A very common issue: About 80% of children will have at least one ear infection by the age of 5, and 75% will have one by the age of 3. It is also said that otitis media (middle ear infection) is the most common cause of hearing loss in children, costing approximately $2 billion annually on medical and surgical treatments in the U.S. In addition to otitis media, children and adults may suffer from otitis externa (infection of the outer ear), commonly referred to as swimmer’s ear. If you are a parent with a young child in daycare or a parent with a child who spends a lot of time under water, you have no doubt had some experience with ear infections and it was more than likely, not a pleasant one. What causes ear infections and why are they so common? Well, swimmer’s ear (otitis externa) is probably the most common type of ear infection during the summer months and occurs when water is trapped in the ear canal, usually from swimming and spending a lot of time in the water, causing bacteria to grow. Other causes of otitis externa can be anything that breaks the skin in the ear canal causing bacterial growth such as cotton-tipped applicators, bobby pins, or vigorous scratching.
Middle ear infections (otitis media) are more common during winter and spring. It is an infection in the space behind the eardrum caused by backed up fluid leading to bacterial growth. The fluid gets backed up, usually from a previous infection or cold that has caused the Eustachian tube to become blocked due to swelling and increased secretions in the nose and throat. The Eustachian tube’s purpose is to act as a drain for secretions created by the middle ear and to regulate air pressure. Middle ear infections have multiple causes such as respiratory infections, being exposed to cigarette smoke and allergies. It can also be caused by the baby’s position during bottle-feeding, if the baby is lying flat while sucking the Eustachian tube does not work properly. There has been a dramatic rise in the number of ear infections over the last two decades due to the need for a two-income household and moms returning to the workplace before the child’s immune system has had a chance to fully develop. Infants and toddlers are continually bombarded by respiratory infections in day care centers.
Are there long-term complications from chronic ear infections? Yes. There can be possible long-term complications with both types of ear infections if not treated properly. The list of complications that can arise from improperly treated swimmer’s ear are chronic otitis externa, narrowing of the ear canal that would affect hearing and future infections, facial infections, and, in the immune challenged, malignant otitis externa. Malignant otitis externa would be the most severe complication, which is the spread of infection to the bones of the ear canal and lower part of the skull.
Since middle ear infections occur in the very young the complications can be detrimental to the development of the child. As previously quoted, middle ear infections are the number one cause of hearing loss in children and this may cause further complications of delayed speech development. Also, middle ear infections can spread to nearby structures in the head like the mastoid bone (mastoiditis), and in extreme cases the brain (meningitis). The mastoid bone is a complex system of air cells that house the structures of the inner ear responsible for balance and facial expressions.
What are some of the symptoms of ear infections? Symptoms of swimmer’s ear start with a mild to moderate pain that is made worse by tugging at the outer ear and an itchy ear. Other symptoms include: a sensation that the ear is blocked or full; drainage; fever; decreased hearing; intense pain that may radiate to the neck, face or side of the head; the outer ear may appear to be pushed forward or away from the skull; and swollen lymph nodes.
Symptoms to look for of middle ear infections in infants and toddlers are: hearing problems; inconsolable crying; irritability; restlessness; fever; vomiting; ear drainage; and tugging at the ear. Symptoms to look for of middle ear infections in children, adolescents and adults are: earache; a feeling of fullness or pressure in the ear; hearing problems; dizziness or loss of balance; nausea or vomiting; ear drainage; and fever.
Is there anything you can do to prevent ear infections? Yes. The key is to keep the ears free of moisture. Dry your ears after swimming or bathing; the safest way to dry your ears is by using a hair dryer. Using removable earplugs while in the water may do the trick, but be sure they fit snuggly in the ear. Also, if you know that you do not have a perforated eardrum, then you can use an eardrop mixture of half vinegar and half alcohol. One other important note is that people with itchy ears or those who have excessive earwax are more susceptible to an infection, so it would be wise to have your ears cleaned periodically by an otolaryngologist (ENT doctor) or your family doctor.
There are multiple preventative options to alleviate middle ear infections, however, none of them are guaranteed to work all of the time. Babies that are breast-feed for the first 6 months are less likely to contract middle ear infections for two reasons: one, the mother is able to pass along important antibodies to protect against various diseases and illnesses, and two, the use of cow’s milk can be an irritant to the Eustachian tube. Allergies are a major factor in chronic ear infections. Singling out the allergen and removing it from the child’s diet or environment will play an important role in the health of your child. Common allergies that may contribute to ear infections are: wheat, dairy products (cow’s milk), pet dander, mold and pollen. Another diet consideration that may help would be to reduce sugar intake. The natural sweetener xylitol (found in some fruits) has been known to reduce ear infections. It is very important to keep your child away from second hand cigarette smoke. Also, be sure your child is getting enough antioxidants in order to boost their immune system such as Vitamins A, C, E and Zinc.
Be cautious of taking too much zinc and of taking it for a long period of time. The RDA for zinc for infants 7 months – 3 years is 3 mg, children 4-8 years is 5 mg, children 9-13 is 8 mg, adolescents 14-18 is 11 mg (males) & 9 mg (females), and 19+ 11 mg (males) & 8 mg (females). If taking it for more than a few weeks, then you should also take copper along with it. Always consult your physician if you are pregnant or lactating before taking any supplementation.
It is important to note that if any type of ear infection is suspected, whether the inflicted be an infant, child, adolescent or adult, that a physician is consulted before starting any treatment plan. In addition, follow up appointments should be made until the infection has been completely dissipated.
Otitis Externa or Swimmer’s Ear
If swimmer’s ear is caught early on it may be successfully treated with a mild acid solution such as boric or acetic acid (vinegar). If the infection persists or was not caught in the early stages cleaning the ear with antibiotics may work, however, this method can only be used providing the eardrum is not perforated. If the ear canal is swollen shut, the physician may place a sponge or a wick in the ear canal before administering antibiotic eardrops as well as prescribing steroid eardrops to reduce the inflammation. It may be necessary for the physician to clean out the ear to remove pus and debris, and he may also run a culture to identify what type of bacteria or fungi that are causing the infection. In addition, oral antibiotics and pain medications may be prescribed, although, over the counter pain relievers should be enough to manage the pain. A warm washcloth or heating pad over the ear may also work for temporary pain relief. In extreme cases where the infection has spread to bones in the skull intravenous antibiotics and surgery may be necessary. The best treatment, however, is to never get an infection in the first place; focus on prevention.
Otitis Media or Middle Ear Infections
The traditional treatment of middle ear infections is oral antibiotics, acetaminophen or ibuprofen for pain and fever, and analgesic eardrops. If the child has allergies the doctor may prescribe antihistamines and if the child has a cold he/she may prescribe decongestants. There are disputes over the effectiveness of antibiotics and its overuse. An alternative to traditional antibiotics is colloidal silver, a natural antibiotic that can be taken orally or used as an ear wash. In addition, a carotenoid complex of 20,000 IU daily will aid in controlling the infection for adults, and 1 teaspoon of cod liver oil for children. An alternative to the traditional approach for pain relief is to place a few drops of warm garlic oil or olive oil in the ear, then a drop or two of lobelia or mullein oil, and then place a cotton ball loosely in the ear. Also, Goldenseal extract and Echinacea are herbs that support immune function; however, a physician should be consulted before starting this alternative treatment option.
Chronic Middle Ear Infections
If middle ear infections become chronic, the treating physician may suggest the insertion of ventilation tubes in order to drain the opposing fluid down the Eustachian tubes and to prevent the build up of future fluid in the middle ear. Typically, as the child grows, the tubes will fall out and the eardrum will heal on it’s own. If for some reason the tubes do not fall out on their own, the doctor will remove the tubes. Other surgical procedures that may be suggested by your physician are the removal of the adenoids or tonsils. Chronically infected and swollen adenoids or tonsils can cause the dysfunction of the Eustachian tubes. Adenoids are small organs located in the back of the throat, behind the sinuses. Both organs are thought to act as a defense against incoming bacteria and viruses. However, if they are constantly enlarged (hypertrophy) they may do more harm than good.
Chiropractic For Middle Ear Infections
Chiropractic adjustment is another option for parents to try before resulting to surgery. Several studies have shown the safety and efficacy of chiropractic treatments in children. “In one study of 46 children (age 5 and under) with otitis media, 93% of all episodes improved, 75% in ten days or less. In another study, five children with chronic recurrent otitis media all responded favorably to chiropractic care.” Alternative Medicine – The Definitive Guide