ear infections

Trends in treatment for these painful, persistent ailments


As predictable as the change of seasons, winter brings pediatricians’ waiting rooms filled with children who have come down with all sorts of infections. After the common cold, ear infections are the most-cited reason for an office visit.

Ear infections result when the eustachian tube, which drains the middle ear, becomes blocked because of a cold, other infection or allergy. This resulting middle-ear infection — an increase in fluid and inflammation behind the eardrum — is called otitis media. Often, the fluid can’t drain through the blocked tube and pushes up against the eardrum, which becomes stretched and painful. Fever may be present, but sometimes your only cue that something is awry is a baby who is cranky or tugs on his ear.

If you suspect an ear infection in a child older than 6 months, it now seems safe to wait a day before taking him to the doctor — as long as he otherwise appears healthy, is still smiling and playing a little and is able to drink liquids. But take your baby to the pediatrician if his discomfort persists for more than a day. If the doctor does diagnose an ear infection after examining your child, she may suggest an over-the-counter non-aspirin pain reliever such as children’s-strength acetaminophen (Tylenol), in addition to other treatments.

Until a few years ago, most ear infections routinely were treated with antibiotics, but not so anymore. The main reason: An over-reliance by the medical community on antibiotics to fight infections — many of which are viral — has led to antibiotic-resistant bacteria and recurrent infections. There also have been recent official opinions from pediatric associations stating that a very high percentage of ear infections will resolve spontaneously in the first three days without medication.

Instead of antibiotics ...

Doctors and parents are looking for other treatments because of the problems caused by too many antibiotics. Kathi Kemper, M.D., author of The Holistic Pediatrician (HarperCollins, 1996), says that parents in her practice try many different alternatives to antibiotics. Some try echinacea (recommended only for children older than 2 years) to boost the immune system. Others try homeopathic remedies or osteopathic cranial therapy, the latter being gentle massage of the head, neck and sacrum (a thick triangular bone located near the lower end of the spinal column).

Andrew Weil, M.D., director of the Program in Integrative Medicine at the University of Arizona in Tucson and author of many books, including Spontaneous Healing (Ballantine Publishing Group, 1995) and Eating Well for Optimum Health (Alfred A. Knopf, 2000), has found that the most useful remedy for recurrent ear infections is cranial osteopathy and the elimination of cow’s milk and milk products from the diet.

The osteopathic treatment addresses misalignment in the skull bones; without proper alignment, fluid can pool in the middle ear and breed bacteria. Researchers at the University of Arizona program and the National Institutes of Health currently are studying the effects of echinacea and cranial-sacral osteopathy on the incidence of recurrent ear infections in children ages 1 to 5.

Regardless of what the underlying cause and subsequent treatments of ear infections are, says Weil: “I don’t think it’s normal for kids to have as many ear infections as they do in our culture. People have just accepted it as a normal part of growing up.”

Moderation and preventionParents and doctors seem to be getting the message about the overuse of antibiotics. According to Kyle Yasuda, M.D., a pediatrician in Seattle, the challenge is deciding when to treat. If a child has a middle-ear infection and is mildly ill, a physician may decide to observe the child and not prescribe antibiotics.

The main thing, says Kemper, is to help your child have a healthy immune system. She recommends that you breastfeed your child for at least a year and don’t expose him to tobacco smoke. If your infant has a cold, feed him in an upright position; this may help prevent blocking of the tubes and accumulation of fluid in the inner ear. Bottles with special venting systems also may help by reducing pressure in the ears. Finally, a new study reported in Pediatrics suggests that restricting use of pacifiers in children older than 6 months can lower the risk of ear infections.