Otitis media, earache, ear infection, glue ear, swimmers ear

One of the most common health issues for children is middle ear infection, also known as Otitis media. Up to 93% (1) of children will have experienced at least one ear infection by 2 years of age, the key reason for this is the physiology of young Eustachian tubes. A child’s tubes are smaller and more horizontal than adults tubes, meaning that fluid is more likely to remain in the ear cavity which increases risk of infection.

With ear infection it is important to separate myth from fact. It is a common belief that ear infections must be immediately treated with antibiotics or they will cause irrevocable damage, this is not the reality for most ear infections. The up to date research indicates that most ear infections are self limiting and will resolve without the need for antibiotics. Practitioners are now advised to follow the ‘wait and see’ (2) approach and only offer antibiotics if the infection worsens. It is worthwhile to note that most ear infections are not in fact bacterial and may be viral in origin, (3) in which case antibiotics are of no use at all.

You can reduce your risk of ear infection by supporting your child’s immune system, limiting pacifier use, breastfeeding for as long as possible, keeping your child away from smokers, and delaying entry into child care centres. Factors that we don’t have control over are genetic predisposition and age. Maori and Pacific island children are more at risk than their European counterparts and children under two more so than other age ranges.

Ear infection can often be tricky to recognise and more than one parent has wondered why they had a crabby baby only to find out days later that they had an ear infection. Signs to watch out for are:

  • Reluctance to feed from a particular side or a desire to feed upright only
  • Loss of appetite in older children
  • Tugging at, pulling or scratching on ear
  • Unable to lie down without pain
  • General grumpiness
  • Discharge from the ear
  • Fever and inflammation

For a confirmed diagnosis you will need to see your health professional who will examine the ear canal for inflammation and bulging of the timpanic membrane, though it is worthy to note that if your child is examined while they are crying then they may simulate the effects of an ear infection without actually having one. Even professionals can have trouble identifying an ear infection and distinguishing between viral and bacterial.

Ear infections may not need antibiotic treatment but there is plenty of evidence (4) to show that middle ear infections can successfully ameliorated by treating with specific natural remedies. There is a two pronged approach to this, supporting the immune system to fight the infection and using topical applications to reduce pain and inflammation.

Immune support:

Echinacea is a very good immune support that is safe even for children. There are a few tinctures on the market that make products specifically for children. Taking a regular dose as a preventative or an increased dose once infection has been identified can promote the body to heal. Echinacea works by increasing the action of ‘natural killer’ cells (5) which recognise and attack infected cells. Echinacea also stimulates interferon production. (6)

Elder (Sambucus nigra) is well recognised for its antiviral and antibacterial properties. (7) Tonics suitable for children can be found that contain either the Elder berry or the Elder flower. Both are effective.

Garlic (Allium sativum) is another very safe natural remedy that can be found at home, and if you can coax your child to eat it, it offers a wide range of antibacterial and antimicrobial benefits. Garlic is best consumed freshly crushed and very lightly cooked to release the maximum amount of allicin. (9)

Topical treatments:

Lavender (Lavandula officinalis) is well known for its pain relief properties (8) using a lavender heat bag applied to the ear is a very gentle way to soothe pain. Adding a few drops of Lavender essential oil to a sterilised carrier oil and dropping it in the ear can reduce pain and inflammation and as lavender is an excellent healing agent it can also reduce the severity of the infection.

Garlic is not only great to take internally, it can be used externally as an infused oil. Garlic oil drops can be introduced directly to the ear to fight the infection.

Mullein oil is available commercially as a natural treatment for ear infection. Mullein (Verbascum thapsus) is a powerful natural antiobiotic and is often found in conjuncton with garlic as an earache treatment.

Sinus massage is actually an excellent way to prevent and to treat ear infections. Done at the onset of a cold or ear pain this can help clear any blockages. An excellent series of videos can be found on the subject here: Massage for children with earache (YouTube)

IMPORTANT: Any topical treatment should be avoided if the eardrum has burst, this can usually be established by examination or if liquid is draining from the ear. A burst eardrum usually heals itself in time with no lasting damage. An unhealed eardrum can lead to chronic ear infection which needs a different approach. (10)

Using these treatments can help children cope with the pain and discomfort of an ear infection as well as reducing the length of time to resolve.

By Sian Hannagan

Natural Mum on the Cheap

http://siananigan.blogspot.co.nz

For children 3 years and over, the oral probiotic BLIS K12 has been scientifically shown to greatly reduce glue ear and tonsillitis.

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References:

(1)  Stats on ear infection
http://www.nejm.org/doi/pdf/10.1056/NEJMoa0912254
Hoberman, A et al. Treatment of Acute Otitis Media in Children under 2 Years of Age 

(2)  Up to date treatment
http://pediatrics.aappublications.org/content/early/2013/02/20/peds.2012-3488.full.pdf+html
Lieberthal A, et al. The Diagnosis and Management of Acute Otitis Media 

(3)  Bacterial vs Viral
http://www.nejm.org/doi/pdf/10.1056/NEJM198206103062301
Henderson F, et al. A Longitudinal Study of Respiratory Viruses and Bacteria in the Etiology of Acute Otitis Media with Effusion 

(4)  Natural remedies
http://pediatrics.aappublications.org/content/111/5/e574.full.html
Sarrell E, et al. Naturopathic Treatment for Ear Pain in Children 

(5)  Natural Killer Cells
http://www.ncbi.nlm.nih.gov/pubmed/11439845
Currier N, et al. Echinacea purpurea and melatonin augment natural-killer cells in leukemic mice and prolong life span. 

(6)  Interferon
http://online.liebertpub.com/doi/abs/10.1089/jir.2006.0104
McCann D, et al. Cytokine- and Interferon-Modulating Properties of Echinacea spp. 

(7)  Elder
http://online.liebertpub.com/doi/abs/10.1089/acm.1995.1.361
Zachay-Rones Z, et al. Inhibition of Several Strains of Influenza Virus in Vitro and Reduction of Symptoms by an Elderberry Extract (Sambucus nigra L.) during an Outbreak of Influenza B Panama 

(8)  Lavender
http://www.sciencedirect.com/science/article/pii/S0378874103002344
Hajhashemi J, et al. Anti-inflammatory and analgesic properties of the leaf extracts and essential oil of Lavandula angustifolia Mill 

(9)  Garlic
http://www.ncbi.nlm.nih.gov/pubmed/10594976
Ankri S, et al. Antimicrobial properties of allicin from garlic. 

(10)  Topical analgesia info
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005657.pub2/pdf/standard
Johansson F, et al. Topical analgesia for acute otitis media (Review)