Which factor is NOT a risk for otitis media?

Breastfeeding is the correct answer because it is associated with a reduced risk of otitis media, rather than being a risk factor for it. Breastfeeding provides important antibodies and nutrients that help boost an infant's immune system, which can decrease the likelihood of infections, including otitis media. Research has shown that infants who are breastfed are less likely to develop upper respiratory tract infections, which are often precursors to ear infections.

In contrast, exposure to tobacco smoke, attending daycare, and being younger than 2 years old are all established risk factors for otitis media. Exposure to tobacco smoke can impair respiratory health and increase the likelihood of middle ear infections. Children in daycare settings are at higher risk for respiratory infections due to increased exposure to pathogens. Additionally, the anatomy of a child's Eustachian tube makes younger children more susceptible to ear infections because it is shorter and more horizontal, allowing bacteria to reach the middle ear more easily.