- What Is Known About Middle Ear Infections
- Healthy Steps: Ear Infections—First Steps
- Healthy Steps: Ear Infections—Full Program
- Preventing Ear Infections
- From Dr. Deborah's Desk
You can tell that normal looking ear must be hurting when you see cranky behavior, tears, and ear-rubbing, all of which tell the story of an ear infection. You may even remember from your own childhood the crackling sounds and miserable feeling of pressure inside your head when you had an earache. Acute ear infections are common, and for most children they come with a moderate to severe degree of pain.
You probably don’t need to rush to the doctor, however. Ear infections trouble more than 30 million children in the U.S. every year. Nearly two-thirds of children with uncomplicated ear infections recover from pain and fever within 24 hours of diagnosis without antibiotic treatment. Over 80 percent recover within a week.
Of course, that’s little solace for the child who can’t sleep and may be running a fever. A child with a throbbing earache demands your prompt attention and comforting. There are some tried and true approaches for resolving your child’s acute pain, and allowing the body to heal the infection.
The small eustachian (middle ear to throat) tubes of young children make them particularly prone to ear infections. Allergies, colds, bacterial, or viral infections can lead to a blocked eustachian tube. The resulting inflammation traps fluid inside the middle ear (behind the eardrum), allowing germs to create an infection.
Symptoms include popping, ringing, and a feeling of fullness or pressure in the ear. Children often have trouble describing this feeling. They may rub and pull their ears, trying to relieve the pressure. Earache pain can be mild to severe, often causing difficulty sleeping and loss of appetite. Children an ear infection may appear dreamy or inattentive because the swelling and congestion has affected their hearing. Ear infections may lead to fever, dizziness, and balance problems.
Infrequently, ear infections can be accompanied by a thick yellow or bloody drainage from the ear. If this occurs, the eardrum has probably ruptured. The hole in the eardrum often heals by itself in a few weeks.
On rare occasions, an unresolved middle ear infection can develop a complication called mastoiditis in which the infection spreads to air cells in the bone behind the ear. Thankfully very rare, mastoiditis can cause serious—even life-threatening, health complications—including hearing loss, blood clots, meningitis, or brain abscesses.
How rare is it? A recent retrospective study involving 2.5 million children showed that you would have to treat nearly 5,000 children with antibiotics to prevent one child from developing mastoiditis. Most children who develop mastoiditis have not seen a doctor for middle ear infection at all. The study concluded that treating this many children with antibiotics poses a larger threat to public health by contributing to antibiotic resistance than is warranted by most common ear infections. Most cases of mastoiditis make an uncomplicated recovery.
Until recently, most doctors thought bacterial infections were the major cause of Otitis media (literally, “inflammation of the middle ear”). Research shows, however, that viruses are often the more likely infectious agents, and antibiotics cannot touch them. Nevertheless, almost half of all antibiotic prescriptions written for children today are for ear infections.
Risks of Antibiotics as an Ear Infection Remedy
The debate continues regarding the usefulness of antibiotics for treating ear infections. At the time of this writing, the pendulum has just swung back in favor of antibiotics after many years of recommending a week's wait before prescribing. This only addresses the acute episode; it does not take into consideration the long-term adverse effects of antibiotics. Some studies estimate the intestines may require months or even years to recover from treatment with antibiotics, with some authors suggesting the body may never return to a healthy state.
In a recent study, 80 out of 100 children recovered from ear infections in a few days without antibiotics. When the drugs were given, the number of kids who recovered rose by only 12 children, while an additional 3 to 20 developed side effects such as rash or diarrhea. If your child's discomfort can be relieved and the general symptoms gradually improve, we adamantly recommend avoiding antibiotics.
If a dose of antibiotics becomes necessary, make sure you help replenish your child's supply of beneficial bacteria by providing a high-quality probiotic after the round is complete.
For the greatest improvement with the fewest steps, do the following:
- Ear drops with breast milk or Gaia Kids Ear Drops, a few drops in the ear canal every few hours. The pain and inflammation should clear up within 24 to 48 hours.
You can also make your own mullein oil: use 3–4 tablespoons of dried or fresh mullein leaves and flowers and follow the recipe for garlic ear drops in the Comfort Measures section below.
- Warm compress: Dip a soft cloth in very warm water or tea and wring it out. When the cloth is cool enough to touch, place it over the child's ear. Alternatively, try a heat pack filled with flax seeds, buckwheat, or rice; these tend to maintain their heat longer and are less messy than a wet cloth.
- Herbal teas: Very warm herbal teas such as lemon balm, catnip, spearmint, ginger, and licorice root help reduce congestion.
- The quickest relief is to be found from matching the pain picture to one of the homeopathic remedies listed below. The better the match, the more likely you will have relief.
A comprehensive program involves many areas in which action steps can be taken, gradually or all at once. Start by following the basic nutrition and healthy lifestyle guidelines, with the following modifications:
Savor Helpful Foods
- Breast milk: Breast milk is unquestionably the most important nutrition your baby can receive. No other substance compares with its ability to promote strong immunity and resistance to infection. Breast feed for six months or until your child consistently asks for the family's food. When you start feeding solid foods, breast feed at the beginning of the meal to make sure the child gets that ultimate nutrition first. Nurse until your child starts to self-wean at approximately age 2.
- Butter: Look for raw or organic butter. All children love and crave butter. Many will sneak it if the parents restrict it. Starting at 5 months, let your baby eat as much high vitamin A butter as desired.
- Egg yolks: Separate the yolks, then boil, and cool them so the baby can pick them up and eat. Note that egg whites are prohibited until age 2.
- Liver paté: In most indigenous cultures, liver serves as a child's first food. It is packed with healing nutrients. See our Paté recipe. You can also grate frozen raw liver onto your plate and consume daily for 2 weeks.
- Garlic: Feed raw garlic to the child early after the onset of an earache. Mothers should also eat garlic while pregnant.
- Fermented foods: Kefir, unsweetened yogurt, sauerkraut, kimchi, and fermented sweet potatoes can also help prevent ear infections.
Avoid Problematic Foods
- Dairy products: Often, pasteurized dairy products are linked to ear infections. The other most common foods causing allergic reactions include soy, wheat, corn, eggs, and oranges. Ear infections are often preventable, and food allergies are the primary modifiable cause. Following a proper diet will likely resolve most recurring ear infections. Foods that appear to trigger symptoms should also be eliminated for a significant period of time. See our Allergy Elimination Diet for details.
- All sugars: Honey, agave, rapadura, corn syrup, and all forms of table sugar lower resistance to infection and can encourage yeast infections.
- Fruit juice in any form: Fruit juices are basically sugar, even if they are watered down. Children get addicted to sugar easily.
- Sodas, coffee, and tea: Avoid sugary sodas and anything caffeinated. Non-caffeinated herbal teas are fine.
- Carbohydrates: Cereals should never be given to babies, especially as a first food. Bread-even whole grain-as well as pasta, cakes, cookies, potatoes, and other starchy vegetables like peas and carrots can overload the body with unnecessary sugars.
Supplements Can Help
- Cod Liver Oil. When the baby is 5 months, start with 1/8 teaspoon, increase to 1/4 teaspoon at eight months, 1/2 teaspoon by one year, and 1 teaspoon by 2 years old.
- Klaire Labs Ther-Biotic Infant Formula: This multi-species probiotics formula includes Lactobacillus GG (Lactobacillus rhamnosus), which is safe at an early age and effective in treating allergic inflammation and food allergies. It can be mixed with breast milk or solid food at room temperature. This is especially important for children who are formula-fed, caesarean-birthed, on antibiotics, or had a maternal diet lacking excellent nutrition. Also give to children with colic or digestive upset. Administer 1/4 tsp daily with food.
Comfort Measures for Ear Pain
- Garlic ear drops: Choose Gaia Kids Herb Drops or make your own. Garlic is both antifungal and antibacterial. Place 2-3 cloves of chopped garlic into a double boiler or a small saucepan. Cover with olive oil and heat gently for 10 minutes. Let it cool to touch, test on your own ear, then drop 1-2 drops into the affected ear of the child. Finally, cover the treated ear with a warm cloth.
- Garlic rub: If you rub raw garlic on your child's feet before bed, the antimicrobial garlic will permeate the body. Your child's breath will even smell of garlic in the morning.
- Massage around the ear: Massaging around your child's ear can help the fluid drain into the eustachian tube and provide some pain relief. Massage from along the back of the ear down toward the jawline in repeated strokes. Discontinue if it causes your child too much discomfort. If the lymph nodes (glands) are swollen, lightly massage to help them drain and relieve discomfort.
- Warm herbal teas: If the pain is caused by congestion-particularly if it is associated with a cold-keep the mucus thinned with very warm herbal teas such as lemon balm, catnip, spearmint, ginger, and licorice root.
- Vaporizer: Using a vaporizer in the room where your child sleeps can help relieve congestion and aching. Use plain water without additives or essential oils. Time spent in a steamy bathroom before bed achieves similar effects.
- Osteopathic adjustment: Simple adjustments can open the eustachian tubes and allow the fluid clogging the middle ear to drain freely, reducing the risk of infection.
Match symptoms of ear pain to select remedy. The symptoms are described in children, but if you are an adult with ear pain, the same symptoms apply. Match the child’s symptoms to the closest description and take the remedy in a 30C potency several times a day, holding off as the symptoms improve, or changing remedies if they do not.
Persistent symptoms, fever, or any alternation of consciousness or pain in other areas should prompt a call to your usual health care practitioner.
If you don't have a home kit, remedies are available for purchase through my office.
- Ear pain starts suddenly after a day out in the cold wind.
- The ear is very painful, and the child is anxious and restless.
- Symptoms are often at their worst around midnight.
- The ear pain starts suddenly and is accompanied by a lot of heat: a fever, flushed face, red cheeks and glassy eyes with dilated pupils.
- The hands and feet might be cool or even icy cold.
- Pain is worse or limited to the right ear.
- Pain is severe, with a throbbing or pulsing quality.
- Pain is made worse by a bump or a jar, and is the worst at 3 PM.
- The ear pain is incredible, seemingly intolerable.
- The child may have a high fever, with one red cheek and one pale cheek.
- Your child is irritable, fussy, and nothing can be done to offer any comfort.
- With every suggestion (or worse: a doctor's exam), the child puts up a huge fight.
Hepar Sulphuris Calcareum
- The pain becomes the worst in the late night or very early morning hours before dawn, and is an intense pain.
- The pain is worse when exposed to cold air, better when the affected ear is covered.
- Warmth might be very soothing.
- Pain goes up into the ear with swallowing.
- The pain is more commonly left-sided and appears late in the night or early AM.
- The child is quite warm, wants open air, and does not want to be held or covered.
- The pain comes on after an emotional day of hurt feelings or a jealous fight with a sibling or friend.
- The ear infections are almost always on the right side, maybe with a sore throat.
- The pains are worse from cold and worse in the late afternoon (4-8 PM).
- Warm drinks help everything.
- Ear infections are frequent, often with colds or sinus infections, with green mucus.
- The pains are worse at night, and may be accompanied by sweating or drooling.
- The illness begins with a cold and develops ear pain after a couple days.
- There may be fever (less likely if antibiotics taken in the past) with a flushed face, feeling warm and wanting the windows open OR to be outside.
- The pain may be described as full or bursting, and the ear drum looks it: red and bulging.
- The pain is worse with nose blowing, at night, and children wake up crying softly and needing gentle comfort.
- Not thirsty, may even refuse to drink.
Your best defense against any disease is a robust immune system, which vaccines can sometimes compromise. Supporting your child's immune system should always be your top priority. Concentrate on good dietary principles and take vitamin D supplements and probiotics. For recurrent infections, add butter oil, and check that vitamin D3 levels are normal: supplement if necessary to bring levels to 40-65 ng/mL.
Seasonal allergies such as hay fever and sensitivities to household allergens like dust, mold, or pet dander may reduce your child's immune capabilities and elicit an allergic response that swells and blocks the eustachian tubes. Because the body is so busy trying to ward off the “invader,” it is incapable of appropriately dealing with a bacterial overgrowth that may occur in the middle ear's warm, moist environment. If you suspect your child is allergic, keep your household reasonably free of environmental allergens by cleaning often, using hypoallergenic materials in the bedroom, and installing a quality air filter.
Secondhand smoke has been proven to increase risk of ear infections, particularly in children. Limit your child's exposure as much as possible.
To avert ear infections in infants, whether breast- or bottle-feeding, elevate the child's head above his or her chest during feedings. When a baby is lying flat, the fluid can run toward the eustachian tubes, causing congestion and, eventually, infection. Following this practice alone can stop ear infections for many infants.
Prop your child's head up at a 30-degree angle while lying down. The upright position encourages drainage and reduces the feeling of pressure often felt while lying flat. By placing something under the mattress or the legs of the bed, you can adjust the upper portion of the bed so it slopes toward the child's feet.
Do your homework on childhood vaccinations before consenting to the standard protocol. Opt out of any vaccination for which the risks are greater than the potential benefit. Definitely do not give your child a yearly flu shot, as is often recommended. The Prevnar vaccine likely does not prevent ear infections, even though you may be told otherwise.
In my practice, the two most important steps to take when facing ear infections are relieving the pain and preventing further problems. Relieving the pain is achieved beautifully with the correct remedy.
The first time I received flowers in my practice were for an Aconitum ear infection, the remedy picked up at my doorstep one evening after a call from a worried parent, “He has his ear infection again!” A day out in the weather, a bit of a slump then an evening of increasing pain and agitation. Aconitum in the evening, and flowers on my doorstep the next day. The young patient had recurrent ear infections prior to receiving the remedy, and this was happily his last childhood ear infection.
The secret to preventing recurring ear infections is to boost immunity and the way to do that is almost always by eliminating hazards -sugar, say, and second hand smoke -and optimizing nutritional status with basic good food, cod liver oil, and probiotics. Dad David was in my office today, buying the probiotics for himself and his daughter—they want to take the oil, they know it makes them healthier but only Mom can tolerate the taste of the oil directly. I haven't seen any of the family for an acute illness since they started taking fermented cod liver oil.
This information is provided for educational purposes only, and any individual diagnosis or treatment should be determined by you and your doctor. See Additional Information.