Ear Infections in Children

MIDDLE AND INNER EAR INFECTIONS

Currently, the most common medications prescribed for children are antibiotics. At the our Wellness Center we believe, and it has been our experience for the last 12 years, that over 95% of children’s antibiotic prescriptions can be easily avoided. Nowhere is this more true than with middle or inner ear infections.

Middle ear infections, medically known as acute otitis media, and inner ear infections, known as acute otitis interna are seen in over 60% of all children before they reach the age of six, each child usually having several episodes. Even though the most commonly recommended course of treatment in conventional medicine is an antibiotic (many recent articles in medical journals recommend avoiding antibiotics, however), we have had over 95% success in treating these infections naturally, without any antibiotics. By using natural treatments we avoid the side effects of the antibiotics and, as a side benefit, the immune system becomes stronger. This, in turn, usually will decrease the number of future infections from which your child may suffer. Also included later in this information is a discussion of the child who has already suffered from frequent ear infections and what can be done to decrease the future recurrence of, and surgery for, this painful condition.

CAUSES OF EAR INFECTIONS

Middle and inner ear infections are usually caused by a current or recent “head cold” (upper respiratory tract infection) or an allergy. They are rarely, if ever, associated with water running into the ears from swimming or bathing (these are external ear infections, also known as swimmer’s ear). The tube which usually drains the middle ear space internally, called the Eustachian tube, becomes swollen from inflammation of the tissues much like the way the nose gets stuffy during a cold. This prevents liquids, normally produced by the tissues of the middle ear from draining properly, causing them to build up in the middle ear space. The liquid may then become infected both because the immune system is weaker during and after a cold (some of its energy has been used up) and because bacteria and viruses like to grow in this liquid.

DETERMINING IF YOUR CHILD HAS AN EAR INFECTION

When your child is suffering from an ear infection s/he will usually have symptoms. The most common symptoms are earache, which may be expressed by irritability or being very fussy in smaller children and infants, and fever. Other symptoms may include vomiting, diarrhea, hearing difficulty, crackling or popping noises heard by the child, or a persistent cough. In fact, (rarely) s/he may not even seem to be sick and the ear infection may be detected at a well child checkup. Sometimes in infants teething symptoms are confused with the symptoms of an ear infection because babies with teething may have a low fever, be fussy and pull at their ears.

Unfortunately, there is no sure way to know if your child has an ear infection other than to actually have a trained professional visualize the ear drum.

HOW YOUR CHILD’S EAR INFECTION IS TREATED

Typically, otitis media will be treated by using antibiotics (several recent studies clearly show that this is rarely necessary). These antibiotics prevent bacteria from reproducing. Antibiotics only will work on bacteria-caused infections, and up to 50% of the episodes of otitis media are caused by viruses which cannot effectively be treated by antibiotics. Viruses are not affected by antibiotics because antibiotics are designed to be only effective for bacterial infections.

In addition, the antibiotic must be the correct one for that bacteria, meaning that it has not yet developed defense mechanisms which render that specific antibiotic ineffective. As you may already know, bacteria are rapidly changing to survive and actually thrive in the presence of antibiotics. This means that stronger and need to be used by the conventional physician, usually with increasing frequency of side effects. It also means that the antibiotic may not work for whatever infection is being treated. The bacteria can also develop a resistance to the antibiotic during the course of treatment.

Finally, since most antibiotics only prevent the bacteria from multiplying, your child’s defenses or immune system must be strong enough to destroy the bacteria that are remaining. Unfortunately, we have found that antibiotics have a tendency to lower the body’s defenses. Therefore, even after a few, but especially after several courses of antibiotics, the bacteria may be stronger than the body’s defenses and the infection may be almost impossible to cure. One of the patients referred to us, an 11 months old girl, had such a weak immune system from all the antibiotics she had received that she was receiving daily injections of antibiotic to control the infections, and this was even becoming ineffective because of her weakened immune system.

In our experience, antibiotics do have two advantages over other treatments for an individual infection. The first is that, if the correct antibiotic is chosen and taken properly, the symptoms of the ear infection will get better faster (about two to three days). The second is that the possibility of the bacteria spreading to another part of the body (e.g. development of bronchitis, pneumonia, mastoid [the bone directly behind the ear in the skull] infection and meningitis from the bacteria traveling out of the middle ear) or of the ear drum breaking or rupturing is slightly lower (about one out of two thousand ear infections) than with optimal natural treatment of the condition. About 80-85% of all ear infections will be gone after ten days of antibiotic treatment. The two major problems with antibiotic treatment are that the treatment lowers the body’s defense mechanisms and that there is an 8 to 20% chance that your child will have side effects if he or she takes antibiotics. Since the immune system typically becomes weaker with each antibiotic prescription many children will have other infections, causing a cycle with repeated infections requiring repeated antibiotics.

A second way to manage ear infections is to let the body itself fight the infection, treating only the symptoms. In fact, it has been common practice in many locations and cultures to only use folk or home remedies and/or pain or fever treatments for centuries before antibiotics were discovered. The benefits of this treatment method are mostly the lack of side effects. Of course, the immune system will also be strengthened by successfully dealing with the infection. Our experience is that about 90% of all infections will clear up with this method in the customary two week treatment period. The two main problems with this choice of treatment are that the symptoms tend to last longer than with the other methods (range of two to ten days, the average being four to five days) and that the possibility of the infection spreading to other parts of the body or of the ear drum rupturing is higher, approximately one per hundred infections treated.

We have found at our Wellness Center that the best way to manage otitis media and otitis interna is by using an herbal and homeopathic regimen. The use of our natural treatment program increases the percentage of ear infections clearing up at the two week follow-up to above 95% (approximately 98% in our experience) with almost no side effects (about 0.1%). Symptoms last an average of one day longer than with antibiotics (three to four days) and the rate of infection spread or ear drum breakage is about one per thousand, only slightly more than with antibiotics, and far less than with nontreatment.

The greatest benefit of using our natural therapies is that they work with the body to help the immune system combat the infection better and become stronger. This will usually, in our experience, decrease the frequency and severity of all types of future infections. In addition, when our natural treatment program is begun at the onset of a cold, most ear infections will never even occur. Our treatment is as follows. We use the Immune Formula (from “kidsWellness”^TM) according to the directions on the label four times daily for fourteen days. You can either give them directly into your child’s mouth or mix them in his/her favorite fruit juice or other beverage. These have specifically been designed to be pleasant tasting. This formula should never be taken for more than four consecutive weeks. After this time it is necessary to stop the Immune Formula for at least one week.

Second, you should warm up a bottle of “kidsWellness”^TM Ear Drops Formula to a lukewarm temperature in a pot of hot water (not in a microwave). Place several drops in both ear canals (outside opening of each ear) while the ear opening is pointing straight up so that the drops drain down the canal in order to come in direct contact with the ear drum and then plug the canal with sterile cotton large enough so that it cannot be pushed into the ear canal. The cotton ball is not essential; it only prevents the ear drops from coming out of the ears and staining clothes, bed sheets, etc. These ear drops are also used four times daily and continued for fourteen days to be most effective.

The third important preparation we use is a homeopathic combination designed to support the ear structures and help with many of the symptoms of the ear infection. This preparation, called “Newton Labs Kids Earache”, is a liquid combination homeopathic to be given under the tongue or anywhere in the mouth. Give your child three drops if under one year old, six drops for 12 months and older (do not touch the dropper hands as this may contaminate it) three to four times daily between meals for ten days. Your child should not eat or drink anything but water for at least 15 minutes both before and after each dose or you will make the “medicine” ineffective. The dose may be repeated every 15 minutes if necessary for ear pain.

The ears should then be rechecked by your doctor’s office after the two week treatment period. If the infection has not cleared by then, another course of treatment will then be recommended. The conventional physician will usually prescribe another course of antibiotics. Another two weeks of either of the above natural methods may also be used. We recommend treatment with another two week course of natural treatment before making the change to antibiotics unless there have been complications, the infection has spread to another part of the body or the ear drum has ruptured.

Sometimes the infection has disappeared but there is still some liquid. This is actually very common, occurring in about 50% of ear infections, although it is our experience that persistent fluid is less frequent with our natural treatment program. There is a possibility that this liquid may become infected again, or be persistent (chronic). For this reason we recommend that residual fluid be treated with the “kidsWellness”^TM Ear Drops Formula three to four times daily and Newton Labs kids earache twice daily for two to three more weeks, followed by another ear check at the doctor’s office. Neither antibiotics nor any other conventional method of medical treatment have been shown to be effective with persistent fluid.

One additional benefit of herbal/homeopathic treatments for mild to moderate illnesses such as middle and inner ear infections is that some treatment is better than none at all. We feel, especially with ear infections, that you should aim for four treatments daily as this will be the most effective. However, if all four are not given every day for fourteen days, there still will, in our opinion and experience, be benefits. For example, in the past we treated ear infections with the natural treatment program three times daily with about 95% success. Even twice daily use will be superior to nontreatment and your child’s infection most probably will clear up. Remember that the natural treatments are enhancing your child’s natural body defenses and not working against them.

Our herbal and homeopathic treatment program can also be combined with the other therapies listed in the next paragraph. They can even be combined with antibiotics, although we usually don’t recommend this. Correction of antibiotic damage to the intestine and immune system will be covered later in this information.

Other therapies we have found useful include chiropractic or osteopathic manipulations to relieve pressure on the spinal nerves and surrounding muscles, especially in the neck area. The spine of the neck is where the nerves which control the Eustachian tubes and other functions of the ear tissues come out from the spinal cord. Neuromuscular therapy has also been effective in some of our patients. This therapy involves a very deep muscle massage and stimulation of acupuncture “trigger points” or areas where nerve “blockages” interrupt proper flow of nerve energy. Acupuncture, acupressure, and craniosacral therapy may also be effective for some children who suffer from ear infections.

EAR INFECTION RISK FACTORS

For occasional ear infections you may or may not wish to deal intensively with any of these risk factors. However, the younger your child when he/she has his/her first ear infection, the more likely that there may be repeated infections, even without antibiotic treatment. You therefore may wish to consider possible changes in lifestyle and diet even with the first infection. This section is especially important if your child suffers from ear infections frequently or has a chronic condition of fluid in the middle ear space.

The risk factors will be listed in the order of importance according to our experience from most important to least important. They may not all be applicable in your child, nor will they necessarily all be factors you can change.

The most important risk factor in repeated ear infections is actually caused by the conventional treatment for ear infections and other bacterial processes: antibiotics. Antibiotics taken by mouth alter the intestinal tract by eliminating a large number of the important “healthy” bacteria necessary for digestion and for proper functioning of the immune system. Unfortunately, the most favorable bacteria, such as Acidophilus and Bifidis are the most susceptible to the usually prescribed antibiotic therapies. Under normal conditions, these healthy bacteria will naturally control populations of both harmful bacteria and yeasts, keeping everything in balance. When antibiotics are given however, the favorable bacteria are decreased and there is an overgrowth of the other potentially harmful organisms. Since about 60% of our immune system is in the area of the intestines, this can have a major affect anywhere in our body’s defenses.

We recommend, whenever antibiotics are necessary, that treatments designed to keep the intestine in balance (“probiotics”–products designed to be favorable or “pro” to the balanced life or “bios” of the intestine) be given along with the antibiotics and for a length of time after you have stopped the antibiotics. This information is included in our web site under Antibiotic Use and Overuse (future) .

Use of these probiotic treatments are also beneficial if your child is suffering from frequent ear infections which have been treated with antibiotics because they help to restore balance in the intestine and thereby neutralize the immune depressant effect the antibiotics have caused. They must be taken for between six months to two years in chronic cases. These products are available through our web site. .

Depending on the circumstances and the urgency of the situation we may also recommend complete analysis of either the fecal organisms by a “Comprehensive Digestive Stool Analysis with Parasitology”. In addition or instead of fecal testing we may analyze chemicals produced by these organisms by testing urine organic acids. Both of these tests are available through our center. We also provide expert analysis, full reports and detailed individualized treatment programs.

The second most important risk factor in our experience is eating or drinking dairy (cow milk related) products. We recommend complete elimination of all dairy ingredients for at least six to twelve months. Dairy restriction may need to be continued if the condition returns later. There are several reasons why dairy products may cause either middle ear fluid or infections. The first is that cow milk related products are the most common cause of allergic or sensitivity symptoms as recognized by us and many other authorities in the wellness field. In addition, dairy products tend to increase amounts of mucous throughout the body and swell the mucous membranes (e.g. congest and inflame the Eustachian tube). Dairy products are also a source of hidden antibiotics, steroids and hormones. (Animals receive an estimated 16 million pounds of antibiotics every year in the U.S.) They cause digestive problems causing further food allergies and imbalances in the intestinal organisms mentioned above. Finally, they frequently are a cause of mineral imbalances which affect the nerve and muscle tissues important in maintaining proper function of the Eustachian tube.

Instead of cow milk products you should investigate products made from goat, soy, rice, oat or almond milks. While on the subject, other food allergies or sensitivities may be less commonly involved which can be tested by a blood sample through either an IgG or IgG4 test (available through our center or other nutritionally oriented physicians). By far the most common and serious food problem, though, is dairy products. We will rarely recommend food sensitivity for this condition unless there is the presence of chronic fluid unresponsive to all other recommendations.

The third important cause of frequent or chronic ear conditions is day care. Leading experts consider most day care centers a breeding ground for a number of different illnesses. The most commonly transmitted illness in day care is the upper respiratory tract infection or common cold. The typical child in day care will get some form of illness about every ten days to three weeks. Since most of these illnesses are cold type illnesses, and there are hundreds of different cold viruses, your child, while in day care, is more likely to have a complication of the cold virus, such as otitis media, even if he/she is attending only two or three days a week.

The next most likely cause of ear infections is irritation of the mucous membranes from “second hand” or “sidestream” tobacco smoke present in closed spaces such as the house (yes, even if smoking is done in the bathroom with a fan on and the window open) and car. This is a less frequent cause only because most parents will, out of courtesy to the baby, smoke tobacco products outside these areas. If someone is smoking around your child do what you can to either make him or her to stop smoking or at least to smoke away from your child and not within any closed space he or she will be staying in. Passive or sidestream tobacco smoke has hundreds of different chemicals which cause swelling of mucous membranes anywhere in the body, including the Eustachian tubes, and also deplete vitamins important to the body’s defenses.

Other strong odors or chemicals can also irritate the mucous membranes. Do whatever you can to avoid as many of these as possible. This includes such things as air fresheners, perfumes, cologne, insect sprays, mold and mildew, bleach, etc. You may wish to investigate using natural types of cleaning supplies. We emphasize, though, that the tobacco smoke is usually by far the most serious problem in the category of irritating chemicals for your child’s Eustachian tubes.

Finally, children over 15 to 18 months old (younger if possible) should stop using the baby bottle to drink any liquids. Younger children and infants should be fed the bottle with the head held higher than the torso/chest area. Eliminating the bottle is necessary to avoid irritation of the Eustachian tube drains where it ends in the back of the nose and throat (nasopharynx). Milk, juice or other liquids, even water, can irritate this opening when they flow into the area of the Eustachian tube causing swelling of its tissues. This swelling will then prevent the middle ear space from draining properly.

RECOMMENDATIONS FOR CHRONIC CONDITIONS

If your child has either a chronic condition of fluid in the middle ear or is having frequent ear infections we strongly recommend that you eliminate whatever of the above risk factors that you can, especially antibiotics (unless they are being used to treat a serious, or potentially life-threatening infection) and all dairy (cow milk related) products. We always recommend probiotics in chronic or recurrent conditions to improve intestinal function and flora. In addition, we would recommend you consult someone who practices the other methods of healing mentioned previously, i.e. chiropractic or osteopathic manipulations, neuromuscular therapy, acupuncture or acupressure.

When an ear infection occurs you have the choice of treating it in any of the ways previously discussed. We would recommend the natural treatments, using antibiotics only as a backup for more difficult cases. If your child has taken a great deal of antibiotics he/she will likely have a weakened immune system and may require occasional antibiotics (remember the probiotics) until the immune system strengthens.

You may already have discussed the option of surgery, usually involving placement of a tube in each of your child’s ear drums, with or without the removal of some of the lymphatic tissue in the back of the nose, called the adenoids (similar in structure and function to the tonsils). There are obviously some risks to this procedure which are best discussed with both the surgeon and the anesthesiologist.

We believe that surgery is only necessary for a small percentage of children with chronic middle ear problems and, therefore, rarely, if ever, recommend it without at least a six to eight month trial of the above recommendations. Our experience is that, with a good trial of the dietary, lifestyle and supplement recommendations listed above, over 95% of the children that had been recommended for surgery have been able to avoid these operations. We have only one child every year or two that requires the surgery following comprehensive treatment at our center.

Occasionally, physicians will instead recommend “prophylactic” or preventative antibiotics. This is a small daily dose of an antibiotic to prevent the next ear infection from occurring. It has been our experience that this only delays, but does not avoid the decision of, whether or not to operate on your child.

We wish you well in your journey toward health and hope that the above information is helpful. If you have any comments or questions or would like to have further information regarding our products (recommended products available on this site) or services, please contact us at www.kidswellness.com.

Your partners in health, Dr. Rydland and “kidsWellness”^TM

Copyright 1999, Eric N. Rydland, M.D., all rights reserved