Tiny Ears, Big Challenges: Navigating Ear Infections with Your Little One

Mother comforts her child who is dealing with an ear infection

Summary

  • Ear infections often resolve on their own, without the need of antibiotics. If symptoms are mild, it’s worth discussing a “watchful waiting” approach with your pediatrician (unless your baby is younger than 6 months). 
  • Natural ways to relieve ear pain include massaging around the ear, applying gentle heat, and acupuncture.
  • Some of the ways to prevent ear infections include breastfeeding, good hand hygiene, avoiding sick contacts, and keeping up to date with vaccinations.
  • Ear tubes are a good option to improve the quality of life of children with recurrent ear infections. New procedures for ear tube insertion can be done in-office without the need of general anesthesia.
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As parents, we often find ourselves navigating various health challenges our little ones face, and one common issue is ear infections. From the crying spells to the restless nights, dealing with an ear infection can be quite challenging, no matter if your child is an infant, toddler, or older! But fear not—armed with the right information and strategies, you can help alleviate your child's discomfort and promote their recovery.

Keep reading and you’ll learn:

  • Why antibiotics may not be the best solution for an ear infection
  • Tips for soothing ear pain
  • How to prevent ear infections
  • Whether ear tubes are worth a shot

Why ear infections are so common in little ones

Ear infections (otitis media) are like unwelcome guests that frequently knock on the door of our children's health. They occur when bacteria or viruses invade the space behind the eardrum, causing inflammation and fluid buildup in the middle ear. This buildup of fluid can be painful and disrupt hearing. Recognizing the signs and symptoms of an ear infection is crucial.

Common symptoms include:

  • Ear pain
  • Fever
  • Fussiness or irritability
  • Rubbing or tugging at an ear
  • Difficulty sleeping [1]

But why are ear infections such a persistent problem? You may be wondering, are ear infections contagious? 

Fortunately, ear infections aren’t contagious. They are super common in children because little ones’ eustachian tubes—passages that connect the middle ear to the back of the nose and upper throat—are smaller and more horizontal compared to adults, making it more difficult for fluid to drain out of the ear. This leads to a higher risk of ear infections.

Besides, children often spend time in close contact with others, such as in daycare or school settings, increasing their exposure to germs that can cause ear infections. While an ear infection itself is not contagious, the underlying illnesses that can lead to it, such as colds and flu, certainly are.

The dilemma of antibiotics

You might wonder, why not just pop some antibiotics and be done with it? Well, here's the twist —antibiotics, in many cases, aren't very effective against ear infections in children. 

Ear infections may be caused by viruses, and in that case, they typically resolve on their own without the need for antibiotics. In fact, one study found that a whopping 80 percent of children recover from an ear infection in about three days without antibiotics [2].

On top of that, antibiotics can wreak havoc in your little one's tummy, disrupting the friendly microbes that keep things running smoothly. This can lead to tummy troubles [2] and other not-so-fun issues down the road. In fact, antibiotic use during childhood has been associated with a higher risk of asthma, allergic rhinitis, and eczema later in life [3]-[6].

Besides, using antibiotics too often is like giving bacteria a cheat code to become antibiotic-resistant, making future infections harder to tackle. So, it's wise to keep antibiotic use in check to protect our body's microbial squad and keep things in balance.

Did your child take antibiotics recently? Take a Tiny Health gut test to see how antibiotics impacted their gut microbiome and take any actions needed to promote faster recovery.

If your child's symptoms are mild, it might be worth discussing "watchful waiting" for 2-3 days with your pediatrician, to see if their immune system can kick those pesky germs to the curb on its own. The only exception is with babies under six months, where antibiotics are usually recommended. If the ear pain doesn’t subside after 3 days, your child has a fever of 102.2°F (39°C) or higher, or there is fluid draining from their ear, visit or call your pediatrician as antibiotics may be needed. 

Keep reading for ways to navigate an ear infection without antibiotics.

Tips for soothing ear infection pain without antibiotics

Now, let's talk about practical steps you can take to ease your child's discomfort once that pesky ear infection has decided to crash the party:

  • Apply gentle heat. A warm, clean cloth, a microwavable heating pad, or a semi-filled hot water bottle wrapped in a towel and placed on the ear can work wonders in easing pain.
  • Gentle massage. Massaging around the ear can promote drainage and alleviate pain.  Use your thumb to gently press on the area along the back of the ear with downward movements, until you reach the jawbone, five to ten times. Repeat this a few times a day.
  • Natural ear infection remedies. For babies older than one year, consider using mullein garlic oil, a natural antimicrobial, to help fight the infection. However, avoid using oil drops if your little one has a perforated eardrum or if you notice any drainage coming out of their ear.
  • Acupuncture. Consider taking your toddler to your local acupuncturist to address ear infection without the use of medication. Traditional Chinese medicine effectively uses therapies such as massage and quick, toddler-safe needling to stimulate the body's response to infection.
  • Rest. Encourage your little one to rest. A well-rested body is better equipped to fight off infections.

Your pediatrician may also prescribe some medications for fever or pain, like acetaminophen or ibuprofen.

How to help prevent ear infections in children

Of course, prevention is always better than a cure. Here are some proactive steps you can take to reduce the risk of future ear infections:

  • Breastfeed if possible. Breastmilk contains antibodies that can help protect your baby against ear infections [7], [8]. It's nature's way of giving your little one a boost in immune defense.
  • Hand Hygiene. Keeping your hands clean can prevent the spread of harmful bacteria, reducing the likelihood of ear infections. Learn and practice proper handwashing with your family, but avoid the temptation to use potentially harmful hand sanitizers.
  • Avoid sick contacts. Steer clear of sick individuals, whether they're children or adults. Minimizing exposure to germs can go a long way in safeguarding your child's health.
  • Vaccination. Consider having your  child vaccinated with the pneumococcal conjugate vaccine. Besides protecting from pneumonia and meningitis, it has been shown to reduce the incidence of ear infections caused by Streptococcus pneumoniae bacteria [9], [10].
  • Avoid smoke exposure: Keeping children away from secondhand smoke may reduce the risk of ear infections [11]-[13].
  • Consider trying a Lactobacillus probiotic. For some children, a Lactobacillus probiotic may help reduce future episodes of ear infection and decrease antibiotic use [14]. However, there isn’t enough evidence to recommend a specific Lactobacillus strain.

Ear tubes: does my child need them?

Sometimes, despite your best efforts, ear infections just keep coming back for more playtime. If your little one (6 months or older) is dealing with recurrent ear infections—think three or more episodes in six months, or four or more in a year [15]—and especially if they continue to accumulate fluid in the middle ear once the infection has subsided, they may be a good candidate for ear tubes.

Ear tube surgery is like giving those ears a tiny ventilation boost by inserting little tubes into the eardrums to prevent fluid buildup. While the number of subsequent ear infections may not decrease when compared to medical treatment [16], ear tubes may help decrease physical pain, prevent hearing loss and speech impairment [17]-[19]. Ear tubes also make it possible to use topical antibiotics if needed, which are gentler on your little one's gut compared to oral antibiotics.

Traditionally, ear tube surgery involves general anesthesia, which can be a bit daunting (and pricey!) The Hummingbird device and the Tula System [20] are two new and safe approaches that allow for in-office ear tube placement without the need for general anesthesia, and they're quick as a wink.

Navigating child ear infections with confidence

Dealing with ear infections in children can be a daunting task, but armed with the right knowledge and strategies, you can navigate through it with confidence. Remember, most ear infections resolve on their own without antibiotics, and there are some natural strategies and preventive measures you can employ to ease your child's discomfort and reduce the risk of future infections.

If your child ends up needing antibiotics for ear infection, it's worth checking their gut microbiome 4-6 weeks later to see how it responded. With a Tiny Health gut test, you get personalized interventions and support for a quicker recovery of their gut microbial community.

Finally, if surgical intervention becomes necessary, rest assured that it can greatly improve your child's quality of life. So, stay informed, stay proactive, and above all, shower your little one with love and care as they brave these common childhood ailments.

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References

[1] “Preventing and Treating Ear Infections | CDC.” Accessed: Apr. 22, 2024. [Online]. Available: https://www.cdc.gov/antibiotic-use/pdfs/EAR-INFECTION-H.pdf

[2] T. R. Coker et al., “Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: a systematic review,” JAMA, vol. 304, no. 19, pp. 2161–2169, Nov. 2010, doi: 10.1001/jama.2010.1651.

[3] Z. Aversa et al., “Association of Infant Antibiotic Exposure With Childhood Health Outcomes,” Mayo Clin. Proc., vol. 96, no. 1, pp. 66–77, Jan. 2021, doi: 10.1016/j.mayocp.2020.07.019.

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[5] S. Foliaki et al., “Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III,” J. Allergy Clin. Immunol., vol. 124, no. 5, Art. no. 5, Nov. 2009, doi: 10.1016/j.jaci.2009.08.017.

[6] K. Yamamoto-Hanada, L. Yang, M. Narita, H. Saito, and Y. Ohya, “Influence of antibiotic use in early childhood on asthma and allergic diseases at age 5,” Ann. Allergy Asthma Immunol. Off. Publ. Am. Coll. Allergy Asthma Immunol., vol. 119, no. 1, Art. no. 1, Jul. 2017, doi: 10.1016/j.anai.2017.05.013.

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[8] F. K. Al-Nawaiseh, M. T. Al-Jaghbir, M. S. Al-Assaf, H. K. Al-Nawaiseh, and M. M. Alzoubi, “Breastfeeding initiation and duration and acute otitis media among children less than two years of age in Jordan: results from a case-control study,” BMC Pediatr., vol. 22, no. 1, p. 370, Jun. 2022, doi: 10.1186/s12887-022-03427-7.

[9] “Pneumococcal Vaccination: What Everyone Should Know | CDC.” Accessed: Apr. 22, 2024. [Online]. Available: https://www.cdc.gov/vaccines/vpd/pneumo/public/index.html

[10] J. L. de Sévaux et al., “Pneumococcal conjugate vaccines for preventing acute otitis media in children,” Cochrane Database Syst. Rev., vol. 11, no. 11, p. CD001480, Nov. 2020, doi: 10.1002/14651858.CD001480.pub6.

[11] M. A. Patel, D. J. Mener, E. Garcia-Esquinas, A. Navas-Acien, Y. Agrawal, and S. Y. Lin, “Tobacco Smoke Exposure and Eustachian Tube Disorders in US Children and Adolescents,” PloS One, vol. 11, no. 10, p. e0163926, 2016, doi: 10.1371/journal.pone.0163926.

[12] S. Amani and P. Yarmohammadi, “Study of Effect of Household Parental Smoking on Development of Acute Otitis Media in Children Under 12 Years,” Glob. J. Health Sci., vol. 8, no. 5, pp. 81–88, Sep. 2015, doi: 10.5539/gjhs.v8n5p81.

[13] M. Yamada and M. Nakazawa, “Status of home-based secondhand smoke exposure among children and its association with health risks in Japan,” Prev. Med. Rep., vol. 38, p. 102585, Feb. 2024, doi: 10.1016/j.pmedr.2023.102585.

[14] A. M. Scott et al., “Probiotics for preventing acute otitis media in children,” Cochrane Database Syst. Rev., vol. 6, no. 6, p. CD012941, Jun. 2019, doi: 10.1002/14651858.CD012941.pub2.

[15] M. Spaw and M. Camacho, “Tympanostomy Tube,” in StatPearls, Treasure Island (FL): StatPearls Publishing, 2024. Accessed: Apr. 22, 2024. [Online]. Available: http://www.ncbi.nlm.nih.gov/books/NBK565858/

[16] A. Hoberman et al., “Tympanostomy Tubes or Medical Management for Recurrent Acute Otitis Media,” N. Engl. J. Med., vol. 384, no. 19, pp. 1789–1799, May 2021, doi: 10.1056/NEJMoa2027278.

[17] Y. Chow, D. A. M. Wabnitz, and J. Ling, “Quality of life outcomes after ventilating tube insertion for otitis media in an Australian population,” Int. J. Pediatr. Otorhinolaryngol., vol. 71, no. 10, pp. 1543–1547, Oct. 2007, doi: 10.1016/j.ijporl.2007.06.001.

[18] A. R. Lameiras, D. Silva, A. O Neill, and P. Escada, “[Quality of Life of Children with Otitis Media and Impact of Insertion of Transtympanic Ventilation Tubes in a Portuguese Population],” Acta Med. Port., vol. 31, no. 1, pp. 30–37, Jan. 2018, doi: 10.20344/amp.9457.

[19] Y. Jabbari Moghaddam and A. Mirghaffari, “Evaluation of Children Quality of Life after Serous Otitis Media Surgery,” J. Caring Sci., vol. 7, no. 3, pp. 131–135, Sep. 2018, doi: 10.15171/jcs.2018.021.

[20] L. R. Lustig et al., “In-Office Tympanostomy Tube Placement in Children Using Iontophoresis and Automated Tube Delivery,” The Laryngoscope, vol. 130 Suppl 4, no. Suppl 4, pp. S1–S9, May 2020, doi: 10.1002/lary.28612.