By Shiroko Sokitch, MD
Symptoms of Ear Infection
One of the most common problems pediatricians see is ear infection. Almost half of all children will have at least one middle ear infection during their first year, and by age three, over two-thirds of all children will have had at least one middle ear infection. Symptoms include ear pain, fever, irritability, and sometimes dizziness in older children. Parents should also be on the lookout for more subtle signs, such as low appetite, less than normal activity, shaking the head or pulling on the ear and crying. Occasionally, the pressure in the middle ear will build up to a point where the eardrum bursts, resulting in pus and blood drainage from the ear. As alarming as this sounds, generally the child will feel better afterwards. The tear in the eardrum allows the fluid to drain, and the hole will usually heal within a few days.
Causes of Ear Infection
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 four main causes are:
3. Mechanical obstruction
4. Nutritional deficiency
In Childhood Ear Infections, Dr. Michael A. Schmidt presents over 16 scientific studies that show that many cases of 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 management, such as elimination and rotation diets, can produce dramatic recovery in allergic children with chronic ear infections.
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.
In addition to allergies contributing to the obstruction of the eustachian tube, another form of obstruction called biomechanical obstruction, can further contribute to ear problems. This blockage is due to problems of the structural components around the ear and eustachian tube, including the bones of the jaw, skull and neck.
The head is made up of many bones that are supposed to move gently in synchronization with one another. The movement of these bones allows for the proper movement of the fluids in the head, including the fluids connecting between the sinuses, eustachian tubes and ears. Many things can change the proper movement of the bones in the head, including falls, recurrent infections, and the trauma of birth, especially if forceps were used for delivery. Since an ear infection contains fluid that accumulates behind the ear drum, gentle movement of the bones of the head to allow drainage of the fluid can prevent and cure such an infection.
Craniosacral work is the gentle movement of the bones of a child’s head and sacrum. Using craniosacral work for treatment and prevention of ear infections is especially helpful. Practitioners who do this work are usually chiropractors who take a special course in cranial work, or osteopathic physicians. Osteopaths are trained exactly like MD’s and practice medicine, but are also trained in osteopathic manipulation. Some osteopaths specialize in the field of cranial osteopathy. When you are looking for someone to work with your child, seek a pediatric chiropractor or osteopath who specializes in cranial work.
It is important to consider nutrition in the prevention and treatment of ear infections. An organic, unprocessed, whole foods diet, low in sugar, is essential for creating good health with high immune function. 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, margarine and baked goods, and saturated fats such as meat and dairy) 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. A recent study found that the U.S. has the highest incidence of essential fatty acid deficiency in the developed world. Fatty acid deficiency contributes to ADD and ADHD and other learning disorders, as well as poor immune function. Essential fatty acids are found in flax oil, evening primrose oil, borage seed oil and fish oil. This should ideally be started by the mother while she is pregnant and during breast-feeding. One or two teaspoons per day of flax oil, depending on age, may be all the child needs.
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. Therefore, it is valuable to give children a good multivitamin and mineral supplement. Vitamin C is essential to the immune system, and depending on the child, the need may be from 250 to 500 mg of vitamin C per day. 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.
Supplementation of the diet with intestinal bacteria is important to healthy immunity, especially if a child has been on antibiotics. L. acidophilus is recommended for children over age seven, and B. bifidus for children under seven.
Breastfeeding is important to ensure that a child has a healthy immune system. Mother’s milk contains all the immune protecting complexes the child needs. Children who are breastfed are overall healthier than those who are not. The sucking action required to breastfeed also helps the Eustachian tubes open and close, which makes a difference in the frequency that a child is likely to get ear infections.
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 over the last 8 years has shown that antibiotics actually make very little difference in the recovery from an ear infection. Yet, antibiotics are usually prescribed in children with ear infections. A reasonable approach in treating a child with an ear infection, who is otherwise healthy, is to wait four days and see if the body will recover without antibiotics. If after four days, the infection has not gone away, antibiotics may make a difference. Keep in mind that if an allergic child continues to be exposed to an allergen, or if the main cause is not resolved, recurrent infections are likely.
From the perspective of the whole person, 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 block the formation of some 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.
Herbs are helpful to prevent and stop ear infections at various stages of the illness. Echinacea can be given in child size dosages to prevent a cold from causing further problems. There are also various herbal formulas designed for children’s ear infections available in health food stores. One such formula is Herbal Wellness for kids (made by Rainbow Light). There are other stronger formulas available from either western or Chinese herbalists.
Lifestyle habits also make a difference in recurrent ear infections. A child should not lie down on his or her back to drink a bottle or feed. This is more likely to push fluids into the Eustachian tube and cause ear problems.
These are some alternative options for how to deal with ear infections in children. Keep in mind there are definite times when antibiotics should be used. If you have questions about which treatment is most appropriate, contact your holistic physician.
Dr. Sokitch is a medical doctor practicing Traditional Chinese Medicine and nutritional medicine. She is the director of Heart to Heart Medical Center in Santa Rosa, California, providing the best of alternative and conventional medicine.