Earaches are the number one cause of pediatric visits. Fluid can easily build up in a child’s tiny middle ear, creating pressure on the eardrum and causing intense pain. Most ear infections, however, are painful but not serious. According to the American Academy of Pediatrics (AAP), 70% of children with ear pain get better on their own within two or three days. Here are the three types of ear infections:
- Acute Otitis Media is painful and responds to antibiotic treatment. Usually caused by bacteria.
- Otitis Media with Effusion is fluid build up in the ear without any signs of infection (pain, redness, fever). Usually caused by a viral infection and not helped by antibiotics.
- Otitis Externa (Swimmer’s Ear) is an infection that can cause the ear to itch and be very sensitive to touch or pressure. There may be drainage from the ear. Antibiotics may help.
Ear infections are the most common reason that antibiotics are prescribed for children. We now know that the overprescribing of antibiotics can contribute to antibiotic resistance. In fact, the CDC issued a Threat Report on antibiotic resistance. In an effort to promote antibiotic best practices, the CDC encourages what they call, “antibiotic stewardship:”
- Ensuring all orders have dose, duration, and indications.
- Get cultures before starting antibiotics.
- Take an antibiotic “time-out.” Reassess antibiotics in 48 5o 72 hours.
The American Academy of Pediatrics (AAP) treatment guidelines for ear infections were revised in 2013 to reflect CDC concerns over antibiotic resistance. The AAP recommends that clinicians should not diagnose Acute Otitis Media (AOM) in children who do not have middle ear inflammation. The management of AOM should include an assessment of pain. If pain is present, the clinician should recommend treatment to reduce pain.
The clinician should prescribe antibiotic therapy
- for AOM in one or both ears in children 6 months and older with moderate or severe earache for at least 48 hours or temperature of 102.2°F or higher.
- for AOM in both ears in children 6 months through 23 months of age with mild earache and temperature less than 102.2°F.
The clinician should either prescribe antibiotic therapy or offer observation with close follow-up based on joint decision-making with the parent(s)/caregiver
- for AOM in one ear in children 6 to 24 months of age without a severe earache and with temperature less than 102.2°F.
Clinicians should reassess the patient if the caregiver reports that the child’s symptoms have worsened or failed to respond to the initial antibiotic treatment within 48 to 72 hours and determine whether a change in therapy is needed.
Underlying Causes of Ear Infections
Babies who are breastfed have a lower incidence of ear infections than do formula fed babies and the AAP recommends exclusive breastfeeding for at least six months. Second-hand smoke can aggravate ear infections and some studies show that pacifier use may put babies at higher risk for ear infections. If your child experiences more than two ear infections a year, you should look for underlying causes. There are several reasons why fluid might build up in the middle ear. They include:
Allergy. Many studies have suggested a link between food intolerance and middle ear problems. One study tested 104 children with recurring middle ear problems for food allergy and discovered 81 to be allergic. After eliminating the offending foods, 86% got better, and 94% got worse when the offending foods were reintroduced. The most common allergens are dairy products, wheat, egg white, peanuts, and soy.
Nutritional deficiency. Researchers have found that children with high susceptibility to ear infections are often deficient in zinc, iron, or vitamin A. One study found substances related to the improper intake of dietary fats in the middle ear fluid of children with otitis media. Often children with recurrent earaches improve simply by switching to a more wholesome diet.
Mechanical obstruction. A blockage of the eustachian tube can occur as a result of swollen tonsils or adenoids, or from structural problems in the bones surrounding the ear. The biomechanics of these delicate bones can be disrupted by any physical trauma, including a fall or a difficult birth. Chiropractic adjustments or craniosacral therapy are often effective at resolving these problems and preventing recurring ear infections.
Home Remedies for Earaches
Herbs. Ear drops can help relieve the pain of an earache. A blend of mullein and garlic oil is a good choice because of its antiviral and antibacterial properties. To administer ear drops:
- Run hot water over a spoon until it is warm
- Pour a few drops of oil onto the spoon to warm the oil
- Alternately, run the glass dropper filled with oil under warm water and test its temperature by putting a drop on the back of your hand.
- Put two to three drops of the oil in each ear while your child is lying down
- Plug the ear loosely with a cotton ball.
Repeat two or three times a day for no more than four days.
Aromatherapy. Make an aromatherapy ear rub with 2 to 3 drops of lavender, and/or chamomile essential oils in 1 ounce of olive oil. Rub the oil mixture around the outside of the ear and over the lymph nodes on the side of the neck, or dab a cotton ball in the oil, gently place it in the ear, and leave it in for a few hours.
Homeopathy. Homeopathic remedies can be administered at home to relieve the pain of occasional earaches. See Homeopathic Medicine At Home for more information.
- If your child is angry, fearful, and sensitive to light and noise, consider Belladonna, which is effective for earaches that come on suddenly, with severe, throbbing pains.
- Chamomilla is good for earaches associated with teething.
- Children who need Pulsatilla tend to be weepy, sensitive, and clingy. Their cheeks will be pale, and there may be a thick, yellow-green discharge from the nose or the ear. Symptoms often come on gradually, frequently following a cold.
- Aconite is for the sudden onset of earache after a chill. The child may awaken in the night screaming with pain and appearing anxious and scared.
- Recurring earaches also respond well to homeopathic treatment; consult a trained homeopath for help in choosing the right remedy.
And, don’t forget the natural soothers of a cozy bed, a cool washcloth on the forehead, or a hot water bottle to lean against. Good simple food, hearty soups, homemade lemonade and the company of loved ones are sure to help the healing process.
About Peggy O’Mara. I am an independent journalist who edits and publishes peggyomara.com. I was the editor and publisher of Mothering Magazine for over 30 years and founded Mothering.com in 1995. My books include Having a Baby Naturally, Natural Family Living, The Way Back Home and A Quiet Place. I have conducted workshops at Omega Institute, Esalen, La Leche League, and Bioneers. I am the mother of four and grandmother of three. Please check out my email newsletter with free tips on parenting, activism, and healthy living.