Acute otitis media in the first hours and days of life has often been described by pathologists. And the clinical aspects were given concerted attention by Gomperz some 60 years ago in an investigation using the head mirror for ear examination.1 More recently, in the Archives of Otolaryngology, clinical evidence has been reported which focuses attention once more on the problem.2 In this study newborns in the nurseries of a large charity hospital were examined with the otoscope during the first week of life, and currently accepted signs of otitis media were found.
Allowing for certain differences, the newborn ear is similar to that in the adult. On the first day the external canal and drum are obscured by creamy whitish material, apparently vernix caseosa, which can be irrigated away with a small-tipped medicine dropper and light mineral oil. By the fourth or fifth day the debris has