Changes in day care attendance rates and in the occurrence of adenoidectomies and tympanostomies.

The care of a child in a day care center is a marked risk factor for acute otitis media. In a nationwide questionnaire survey we found that the rate of tympanostomies and adenoidectomies was 59-67% higher for the children cared for at a day care center before the age of 3 y. When the local authorities in Finland at the beginning of 1990 were obliged by law to arrange day care for all children under 3 y, the number of adenoidectomies performed on children at this age increased by 30%.