Wednesday, November 17, 2010

Ear Infections and Antibiotics

On November 16th, the Journal of the American Medical Association published a study asserting that antibiotics only moderately increase the rate of cure of ear infections, while also significantly increasing the risk of side effects, including diarrhea and rashes. It found that 80 out of 100 children would recover in a few days without antibiotics, while 91 out of 100 would recover with antibiotics. The children in the study who did not take antibiotics relied on agents to reduce pain and fever during their ear infections.

The reasoning behind this is simple. Ear infections can be divided into three main types. Acute otitis media (AOM), or an acute infection of the middle ear, is the most common type of ear infection in children. Another type is acute otitis media with effusion, in which the area behind the eardrum fills with fluid.

And otitis externa is an infection of the outer ear, more commonly called "swimmer's ear," due to its prominence amongst swimmers. Of these, otitis externa is the only one caused mainly by bacteria. AOM may be caused by bacteria or viruses, while AOM with effusion is caused by viruses. Antibiotics are only effective against bacterial infections.

This is an interesting conundrum. Parents who take their suffering children to the doctor do not particularly like to hear that their child does not need an antibiotic. They expect to walk out with something in their hand that will address the infection. The thing is, ear infections can often be successfully and naturally treated at home. Employing the following measures can contribute to quick resolution of an ear infection.
  • Use warming socks. This is perhaps the most important treatment for an ear infection. Make sure your child's feet are warm by either having your child take a warm bath or shower, or just a simple foot bath. (If your child has a fever, you probably can skip this step.) Wring out a pair of cotton socks in cold water until they are just damp. Put them on your child's feet, then put a pair of wool socks on top of them. Immediately have your child go to bed or take a nap. This will increase lymphatic flow away from the ear and drain it quickly. It will also stimulate a fever. And your child will sleep deeply and comfortably. (If you're a parent, you know just how blessed this can be!)
  • Fast. Remember when doctors used to say "don't take anything by mouth, except for liquids"? This is it. There are a few exceptions to this rule, like chicken broth or miso soup (my personal favorite). Otherwise, when someone has a fever, usually their appetite is suppressed. The body needs all the energy it can to fight that infection, and since digestion takes 60% of a body's energy, this makes sense.
  • Drink. Water is, of course, highly recommended here. But often, people with fevers are also dehydrated and sweating out precious electrolytes. As stated above, chicken soup and miso soup are excellent choices to help with replenishing electrolytes.
  • Rest. Again, an ailing person's body is trying to fight an infection, so the more a person can rest, the better off they will be. (This does not include lying down and watching stimulating TV shows!)
  • Gentle movement. If your child can move around a bit (i.e., walk), this may help move blood around and help him or her to feel better. But this is only to your child's tolerance; do not force them to move if they don't want to.
  • Avoid medicines that reduce fevers. Considering that I recommend using warming socks that stimulate a fever, this should make sense. Bacteria and viruses often are destroyed in temperatures above 102 degrees. If you can maintain a high fever, your body will be able to mount a more effective response. Taking anti-inflammatories blunt your body's immune response and may prolong ear infections. Read more information here on why fevers are good, when and how to lower a fever safely and naturally, and when to go to a hospital if a fever goes too high.
  • Consider vitamin D. There is often a high correlation between an inadequate immune system and low levels of vitamin D. The easiest way to increase one's vitamin D, of course, is to sunbathe regularly, exposing plenty of skin to the sun. But at this time of year, it's often too cold to do this, and vitamin D supplementation comes in handy. For children, the guideline is 1,000 IUs per 25 pounds of body weight.
Some people swear by other remedies like garlic oil or hydrogen peroxide placed in the ear. But these are NOT recommended if there is a perforated eardrum.

If your child is prone to repeated ear infections, this may be a reason to see a naturopathic doctor in your area. Naturopathic doctors can address not only the reason why your child suffers ear infections regularly, but can also recommend measures to support your child's health in general. And the healthier your child can be today, the healthier they will be in the future.

Best wishes for a season free of ear infections. But if your child does end up getting an ear infection, you now have powerful tools to treat it effectively!