Little Ears: Ear Infections in Children By Julie Ormonde, MS, LAc

With such extreme statistics, we need to find a way to not only treat these infections, but also prevent them. Simply giving penicillin is not enough, and often is neither necessary nor medically indicated.

What Is It?

An ear infection is also known as Acute Otitis Media (AOM). It involves the middle ear and the Eustachian tube. The Eustachian tube is a long tube that connects the ear to the nose and throat. This tube allows for the drainage of fluids out of the middle ear. When the tube is blocked, often from a respiratory or sinus infection, fluid builds in the middle ear. This fluid is a fertile ground for bacterial growth (infection). However, one quarter of ear infections are viral, not bacterial, which we will look at more below in terms of treatment.

In small children, the tube is shorter and more horizontal, thus reducing drainage and encouraging fluid build up. As the child grows, the Eustachian tube becomes longer and more vertical.

What Does It Look Like?

The first complaint usually a severe earache. Other symptoms may include fever, nausea, vomiting, and diarrhea. Infants and toddlers who are unable to communicate will tug, hit, or rub their ears and may be irritable.

If you notice the following symptoms, your child should be seen by a physician immediately: severe fever with inability to move their neck, redness and/or swelling around the ear, headache, sudden hearing loss, or dizziness. Drainage and sudden pain relief can indicate eardrum rupture - though the child may seem better, they must be seen.

Who Gets It?

Those most susceptible usually are babies and children born with birth defects, cleft palate, and impaired immune systems. There appears to be a familial correlation, and boys contract them more than girls do.

Most ear infections appear after an upper respiratory or sinus infection. The fluid build up fluid from these types of infections is often very thick and easily blocks the Eustachian tube.

Cigarette smoke has been shown to cause ear infections, and it makes existing infections get worse and last longer. If you smoke, do your child a favor and don't smoke near them.

Because of the length and position of the Eustachian tube, bottle-feeding (especially lying down) allows for fluids to drain directly into the middle ear. It is, therefore, very important to feed your baby on its side facing you (simulate breastfeeding with a bottle), or sitting up. This brings up the subject of breastfeeding versus formula. Formula-fed babies are 70% percent more likely to get an ear infection than breastfeed babies. Two advantages of breastfeeding are positioning and natural, immune-enhancing antibodies.

Also consider food allergies as a cause. Children, especially those who have issues with dairy, may have an affinity to thick fluid build up.

How Do You Prevent Ear Infections?

• Breastfeeding
• Limited pacifier use
• Gently blow noses, holding the nostrils shut while blowing can encourage fluid back into the ears
• Eliminate dairy foods and spicy foods
• Vaccination. Vaccines are controversial. Some studies have shown that, while they do not specifically prevent ear infections, vaccines prevent illnesses caused by organisms that are associated with ear infections, such as Haemophilus Influenzae (Hib) and Influenza. In a recent large study, the pneumococcal vaccine Prevnar reduced the number of ear infections caused by the pneumococcal bacteria by 34% and the overall number of ear infections by 7%. Whereas another recent study stated that the influenza vaccine did not affect the occurrence of ear infections in children aged 6 to 24 months. The pros and cons of vaccines need to be carefully weighed by the individual parent. The great vaccine debate will be left for another article, but is brought up here only as an option.

Treatment

Western Treatment

If the child is under 2 years old, or is at risk for complications from infection, the doctor will most likely prescribe antibiotics. Although this is changing, there are still quite a few doctors who prescribe antibiotics for all ear infections. It is difficult to tell which ear infections bacteria cause, and which ones are caused by viruses and will clear up on their own. It is now known though, that bacterial ear infections often do not require antibiotics to heal. Other doctors ask parents to watch their child for a couple of days. If the child starts to improve (80% of infections clear on their own, regardless of the cause) then no treatment is given. At home the parent can give Tylenol, Advil or Motrin (note - please double-check all dosages of any medicine before administering to children). Decongestants, antihistamines, and other nonprescription cold remedies are usually not effective.

As an interesting side note, children who have had two ear infections within 3 months are more likely to have another ear infection, especially if the infection was treated with antibiotics.

Chinese Medicine Treatment

The following points can be firmly pressed with your index finger and/or massaged to facilitate the healing process. You may additionally massage around the ear, but you will need to have a softer touch, as this area will likely be sensitive.

Points and Massage

· LI4 - In the soft web area of the hand between the thumb and the index area, massage with your thumb on top of the child's hand and your index finger below
· ST44 - At the base of the 2nd toe, at the web
· SJ5 - two of the child's finger widths above the wrist on the dorsal side of the arm (opposite the forearm)
· GB20 - massage the whole width of the base of the skull, paying particular attention to the outer edges

If the following are present add corresponding points:

Nausea/Vomiting
P6 - this point is located directly opposite of SJ5 on the inside of the wrist
Rub lightly down from the ribs down the length of the belly

Diarrhea
Use a counterclockwise circular massage around the navel

Fever
Shi Xuan - tips of the fingers, you can use the tip of your nail to push into this area child permitting
Use moderate pressure to rub in a straight line from the wrist to the elbow on the forearm. This needs to be done for as long as the child will allow up to 250 times. You can also use alcohol to help disperse heat.

Restlessness
Yin Tang - directly between the eyebrows

Herbs
Please see a practitioner for individual herbal advice. Herbs will vary depending on the symptoms.

Diet
It is best to avoid greasy and phlegm producing foods, such as bananas, avocados, peanuts, cheese, milk and cold foods. You may also try eliminating spicy foods to see if that makes a difference. Only certain types of ear infections are related to spicy foods, but it is worth it to try to eliminate these. Not only will this let you know if these are particular foods your child should not have in general, but it will speed healing.

Other Natural Remedies

• Apply heat to the ear with a warm washcloth
• Encourage rest
• Use herbal remedies:
• Echinacea (antiviral) and Goldenseal (antibacterial) can be helpful at the onset of symptoms.
• Garlic oil and/or Mullein flower oil drops, 1-2 drops, 3 to 5 times a day. Heat the oil to body temperature or slightly higher and drop into the ear with your child lying on his or her side.

If after a couple of days you are not seeing a positive response, it would be best to take your child into a Chinese Medicine practitioner for treatment.
I encourage you to see one from the onset of symptoms,
as this will help the child heal faster and be in less pain.

Remember that the best medicine is preventive and that is what Chinese Medicine is ultimately designed to be.

Take care,
Julie Ormonde M.S., L.Ac.
AcuMama at cox dot net (spelled out to avoid spam email harvesters)

*Please note chronic and other types of ear infections are not in the scope of this paper.

References:

1. Duffy L., Faden H, Wasielewski R, Wolf J, Krystofik D, Tonawanda/Williamsville Pediatrics exclusive breastfeeding protects against bacterial colonization. Pediatrics. 1997 Oct;100 (4):E7
2. Hoberman A, Greenberg DP, Paradise JL, Rockette HE, Lve JR, Kearney DH, Colborn DK, Kurs-Lasky M, Haralam MA, Byers CJ, Zoffel LM, Fabian IA, Bernard BS, Kerr JD. Effectiveness of inactivated influenza vaccine in preventing acute otitis media in young children: a randomized controlled trial. JAMA. 2003 Sep 24;290(12):1608-16.
3. Miser W. To treat or not to treat otitis media - that's just one of the questions. J Am Board Fam Pract 2001 14(6):474-476,.
   
4. Zand J. 2003 Smart Medicine for a Healthier Child
5. Deadman, P. A Manual of Acupuncture. Journal of Chinese Medicine Publications, 1998.