Breast milk offers significant short-term immunity against otitis media during the early years, with over 6 months showing the highest efficacy in reducing the risk of middle ear infection.

To review the existing research on how breast milk (from direct breastfeeding or donated sources), offers protection against OM during the early years of life.

To look for relevant OM literature within the realm of breast milk feeding, databases, such as PubMed, Google Scholar and Embase databases were explored from January 2008 to July 2023.

Immunoglobulin A (IgA) provides transient immunity lasting 2-3 days against OM pathogens. Continuation of breastfeeding for up to 7 months appears effective in mitigating OM.

The roles of transferred IgM, IgG, and other components like microRNA, hormones, oligosaccharides, stem cells, and interleukins in breast milk remain uncertain.

While any breastfeeding duration is preferable to none in reducing OM risk (with odds ratios ranging from 0.23 to 0.81 across studies), variability exists. Breastfeeding for more than equals to 6 months shows the highest efficacy in reducing OM risk, but benefits seem to diminish after age 2. Expressed breastfeeding does not demonstrate added benefits, and the protective effects of donor breast milk against OM remain inconclusive.

Many constituents of breast milk contribute to the protection against OM at a younger age (early childhood).