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March 20, 2018  |  Login
Ear Infection
by James F. Balch, M.D. and Mark Stengler, N.D.

The prescribing of antibiotics for otitis media with effusion is controversial. This refers to the presence of fluid in the middle ear, in the absence of signs or symptoms of acute infection. According to the U.S. Agency for Health Care Policy and Research, most cases of otitis media with effusion resolve spontaneously. It must also be recognized that fluid left in the middle ear after antibiotic treatment is normal. Approximately 70 percent of children have fluid in the middle ear at 2 weeks, 50 percent have fluid at 1 month, 20 percent have fluid at 2 months, and 10 percent have fluid at 3 months after appropriate antibiotic therapy. According to studies, the fluid that remains does not need to be treated with antibiotics, as is typically done.

Conventional Treatment for Ear Infections

Ear infections have reached nearly epidemic proportions in the United States. In response, frustrated doctors have come up with aggressive treatments, usually in the form of heavy antibiotics and ear tubes. Sometimes these strategies are necessary and effective, but all too often doctors employ them as a first line of a defense, rather than as a last resort. Tubes in the ears, which relieve pressure on the eardrum and allow pus to drain, may seem like a good idea, but the tubes themselves often cause a great deal of damage. Interestingly, a study published in the Journal of the American Medical Association found that only 42 percent of these surgeries were appropriate. If your doctor recommends ear tubes, question him or her closely. Make sure that any treatment is tailored to your needs or your child's. And as always, try conservative measures-dietary changes, immune enhancement, homeopathy, and gentle herbals-before turning to harsh drugs or invasive procedures.


While ear infections can occur at any age, they are most common in early childhood and infancy. In fact, ear infections are the reason for more than half the visits to pediatricians in the United States. Statistics show that acute ear infections affect two-thirds of American children under age two, while chronic ear infections affect two-thirds of children under age six!

There are two main categories of ear infection. The first is an outer ear infection, also known as swimmer's ear or otitisexterna. It affects the ear canal, which runs from the ear opening to the eardrum, and happens when a substance (usually, water-hence the nickname) enters the ear canal and is trapped there by a build-up of wax. In this stagnant condition, bacteria breed and flourish. The body responds to the infection with inflammation, redness, pain, and sometimes a fever.

The second category, called a middle-ear infection or otitis media, is much more common, especially in very young children and infants. Most ear infections are usually associated with an upper respiratory infection or an allergy. Forty percent of cases involve bacterial infection, with the most common being Streptococcus pneumoniae. Many ear infections involve a viral infection that is unresponsive to antibiotics. Chronic middle ear infections (also known as serous otitis media or glue ear) refer to chronic swelling of the eardrum as a result of fluid accumulation. One of the reasons infants are more susceptible to ear infections is due to the fact that the eustachian tube (which drains fluid from the middle ear) is more horizontal than it is in adults and does not drain as efficiently. This tube becomes more vertical and drains better as children get older. The key is to prevent the build-up of this fluid with a proper diet. Food allergens, such as cow's milk and sugar, trigger a cascade of inflammation responses that often result in mucus and fluid. These foods are often the root problem. In addition, avoiding environmental allergens is important-particularly secondhand smoke. Addressing food allergies and environmental allergens is crucial so that "germs" do not have an environment to grow in. Of course, a healthy functioning immune system is also key in preventing infection.

Some infections are the result of a malfunctioning or still-developing eustachian tube, the passage that connects the three bones of the middle ear to the nose and the throat. When the eustachian tube isn't working properly, mucus isn't able to drain from behind the eardrum into the upper respiratory tract; instead, it remains trapped and causes pain and pressure. This situation often leads to infection, especially if there has already been a mucus-producing disease of the upper respiratory system, such as a cold or the flu

Middle-ear infections can be quite painful. There may be a fever, perhaps a very high one, with some hearing difficulty or nausea and vomiting. If your child pulls or slaps at his or her ear, an infection is a strong possibility. Take all ear infections and ear pain seriously. The following treatments can be used to relieve pain, but do call a doctor for professional advice in the presence of a sustained fever or if the ear continues to hurt. If you or your child experiences severe ear pain, followed by a sudden relief and/or a discharge of blood or pus, consult a doctor immediately, even if you or the child feels well.

The over-prescribing of antibiotics for childhood ear infections has been a contributing factor to antibiotic-resistant bacteria. more

Next: What are the Symptoms of an Ear Infection

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