Most parents will deal with ear infections or earaches at some point in their parenting career. Approximately 80% of children will have at least one episode of acute otitis media (the medical term of an inner ear infection) before they are school age. [1]

Usually, ear infections occur because the tube that drains the inner ear into the throat lies more horizontal and with an upper respiratory infection, it gets congested inhibiting fluid/organisms from moving freely resulting in them getting stuck in the inner ear and multiplying.  When children get an ear infection, they will often complain of pain, tug at the ear, have a fever, may be irritable, be coughing and have a runny nose.

Treating an Ear Infection

An appropriate diagnosis is important when deciding treatment for an ear infection. In order to properly diagnose an ear infection it is important to have your Doctor – either Naturopathic or Medical, look in your child’s ear. By doing this, we will be able to see if the eardrum is inflamed, swollen, or has fluid behind it. 

According to an evidence review by American Family Physician in 2019[2], Acute Otitis Media resolves in 81% of children without antibiotic treatment and the use of antibiotics will only increase that resolution percentage by 12% so antibiotics may have limited benefits compared with the side effects (i.e. rash, vomiting, diarrhea, antibiotic resistance). The general recommendation is to wait 48 to 72 hours before starting antibiotics, as ear infections will often clear up without antibiotics. During this time frame, Naturopathic Medicine has some great tools to help support the immune response and soothe the infection naturally. Generally we will follow up in 2-3 days by email or a quick phone call and then recheck the ear in 5-7 days to ensure things are resolving.  It is important to note that children under the age of 6 months, children under 2 with bilateral ear infections, or anyone with discharge from the ear or severe symptoms (high fever, looking severely unwell) should be seen by a Medical Doctor for antibiotics. 

Naturopathic Treatment Options:

• Support the immune response with Elderberry or Echinacea. Both of these herbs are safe and effective in children and come in good-tasting syrups. Dose depends on age, so consult a ND for specific recommendations.
• Probiotics may also be helpful. While studies looking specifically at using probiotics to reduce ear infections have been mixed, many do support the use of probiotics in reducing viral illnesses, which can in turn reduce the incidence of developing an ear infection. If your child has had one or more rounds of antibiotics in the past, they may need probiotic therapy for a few months to repopulate the gut flora.
• Use garlic-infused ear oil. In our office, we use an ear oil blend made by St. Francis. The garlic is very effective in treating the infection and the St. Johns Wort acts as topical anaesthetic helping to reduce pain. A study in 2001[3], found that a similar blend was as effective in reducing pain association with an ear infection.

Never put anything in the ear if there is drainage, or if you suspect the eardrum has ruptured. Always bring your child in for an exam before treating at home

• Eustachian tube massage: Give firm but gentle massage all around the jaw and head in the area adjacent to the ear. Massage in a downward direction behind the ear on the neck and apply gentle inward pressure in front of the ear toward the cheek). This will help to drain fluid in the inner ear and stimulate pressure points in the area.
• Make an onion poultice: Slice half of a medium onion and blanch in hot water for 5-10 mins. Drain and wrap in a tea towel or thin cloth. Cover the ear for 5-10 mins.

Be sure that the temperature is not too hot as if it is you can burn the skin

• To reduce pain, use heat. A hot water bottle applied over the ear can help to reduce pain, especially when used with an herbal ear oil.

***Remember sometimes antibiotics are warranted. You need to seek antibiotics if your child’s symptoms have not improved in 48-72 hours or they become more unwell. Also, as noted above antibiotics are need if your child is under the age of 6 months, under 2 with bilateral ear infections, has discharge from the ear or has severe symptoms (high fever, looking severely unwell) should be seen by a Medical Doctor for antibiotics.

Chronic Ear infections

Some children are prone to ear infections and may suffer frequently, especially during cold and flu season. It is important to consult a Naturopathic Doctor as chronic ear infections can be due to more systemic issues and connected to other issues like eczema. For these children, it is important to identify possible food intolerances, improve digestion as well as the immune system. If you had ear infections as a child and are looking to generally prevent ear infections in your children some things that can be done are limit exposure to tobacco smoke or environmental air pollution, breastfeed for at least the first 6 months of your child’s life, limit pacifier use after 6 months of age and bottle propping. 

[1] Otitis Media:Diagnosis and Treatment. Am Fam Physician. 2013 Oct 1;88(7):435-440.

[2] Otitis Media: Rapid Evidence Review. Am Fam Physician. 2019 Sep 15;100(6):350-356

[3] http://www.ncbi.nlm.nih.gov/pubmed/11434846