A comprehensive review of studies published in the British Medical Jour- nal found that there was no signiﬁcant dif- ference in children with acute ear infec- tions when antibiotics were given, as com- pared to a placebo.
While ear infections can occur at any age, they are most common in early childhood and infancy. In fact, ear infections are the reason for more than half the visits to pedi- atricians in the United States. Statistics show that acute ear infections affect two-thirds of American children under age two, while chronic ear infections affect two-thirds of children under age six!
There are two main categories of ear infection. The ﬁrst is an outer ear infection, also known as swimmer’s ear or otitis externa. It affects the ear canal, which runs from the ear opening to the eardrum, and happens when a substance (usually, water—hence the nickname) enters the ear canal and is trapped there by a build-up of wax. In this stagnant condition, bacteria breed and ﬂourish. The body responds to the infection with inﬂammation, redness, pain, and sometimes a fever.
The second category, called a middle-ear infection or otitis media, is much more common, especially in very young children and infants. Most ear infections are usu- ally associated with an upper respiratory infection or an allergy. Forty percent of cases involve bacterial infection, with the most common being Streptococcus pneumoniae. Many ear infections involve a viral infection that is unresponsive to antibiotics. Chronic middle ear infections (also known as serous otitis media or glue ear) refer
to chronic swelling of the eardrum as a result of ﬂuid accu- mulation. One of the reasons infants are more susceptible to ear infections is due to the fact that the eustachian tube (which drains ﬂuid from the middle ear) is more horizontal than it is in adults and does not drain as efﬁciently. This tube becomes more vertical and drains better as children get older. The key is to prevent the build-up of this ﬂuid with a proper diet. Food allergens, such as cow’s milk and sugar, trigger a cascade of inﬂammation responses that often result in mucus and ﬂuid. These foods are often the root problem. In addition, avoiding environmental allergens is important— particularly secondhand smoke. Addressing food allergies and environmental allergens is crucial so that “germs” do not have an environment to grow in. Of course, a healthy func- tioning immune system is also key in preventing infection.
Some infections are the result of a malfunctioning or still-developing eustachian tube, the passage that connects the three bones of the middle ear to the nose and the throat. When the eustachian tube isn’t working properly, mucus isn’t able to drain from behind the eardrum into the upper res- piratory tract; instead, it remains trapped and causes pain and
he prescribing of antibiotics for otitis media with effusion is controversial. This
refers to the presence of ﬂuid in the middle ear, in the absence of signs or symptoms of acute infection. According to the U.S.
Agency for Health Care Policy and Research, most cases of otitis media with effusion resolve spontaneously. It must also be recog- nized that ﬂuid left in the middle ear after antibiotic treatment is normal. Approxi- mately 70 percent of children have ﬂuid in the middle ear at 2 weeks, 50 percent have ﬂuid at 1 month, 20 percent have ﬂuid at 2 months, and 10 percent have ﬂuid at 3 months after appropriate antibiotic therapy. According to studies, the ﬂuid that remains does not need to be treated with antibiotics, as is typically done.
pressure. This situation often leads to infection, especially if there has already been a mucus-producing disease of the upper respiratory system, such as a cold or the ﬂu.
Middle-ear infections can be quite painful. There may be a fever, perhaps a very high one, with some hearing difﬁculty or nausea and vomiting. If your child pulls or slaps at his or her ear, an infection is a strong possibility. Take all ear infections and ear pain seriously. The following treatments can be used to relieve pain, but do call a doctor for professional advice in the presence of a sustained fever or if the ear con- tinues to hurt. If you or your child experiences severe ear pain, followed by a sudden relief and/or a discharge of blood or pus, consult a doctor immediately, even if you or the child feels well.
Conventional Treatment for Ear Infections
Ear infections have reached nearly epidemic proportions in the United States. In response, frustrated doctors have come up with aggressive treat- ments, usually in the form of heavy antibiotics and ear tubes. Sometimes these strategies are necessary and effective, but all too often doctors employ them as a ﬁrst line of a defense, rather than as a last resort. Tubes in the ears, which relieve pressure on the eardrum and allow pus to drain, may seem like a good idea, but the tubes themselves often cause a great deal of dam- age. Interestingly, a study published in the Journal of the American Medical Association found that only 42 percent of these surgeries were appropriate. If your doctor recommends ear tubes, question him or her closely. Make sure that any treatment is tailored to your needs or your child’s. And as always, try conservative measures—dietary changes, immune enhancement, homeopathy, and gentle herbals—before turning to harsh drugs or invasive procedures.
The over-prescribing of antibiotics for childhood ear infections has been a con- tributing factor to antibiotic-resistant bacteria. In addition, they put your child at risk for candida overgrowth (see Candidiasis).
Not all of the following symptoms need to be present for a diagnosis of ear infection.
• Pain, often throbbing
• Pressure or a feeling of fullness inthe ear
• Pus from the ear
• Hearing difﬁculty in the affected ear
• Nausea and vomiting
• Buildup of wax, often the result of cleaning the ears with cotton swabs
• Upper respiratory infections
• Food allergies/sensitivities (especially, overconsumption of dairy products)
• Environmental allergies (molds, dust, animal dander, and hay fever)
• Smoking or secondhand smoke, which irritates the eustachian tube and causes inﬂammation behind the ear drum.
• Not being breastfed: Breastfeeding allows for the transport of immune factors from the mother to the child and matures the digestive tract so that the child is less susceptible to food allergies.
• Season: The incidence of earaches is highest in the winter. In northern climates, ear infections increase in frequency beginning in September.
• Fetal alcohol syndrome: More than 90 percent of children with fetal alcohol syndrome (which occurs from the mother drinking alcohol during pregnancy) have problems with ear infections.
• Genetic: Nearly 60 percent of all children with Down’s syndrome experience problems with otitis media.
• Nutritional deﬁciencies of vitamins A and C and essential fatty-acid imbalance.
• Injuries: Children who suffered a trauma at birth (e.g., forceps deliv- ery, vacuum extraction) and chil- dren with neck and head injuries are more susceptible (an indication for chiropractic, osteopathic, or craniosacral therapy).
These dietary suggestions will help alleviate pain. More important, many of them will
also prevent recurring infections. Signiﬁcant changes in your child’s diet may be nec- essary for optimal results. Work with a nutrition-oriented doctor.
A good diet based on whole grains, high-quality protein, and fresh fruits and vegeta- bles will build up the immune system and discourage infection.
The following tests help assess possible reasons for chronic ear infections: Food allergies/sensitivities—blood or electrodermal
Digestive health—stool analysis
Eustachian tube examination by an ENT specialist
Drink plenty of water to thin mucus secretions.
Essential fatty acids, found in cold-water ﬁsh, ﬂaxseeds, and ﬂaxseed oil, are use- ful in reducing the inﬂammation or the allergies that are often present.
Switch bottle-fed babies to a nondairy formula, with your doctor’s supervision. Breastfeeding mothers should avoid common allergens (e.g., cow’s milk), in order
to not pass the allergenic portion through the breastmilk. Food testing can be done with the mother.
Food to Avoid
Investigate the possibility of food allergies, especially to dairy, wheat, sugar, citrus fruits, soy, eggs, or chocolate. See the Food Allergies section, especially the elimination diet on page 253, for further advice. If you discover a trigger food, remove it from your diet.
If ear infections recur or are chronic, suspend the consumption of dairy products indeﬁnitely. For infants and young children who are bottle-fed, replace the regular cow’s milk formula with a hypoallergenic/predigested formula.
Simple sugars suppress the immune system, so stay away from reﬁned carbohydrates.
A three-day juice fast can help break up excess mucus in the body. Use this therapy for adults only; children should never fast.
Super Seven Prescriptions—Ear Infection
Super Prescription #1 Homeopathic Combination Earache Formula
Take a dose of the formula every thirty to sixty minutes for an acute earache. Improvements should be seen within two to four hours. Otherwise, see the reme- dies listed under Homeopathy in this section for a speciﬁc remedy.
Super Prescription #2 Garlic (Allium sativum) or garlic/mullein drops
Place 2 warm drops in the affected ear three times daily. Do not use if the eardrum is perforated or if fluid is draining out of the ear. These herbs have antibacterial/antiviral effects and natural pain-relieving qualities.
Super Prescription #3 Echinacea (Echinacea purpurea) and goldenseal (Hydrastis canadensis)
Adults can take 4 ml and children 2 ml four times daily or as directed on the con- tainer. Echinacea and goldenseal enhance immune function.
Super Prescription #4 Vitamin C
Adults should take 1,000 mg three to four times daily and children 500 mg three times daily. Reduce the dosage if diarrhea occurs. Vitamin C enhances immune function and reduces inﬂammation.
Super Prescription #5 Larix
Dissolve 1 to 2 teaspoons in a formula bottle for bottle-feeding infants or mix in water for older children and give it four times daily. Larix enhances immune function.
Super Prescription #6 Vitamin A
Give 2,000 to 5,000 IU daily (up to ﬁve days) for children up to six years of age. It’s available in liquid form. Vitamin A supports immune function.
Super Prescription #7 Essential fatty acids
Adults should take 1 to 2 tablespoons of ﬂaxseed oil or 3 grams of ﬁsh oil daily, or a formulation that contains a mixture of omega-3, 6, and 9 fatty acids. For chil- dren give a children’s essential fatty acid formula or 1⁄2 to 1 tablespoon of ﬂaxseed oil daily. It can be mixed into the formula for bottle-fed infants. Reduce the dosage if loose stools occur. Essential fatty acids are helpful for the prevention of ear infec- tions, as they reduce inﬂammation and allergenic tendencies.
. K.H. Friese, M.D., and his colleagues divided 131 young children (average age 5) into two groups. One group of 28 children received conventional treatment, such as decon- gestants, antibiotics, and fever-reducing medi- cines (12 different drugs in all), for ear infections. Another group of 103 children was treated with 1 or more of 12 homeopathic reme- dies. Children receiving the homeopathic treat- ment, on average, experienced 2 days of ear pain and required 3 days of therapy. Nearly 71 percent never had another ear infection after 1 year, and nearly 30 percent had a maximum of 3 recurrences. By contrast, children treated with conventional medicine, on average, experienced 3 days of ear pain and required 10 days of ther- apy. Nearly 57 percent did not have a recur- rence after 1 year, while 43 percent experienced a maximum of 6 recurrences.
Thymus (Thymus vulgaris) extract supports immune function. Take 250 to 500 mg twice daily on an empty stomach or as directed on the container.
Zinc supports immune function. Give 5 mg for chil- dren under two and 10 mg for those older than two. Adults should take 30 mg daily.
Chamomile tea is another way to help a child relax and sleep.
Because of its high mucilage content, marshmallow (Althea officinalis) is soothing to irritated ear mem- branes. Adults should take 2 grams three times a day; children six years and under can take 1 ml of the tincture three times daily.
Saint-John’s-wort oil (Hypericum perforatum) relieves ear pain and ﬁghts infection. Place 2 warm drops in the affected ear three times daily. Do not use if the eardrum is perforated or if ﬂuid is draining out of the ear.
Xylitol nasal spray and chewing gums prevent the buildup of bacteria that may cause ear infections. Use preventatively.
Pick the remedy that best matches your symptoms in this section. For acute earaches, take a 30C potency (or the potency available to you) hourly, up to six doses. After you notice improvement, stop taking the remedy, unless symptoms return. Consultation with a homeopathic practitioner is advised.
Aconitum Napellus is helpful for a painful earache that comes on very quickly. The child experiences violent pain, restlessness, and great thirst. The earache often occurs after being out in the cold, dry wind. The ears are bright red. Aconitum is helpful only if used during the initial six hours of the ear infection.
Belladonna (Atropa belladonna) is for a sudden onset of earache, with high fever and a red face and eardrum. The right ear is more affected than the left. The pupils can be dilated, and child looks and feels hot, but the feet are cold.
Chamomilla (Matricaria chamomilla) is for a child with an ear infection, who is very irritable, angry, and hard to console. The child appears to be in a lot of pain, screaming and crying. The child wants to be carried, but it helps only for a short period of time. One cheek is often red, the other one pale. This is a great remedy for earaches that occur at the same time as teething.
Ferrum Phosphoricum is recommended for a child who has a fever and feels warm. The face and the affected ear are red (such as in Belladonna), but the child does not act sick.
Hepar Sulphuris (Hepar sulphuris calcareum) is helpful when the ears are very sen- sitive to the touch and to cold during an infection. The child is irritable and hard to console. There is a sharp pain in the ear that feels better with warm applications. There can be pus or discharge from the ear.
Lachesis is useful when the left ear is affected or when the infection starts in the left ear and moves to the right. The earache is worse with warm applications and at nighttime.
Lycopodium (Lycopodium clavatum) is helpful for right-sided ear infections. Ear symptoms are often worse from 4 to 8 P.M. and feel better with warm applications to the ear. The child is irritable and may have more gas and digestive upset than normal.
Mercurius Solubilis or Vivus is a great choice for an earache that has an offensive- smelling pus discharge. The child sweats more than usual. There is a thick coating on the tongue, along with bad breath and increased salivation. The symptoms are worse at night.
Pulsatilla (Pulsatilla pratensis) is for a child who has a fever, is weepy, and wants to be held and comforted. Ear pain feels better with cold applications or in the open air, and worse with warmth. The child has a low thirst. The fever and the ear infection often develop at night. There can be a yellow-green discharge from the nose and the ears.
Silica (Silicea) is used for children who are thin and frail, with weak immunity, and who suffer from chronic ear infections. It is also used for acute ear infections and for a ruptured eardrum with pus. Cold and wind bother the child.
Triple Warmer 21, Small Intestine 19, and Gallbladder 2 will ease ear pain.
Massage of the ear, the neck, and the temples is a gentle way to relieve a child’s pain
(or an adult’s).
See pages 686–687 for information about acupressure points and how to administer treatment.
To reduce pain, work the ear/eye area. Stimulate the lymph area to combat infection.
Alternating hot (two minutes) and cold (thirty seconds) towels over the affected ear helps to relieve pain and inﬂammation.
Chamomile oil makes a gentle wash for the infected ear. First dilute the chamomile in a carrier oil, and place a couple of drops into the ear. After ten minutes, lie down on your side, with the infected ear turned toward the ﬂoor. Let the oil drain out (you may want to have a towel handy).
• Make sure not to bottlefeed while children are lying on their backs. They should be at a 30-degree angle or more to prevent ﬂuid accumulation in the eustachian tube.
• Don’t smoke or expose yourself or your children to secondhand smoke.
• Follow the old adage that says not to put anything into your ear that’s smaller
than your elbow. Cotton swabs pack wax into the ear canal.
• During the course of an infection, don’t allow moisture into your ears. Put cot- ton gently in the outside of the ear while taking baths or showers or while washing your face. Don’t go swimming until the infection has cleared.
• To reduce pain, apply heat locally. Try a hot water bottle wrapped in a towel or blow a hairdryer onto the affected ear.
• Chiropractic, osteopathy, and craniosacral treatments can be very helpful for some children with structural and motion abnormalities of the upper neck ver-
tebrae. These abnormalities can cause ﬂuid to build up and not drain properly, providing a breeding ground for infections. Many parents have reported that these types of treatments helped to prevent further ear infections with their children. Speciﬁc treatments by a practitioner can correct these imbalances.