Pediatrics

Earaches

Otitis media (middle ear inflammation) is commonly referred to as ear infection, even though in many cases there is no actual infection present. Chronic ear infection can be a complex, multifaceted problem. The main causes are:
1. Allergy
2. Infection
3. Nutritional deficiency

Allergy
There are many scientific studies that show chronic ear infections are due to food or airborne allergies or hypersensitivity reactions. Allergies can cause significant pressure changes within the middle ear, as well as obstruction of the eustachian tube. The most common allergens implicated in ear infection are cow’s milk and dairy products, wheat, eggs, chocolate, citrus, corn, soy, peanuts or other nuts, shellfish, sugar, and yeast. Dairy is the number one contributor to childhood ear problems. Proper allergy elimination with NAET and allergy management, such as elimination and rotation diets, can produce dramatic recovery in allergic children with chronic ear infections.

Infection
If immune function is lowered for any reason, bacteria or viruses from the nose or throat can find their way into the middle ear and contribute to an ear infection. When these germs multiply, pus builds up behind the eardrum and increases the pressure, which leads to pain and swelling in the ear. Often a common cold with a stuffy, runny nose or a cough precedes the ear infection.

Antibiotics and Other Medications
Ear infections are rarely an emergency and usually will get better without antibiotic treatment. However, there are signs that a parent should watch for. These include high fever, listlessness, stiff neck if the child is old enough to move his/her head, and abnormal mental function. If these things occur, you should have the child seen immediately for evaluation.

Research has shown that antibiotics actually make very little difference in the recovery from an ear infection. Children who use antibiotics have a higher incidence of a repeat infection within six weeks than those who don’t use antibiotics. A study published by the Journal of the American Medical Association concluded that children who took amoxicillin for chronic ear infections were two-to-six times more likely to have a recurrence of their ear problem than those who received a placebo.  Lead author Erdem Cantekin Ph.D. (professor of otolaryngology) said, “Children are being abused by the antibiotic treatment in this country.” (3) In my own clinical practice, it is obvious that children who never take tylenol or antibiotics rarely get ear infections.

Dr. Alfred Berg, past co-chair of the federal panel of experts, said that in most cases the condition disappears within three-six months without treatment.  Antibiotics frequently used in the past, are of very limited value in treating the condition and can cause side effects that lead to the development of drug-resistant bacteria causing more serious disease. Frequent use of antibiotics for common ear infections raises risks that children will harbor drug-resistant bacteria during subsequent illness. Children whose previous ear infections were treated with antibiotics have a rate of Ampicillin (amoxicillin)-resistant bacteria that is three times higher during subsequent otitis media.”(4)

Dr. Michael Poole, a professor of otolaryngology and pediatrics at the University of Texas Medical branch in Houston, emphasized that most infants and young children with otitis media don’t need antibiotic at all. “The disease usually gets well on its own.”

It is important to be aware of the numerous other causes of red ears besides bacteria manifestation. These include: teething, fever, viral infection (for which antibiotics serve no purpose), allergy, etc.

Giving medications to block and suppress an illness can push the illness further into the body. One reason for recurrent ear infections may actually be the medications the child was given to suppress the first infection, including decongestants, Tylenol, aspirin and other drugs. Anti-inflammatory drugs not only block chemicals that promote inflammation, but they also block chemicals that naturally prevent inflammation, as well as trigger the release of substances that make inflammation worse. Use of Tylenol (paracetamol) in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. Exposure to Tylenol might be a risk factor for the development of asthma in childhood. (5)

What can I do to help my child?

The holistic approach in treating a child with an ear infection is to help their immune system clear the inflammation and restore normal drainage of the ears and lymphatics.  With good nutrition, Oriental Medicine treatments and herbs we often see improvement in their symptoms within a day. Keep in mind that if an allergic child continues to be exposed to an allergen, or if another main cause is not resolved, recurrent symptoms are likely.

Nutritional Deficiency
Nutrition is important in the prevention and treatment of ear infections. An organic, unprocessed, whole foods diet, rich in a variety of cooked vegetables and low in sugar, is essential for creating good health with high immune function.

Fats: Dietary fats can either enhance or impair immune function, depending on the type of fat. The wrong types of fats (hydrogenated oils found in deep fried foods, fast foods, margarine, baked and processed foods) can predispose a child to recurrent infections and inflammatory conditions. Essential fatty acids (the good fats) are essential to normal immune and nervous system function. Essential fatty acids are found in flax oil, borage seed oil and fish oil. Supplement your child’s diet with fish, avocados, olive oil and other foods rich in healthy fats.

Vitamins and Minerals: Deficiency of certain vitamins or minerals can weaken a child’s immunity. As with adults, most children do not get all the vitamins or minerals they need to keep their immune systems strong. Be sure to give your child warm cooked meals full of a variety of vegetables three times a day!  Even vegetables for breakfast! You can also provide a good whole food multivitamin and mineral supplement.

Vitamin C is essential to the immune system function. 250 to 500 mg of vitamin C per day can be helpful.

Vitamin D – Studies suggest that vitamin D deficiency can increase the occurrence of acute otitis media. (6)

Vitamin A deficiency has been shown in animal studies to lead to ear infection.

Zinc is necessary for proper immune function and conversion of fatty acids.

Probiotics are important to healthy immunity, especially if a child has been on antibiotics. Products containing L. acidophilus are recommended for children over age 7, and B. bifidus for children under 7.

Herbal Ear Drops   Studies show that herbal ear drops containing extracts of garlic, calendula, St John’s wort and mullein flower – herbs which have antibacterial and anti-inflammatory properties – were found to be as effective in reducing ear pain compared with an anesthetic ear drop(1) and the above ear drops with lavender and Vitamin E were more effective in reducing ear pain than when  given with amoxicillin(2)! Warm a few drops (cold drops may make your child feel dizzy) and put 3-4 drops in the painful ear(s) 3-4x/day.  You can have your child lay down with that ear up for a minute or so and put a little piece of cotton in that ear. Repeat 3-4x/day and as needed for pain.

Echinacea can be given in child size dosages to prevent a cold from causing further problems.

Children’s Ear Formula by Golden Flower, addresses the acute symptoms (the branch). Give a dose every 2 hours until pain is relieved. Usually, the symptoms improve within 24 hours. (If the symptoms last several days, give a dose every 3 – 4 hours.) Loose stools may occur which is how the body expels turbid phlegm. If your child also has a cough or high fever, you will need to use appropriate additional formulas.

Windbreaker is a Chinese herbal formula by Kan Herbs. In Traditional Chinese Medicine, fever and flu are understood as an attack of “wind,” This formula knocks the wind right out of your system! It works GREAT for colds, flus and fever!  The typical dosage for toddlers is 1-2 droppersful 3x/day; for older kids 3 droppersful 3x/day, and for teens and adults 4 droppersful 3x/day.

Lifestyle habits also make a difference in recurrent ear infections. Nourishing warm food such as plenty of varied cooked vegetables and soups and plenty of outside play, limited screen time including phones and regular bedtimes go a long way to supporting your child’s health.

 

Dr. Sally Sherriff, DAOM, practices Traditional Chinese Medicine and nutritional medicine. 831-295-6327.

Citations:

  1. Efficacy of Naturopathic Extracts in the Management of Ear Pain Associated With Acute Otitis Media E. Michael Sarrell, MD; Avigdor Mandelberg, MD; Herman Avner Cohen, MD. Arch Pediatr Adolesc Med. 2001;155(7):796-799. doi:10.1001/archpedi.155.7.796.
  2. Naturopathic treatment for ear pain in children. Sarrell EM, Cohen HA, Kahan E. Pediatrics. 2003 May;111(5 Pt 1):e574-9.
  3. “Antibiotic treatment of otitis media is no more effective than placebo, and increases the risks of reoccurrence.” Cantekin EI., “Antibiotics to prevent acute otitis media and to treat otitis media with effusion.” JOURNAL of the AMERICAN MEDICAL ASSOCIATION 1994; 272(3):203-4 / Medline ID: 94293436
  4.  JAMA November 26,1997;278(20):1643-1645
  5. Beasley R, Clayton T, Crane J, von Mutius E, Lai CK, Montefort S, Stewart A; Association between Paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6-7 years; Lancet 2008 Sep 20;372(9643):1039-48. doi: 10.1016/S0140-6736(08)61445-2.
  6. Hong-Bo Li, PhD, Xu-Hui Tai, PhD, Yue-Hong Sang, BA, Zhen-Ming Xu MD; Association between Vitamin D and development of otitis media; Medicine (Blatimore)2016 Oct; 95(40): e4739. Published online 2016 Oct 7. doi: 
    PMID: 27749530

Information found on Dr. Sally’s website is not intended or offered as medical advice, diagnosis or endorsement of specific treatments or products in anyway. The information provided is for educational purposes only. We recommend that you always consult directly with a suitably qualified professional regarding specific issues you or your child may have.