Ear Infections in Children Facts and Fiction

by Breda Sneddon, Medical Herbalist and mother of two.

• About 90% of children have otitis media at some time before school age.
• More than 60% of children have it before 2 years old.
• 30% to 40% have recurrent ear infections lasting for 3 months, with 10% lasting as long as 1 year.
• Ear infections are the greatest cause of doctor’s visits by young children

Rates of Otitis media have been on the rise in the past decade, concurrent with increases in childhood allergies and asthma.  Likely this is due to a combination of factors including environmental exposures, poor nutrition, and stress. With this, there has been an estimated 45% rise in antibiotic prescribing for ear infections, at least half of which, if not more, is completely unnecessary according to several authoritative medical reviews, as well as the Center for Disease Control and Prevention.

 

Prevention is better than cure

PREVENTING EAR INFECTIONS

Here are 6 sure fire tips for preventing ear infections in your kids – but you’ve got to really do them for them to work!

1. NIP COLDS IN THE BUD

Ear infections generally follow cold symptoms – especially runny noses.  Congestion in the nose finds its way back into the eustachian canals where it becomes an infection breeding ground.  And cold viruses and bacteria also just migrate back there because the back of the throat, sinuses, and eustachian tubes are all interconnected.   So if your child starts to develop a cold, especially if he or she is prone to ear infections, head it off at the pass with good nutrition, herbs, and supplements. First off, take all juice, wheat, dairy, and sugar out of the diet and keep it out for at least a few days beyond the end of all cold symptoms.  Use herbs to bolster immunity and fight infection.  My favorite kid-friendly natural cold remedies are Garlic Lemon Honey Tea (use maple syrup for babies under 1-year old), Elderberry Syrup and Echinacea Blend, age appropriate doses of zinc and vitamin D, and hot steams using Thyme essential oil. (You’ll find the Recipes at the bottom of this blog.)

2. BREASTFEED

Breastfed babies are at least half as likely as their formula-fed cohorts to get ear infections. Breastfeeding through at least age 1 year old also allows you to avoid the problem of deciding what beverage to give your baby! Whether you breastfeed or give your child a bottle, keep her head at a 45 degree upright angle while feeding rather than nursing or feeding her on her side. This prevents milk from getting from the back of the throat up into the immature eustachian tubes where it can be a site for infection. This is more of a risk with cow milk and formula feeding.  As an aside, dummy use increases ear infection risk – for this and other reasons, I generally recommend avoiding their use.

3. AVOID JUICE AND DAIRY

Children who drink a lot of juice and dairy products get more ear infections. They encourage the production of a lot of mucus in the upper respiratory system, while the sugar in them depresses immune function. This can lead to congestion in the chest and ears, a ripe situation for an ear infection, and a decreased ability to fight it off.  Children should not drink juice – ever – as a regular part of the diet. Regular is anything more than a cup as a treat maybe once every few months and no .  Milk – and dairy in general – is a problem, too, though harder to get away from with toddlers. Water is the best beverage for kids. No soda. EVER.

4. USE NUTRITION TO BOLSTER IMMUNITY

A healthy, optimally functioning immune system requires nutritional building blocks including protein, good quality fats, and plenty of important vitamins and minerals. I know feeding kids well – and getting them to eat well – are two totally different things! Kids can be picky and kids also get more than just what we give them – at school, friend’s homes, birthday parties, etc. We’ve got to just do our best to provide them with healthy options, and some simple basic supplements to make up for what might be missing.

Provide a good quality protein at each meal – meat or vegetarian – and good quality fats including olive oil, walnut oil, coconut oil, and avocado at least twice daily. Nuts and seeds are also protein-rich and contain high quality fats. Vegetables should be served at least twice daily, and can be part of a snack in the form of raw veggie sticks, for example, and leafy greens including kale, collards, and broccoli are nutritional treasure troves. Fruits can be part of the meal or snack. I tend to recommend fruits in season, avoiding tropical fruits in the cold weather months, and being more liberal in the summer.

Supplements can include a kid’s multivitamin and mineral, added zinc and vitamin D if not adequate in the general supplement, and a good quality fish oil product. I use Nordic Naturals for the latter, and am a fan of Rainbow Light products, though there are many high quality supplements.

Consider a probiotic as well, particularly if your child has received antibiotics in the past. Completely avoid processed and “junk” foods, and even avoid heavily processed natural foods like soy foods that imitate common dairy and meat foods. Also, keep sweets to a minimum, even natural ones.

5. DON’T SMOKE AND MINIMIZE WOOD SMOKE EXPOSURE

Exposure to tobacco smoke, and even the residue of tobacco smoke on a caregiver’s clothes, dramatically increases the risk of your child getting ear infections. 
Ditto on using wood stoves for heat – it’s an affordable and cozy way to warm your house – but wood smoke exposure significantly increases the rates of upper respiratory infection in kids, including ear infections.

6. ADDRESS STRESS

Even little kids can experience stress, and school-aged children are commonly exposed whether from social pressures, bullying, work pressures, or home life stressors. Sleep is an important part of managing stress and keeping the immune system healthy.

Teaching your child to manage stress from a young age is as important as tying shoelaces and more relevant than knowing when Christopher Columbus sailed the ocean blue. Stress has a direct impact on the immune system. In fact, the nervous and immune systems are interconnected. Teaching your child a simple technique such as saying “I am” on an long inhale and “at peace” on a long exhale, repeated 5 times before sleep, or during any stressful time, can be a lifelong gift. When there is more stress going on, and recurrent infection, counseling can be helpful.

Following the above tips will not only help to prevent ear infections, but will set the stage for your child’s lifelong immune wellness!

 

When is an antibiotic appropriate?

• If your child’s eardrum looks angry, red, and bulging. Because there is enormous variability in skill amongst doctors when it comes recognizing a true ear infection – even with a proper otoscope exam, they are likely to be over diagnosed.
• If your child has severe symptoms and for some reason an effective ear exam is impossible to conduct (inconsolably screaming baby, narrow ear canals), it is also okay to prescribe an antibiotic
• In babies younger than 6 months old with severe signs or symptoms
• In children ages 6 months to 2 years with severe infection or if they have infection in both ears at once
• In children aged 6 to 24 months with non-severe ear infection, either antibiotic therapy or observation with close follow-up is appropriate.
• Antibiotic therapy should be started if symptoms worsen or fail to improve within 48 to 72 hours after onset.

 

FOR REDUCING PAIN:

Use a hot water bottle wrapped in a towel (to avoid burning your child) can bring a lot of comfort to a painful ear. Let your child sleep on a slightly filled hot water bottle – if it is overly full it will be too firm to rest on comfortably. (Do NOT use a heating pad.)

Give firm but gentle massage all around the jaw and head in the area adjacent to the ear. Massage in a downward direction behind the ear on the neck and apply gentle inward pressure in front of the ear toward the cheek (about where sideburns would be). This will facilitate drainage of ear fluids and stimulate pressure points in the area. It may be uncomfortable to your child so do it a few times a day for short periods.

Give Children’s Herbal Compound (Herb Pharm) every 1-4 hours depending on the pain severity. Their formula contains chamomile, lemon balm, catnip, and fennel. It is very soothing and also helps with fever symptoms. For babies the dose is ¼ teaspoon, for children 2-6 ½ tsp., and for older children even up to 1 tsp. each time. It can be diluted in water, and is quite tasty. You can get it on Amazon. Of course, you can also make your own tincture or tea using these same ingredients if you prefer.

You can always give children’s doses of Tylenol or ibuprofen if needed. The herbs, which I prefer, are gentler and safer, but don’t necessarily work as quickly. I try to avoid things that reduce the fever much, because fever is an important natural process for fighting infection.

 

FOR INFECTION:

In addition to the above, I like to use a combination of Garlic Mullein Oil in the affected ear, and a blend of Elderberry Syrup, Echinacea and Anise Seed to boost the immune system and break up upper respiratory congestion.

 

Garlic-Mullein Earache Oil

The classic herbal remedy for ear infections is garlic-mullein oil. Garlic is a natural antimicrobial, addressing infections of both a bacterial and viral nature. Mullein is an analgesic, relieving the pain associated with earaches. It’s very easy to make at home with this recipe or it can be purchased.

 

Echinacea-Elderberry Syrup-Anise Seed Blend

You will need to purchase each of these products separately, and then mix them in equal parts (1/3 each) into a clean glass bottle. A medicine bottle with a dropper is ideal. This blend can be given preventatively starting during the season your child is most apt to ear infections, or at the start of an upper respiratory or ear infection. For prevention I give 1-2 teaspoons daily for children 2 and over (1/2-1/2 of that for babies), and or an acute infection, I give ¼-1 teaspoon 3-4 times daily, depending on severity. Continue at the preventative dose several times a week after all symptoms have cleared to prevent relapse. This product will stay good for a couple of years if stored in a cool, dark area. For babies under 1, make sure the Elderberry syrup is made without honey.

If your little one isn’t improving, or is getting worse, you can always start conventional treatment! But you might be delighted to find that you don’t need to!

IN GENERAL:

Keep your child well hydrated, preferably with water and non-caffeinated herbal teas 

by Breda Sneddon, Medical Herbalist.
Linlithgow 07905 742695