the Eustachian tube also gives the bacteria room to feed on debris in the mucus, which can develop into a middle ear infection. Liquids from the infant's bottle can enter the outer ear, and then the Eustachian tube, thus causing an infection, according to the Children's Hospital of the King's Daughters 2.

Giving Bottles Lying Down

Bottle-fed infants are at greater risk for ear infections than breastfed infants, because of the bottle’s angle during feeding, according to Medline Plus. Parents are more likely to let the infant hold the bottle and drink while lying down, or to feed the infant in a nearly horizontal angle. Breastfed babies naturally feed at a 45-degree angle or greater because of the logistics involved in breastfeeding. Although breastfeeding does not exclude the infant from getting middle ear infections, it does reduce the risk.

Feed in an Upright Position

The Cleveland Clinic suggests ways to help reduce your bottle-fed infant's risk of developing a middle ear infection. Feed the baby with his head and body positioned at a 45-degree angle or greater and never let an infant hold his own bottle to feed in bed.


Bottle-feeding is just one of several potential causes for otitis media. For this reason, breastfed babies are not beyond infection simply because the baby breastfeeds. The child may have other risk factors, which include frequent colds, heredity, and smoking in the home.