Ear Infection

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Ear Infection

Otitis media is an infection of the middle ear the area just behind the eardrum. It happens when the eustachian tubes which drain fluid and bacteria from the middle ear out to the throat become blocked. Otitis media is common in infants and children because their immune systems are immature and their eustachian tubes are easily clogged. It is important that children with otitis media be seen by a health care provider because there can be serious complications if the infection is left untreated.

Signs and Symptoms

Acute otitis media causes pain fever difficulty in hearing and general signs of illness such as vomiting and diarrhea. In infants the clearest sign of otitis media is often incessant crying.

What Causes It?

Blockage of the eustachian tubes may be caused by the following.

Respiratory infection

Allergies

Tobacco smoke or other environmental irritants

Infected or overgrown adenoids

Sudden increase in pressure (such as during an airplane landing)

Drinking while lying on the back such as with a propped bottle

Excess mucus and saliva produced during teething

Otitis media appears most frequently in the winter. It is not contagious in itself but a cold may spread among a group of children and cause some of them to get ear infections.

What to Expect at Your Provider's Office

Your health care provider will use an otoscope to examine your child's eardrums and look for signs of infection.

Treatment Options

Treatment Plan

Although ear infections often clear up by themselves there can be serious complications if left untreated. Therefore an antibiotic is usually prescribed. For repeated infections in children tympanostomy tubes are sometimes inserted into the eardrum. In this procedure the tubes keep open a small hole through which fluids can drain to the outside. Tympanostomy tube insertion is a 10- to 15-minute procedure done under general anesthesia. Usually the tubes fall out by themselves or your provider will remove them.

Drug Therapies

Prescription

Antibiotics—for example amoxicillin or azithromycin; it is very important that the all prescribed medication is taken; usually prescribed for 7 to 10 days

Over the Counter

Acetaminophen or ibuprofen—for pain

Complementary and Alternative Therapies

Nutrition

Eliminate food allergens from the diet. Common allergenic foods are dairy products soy citrus peanuts wheat fish eggs corn tomatoes.

Essential fatty acids reduce swelling and help the immune system function. Children should be supplemented with cod liver oil or other fish oils ( 1/2 to 1 tsp. per day). Vitamin C (100 to 250 mg two to three times per day) enhances immunity and decreases inflammation. Vitamin C from rose hips or palmitate is citrus-free and hypoallergenic.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Herbal eardrops may be effective at reducing infection pain and fluid accumulation. Do not use eardrops if your provider suspects perforation of the eardrum. An ear oil from mullein (Verbascum thapsus) and garlic (Allium sativum) can reduce pain and treat the infection. For otitis with pain include one of the following oils: St. John's wort (Hypericum perforatum) Indian tobacco (Lobelia inflata) or monkshood (Aconitum napellus). Place three to five drops in the ear 2 to 4 times per day. Monkshood is toxic if taken internally.

Coneflower (Echinacea angustifolia purpurea and pallida) may be taken internally as tincture or glycerite 20 drops three to four times a day. The following herbs also may be taken internally: eyebright (Euphrasia officinalis) cleavers (Galium aparine) marigold (Calendula officinalis) and elderberry (Sambucus canadensis) combined in a tea (2 to 4 oz. three times a day) tincture (10 to 20 drops three times a day) or glycerite (20 drops three times a day).

Homeopathy

Some of the most common remedies used for otitis media are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

Aconite for an ear infection that comes on suddenly after exposure to cold or wind; child has bright red ears and high fever

Belladonna for sudden onset of ear infection with great pain

Chamomilla for ear infection with intense irritability especially if your child is teething

Physical Medicine

A hot pack applied to the ear and side of the neck may relieve pain. Blanch half an onion wrap in cheesecloth and apply to your child's ear while it is still hot (be sure it has cooled enough to not burn the skin). The sulphur bonds in the onion will be soothing. May also use a hot water bottle or a sock filled with raw rice and heated.

Massage

Gentle massaging of the neck may assist lymph flow which may speed healing.

Following Up

Let your health care provider know if your child's ear infection does not improve within 24 to 48 hours.

Special Considerations

You can reduce your child's risk of ear infection by reducing his or her exposure to respiratory infections and tobacco smoke. For children who are old enough to chew gum xylitol-sweetened gum has been shown to lessen the frequency of ear infections as well as dental cavities.

Supporting Research

Bitnun A Allen UD. Medical therapy of otitis media: use abuse efficacy and morbidity. J Otolaryngol. 1998;27(suppl 2):26–36.

Bizakis JG Velegrakis GA Papadakis CE Karampekios SK Helidonis ES. The silent epidural abscess as a complication of acute otitis media in children. Int J Pediatr Otorhinolaryngol. 1998;45:163–166.

Cohen R Levy C Boucherat M Langue J de la Rocque F. A multicenter randomized double-blind trial of 5 versus 10 days of antibiotic therapy for acute otitis media in young children. J Pediatr. 1998;133:634–639.

Gehanno P Nguyen L Barry B et al. Eradication by ceftriaxone of streptococcus pneumoniae isolates with increased resistance to penicillin in cases of acute otitis media. Antimicrob Agents Chemother. 1999;43:16–20.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992:243–245.

Reichenberg-Ullman J Ullman R. Healing otitis media through homeopathy. 1996. Available at www.healthy.net/library/articles/rbullman/ottis.htm.

Uhari M Kontiokari T Koskela M Niemela M. Xylitol chewing gum in prevention of acute otitis media: double-blind randomised trials. Br Med J. 1996;313:1180–1184.

Wright E.D Pearl AJ Manoukian JJ. Laterally hypertrophic adenoids as a contributing factor in otitis media. Int J Pediatr Otorhinolaryngol. 1998;45:207–214.

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