Which factors are considered risk factors for developing acute otitis media according to Rebecca's medical history?

Daycare attendance and exposure to cigarette smoke are well-documented risk factors for developing acute otitis media in children. Daycare environments can facilitate the spread of infectious agents among children, increasing the likelihood of upper respiratory infections, which are closely linked to the incidence of middle ear infections like acute otitis media. When a child is in close contact with other children, particularly in a confined space, the chances of respiratory infections being transmitted are heightened.

Exposure to cigarette smoke is another significant risk factor. Children exposed to passive smoke are more susceptible to respiratory infections because the smoke can impair mucociliary function in the respiratory tract and lead to inflammation, thereby making the Eustachian tubes — which connect the middle ear to the back of the throat — more susceptible to infection and dysfunction. This combination of factors clearly contributes to a higher risk of developing acute otitis media.

In contrast, while other factors mentioned in the options may seem relevant, they do not have the same strong correlation with the condition. For example, exposure to animals and pollen may cause allergy symptoms but are not direct contributors to middle ear infections. Lack of vaccinations can contribute to severe infections but isn’t a primary risk factor for acute otitis media specifically, nor does cold weather play a