Will lying down to nurse cause ear infections?

By Kelly Bonyata, BS, IBCLC

You might hear that breastfeeding your baby in a lying down position will cause ear infections. Research indicates that this is not true. No matter what positioning you use, breastfeeding actually works to decrease the incidence of ear infections.

This myth is one of many that has come from a mistaken application of bottle-feeding information to breastfeeding. There is good evidence that if baby is given a bottle of formula while lying flat, the formula can get into the Eustachian tubes and middle ear and cause an infection. However, there are two problems with applying this fact to breastfeeding: (1) breastmilk and formula are not the same — breastmilk inhibits the formation of bacteria, while formula encourages bacteria; and (2) breastfeeding and bottle feeding are not the same — milk does not pool in the mouth when baby is nursing, as as it does when baby drinks from a bottle.

Also, keep in mind that with most nursing positions, baby is lying down while nursing anyway – whether mom is lying down or not!

So don’t be afraid to lie down to nurse your baby. Go ahead and get your rest… while you nurse your baby.


Additional information

“Myth 23: The lying-down nursing position causes ear infections” from Common Breastfeeding Myths by Lisa Marasco in Leaven, Vol. 34 No. 2, April-May 1998, pp. 21-24.

General information on ear infection prevention and treatment

Detecting an Ear Infection by Alan Greene MD FAAP

Ear infections from AskDrSears.com

Cause and Treatment of Ear Infections by Dr. Jay Gordon

Alternative Treatment for Ear Infections by Dr. Jay Gordon

Ear infection articles from Mothering.com

Middle Ear Disease and Allergy by David S. Hurst, MD

Ear infections and the Breastfed Baby by Paula Yount

Ear Infection Information from the American Academy of Pediatrics

Bottle Feeding And Ear Infections: A Formula For Disaster? by Craig Brown, MD

Research on breastfeeding and ear infections

Why breastfeed? Your child will have fewer ear infections from Breastfeeding.com

The Diagnosis and Management of Acute Otitis Media from the American Academy of Pediatrics

Sabirov A, Casey JR, Murphy TF, Pichichero ME. Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6. Pediatr Res. 2009 Nov;66(5):565-70.

Vogazianos E, Vogazianos P, Fiala J, Janecek D, Slap�k I. The effect of breastfeeding and its duration on acute otitis media in children in Brno, Czech Republic. Cent Eur J Public Health. 2007 Dec;15(4):143-6.

Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep). 2007 Apr;(153):1-186.

Chantry CJ, Howard CR, Auinger P. Full breastfeeding duration and associated decrease in respiratory tract infection in US children. Pediatrics. 2006 Feb;117(2):425-32.

Scariati PD, Grummer-Strawn LM, Fein SB. A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States. Pediatrics 1997;99:e5

Dewey KG, Heinig J, Nommsen-Rivers LA. Differences in morbidity between breastfed and formula fed infants. J Pediatr 1995;126:696-702 (risk also increased in FF infant for diarrhea)

Sassen ML, Brand R, Grote JJ. Breastfeeding and acute otitis media. Am J Otolaryn 1994;15:351-7

Paradise JL, Elster BA, Tan L. Evidence in infants with cleft palate that breast milk protects against otitis media. Pediatrics 1994;94:853-60

Aniansson G, Alm B, Andersson B, Håkansson A, Larsson P, Nylén O, et al. A prospective cohort study on breastfeeding and otitis media in Swedish infants. Pediatr Infect Dis J 1994;13:183-8

Harabuchi Y, Faden H, Yamanaka N, Duffy L, Wolf J, Krystofik D. Human milk secretory IgA antibody to nontypeable Hæmophilus influenzæ: Possible protective effects against nasopharyngeal colonization. J Pediatr 1994;124:193-8

Owen MJ, Baldwin CD, Swank PR, Pannu AK, Johnson DL, Howie VM. Relation of infant feeding practices, cigarette smoke exposure and group child care to the onset and duration of otitis media with effusion in the first two years of life. J Pediatr 1993;123:702-11

Duncan B, Ey J, Holberg CJ, Wright AL, Martinez FD, Taussig LJ. Exclusive breastfeeding for at least 4 months protects against otitis media. Pediatrics 1993;91:867-72

Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective cohort study. J Infect Dis 1989;160:83-94

Saarinen UM. Prolonged breastfeeding as prophylaxis for recurrent otitis media. Acta Pediatr Scand 1982;71:567-71


Recommended books on child health and ear infections @

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