It is unfortunate that your baby can easily develop recurrent and chronic ear problems. At about six months, babies lose the maternal antibodies that protected them from common viral and bacterial infections. After that age they become susceptible, and they need to develop their own antibodies to these pathogens. If one of these viruses or bacteria happens to cause an ear infection, then your pediatrician may prescribe antibiotics. This is often the beginning of recurrent ear problems. Continuing to treat the fluid that collects in the middle ear or repeated red eardrums with more antibiotics just exacerbates the problem. And sometimes babies will have these ear problems even if they don’t get antibiotics. In this chapter you will learn the reasons that these ear problems tend to plague babies and find out how to cure them.

the middle ear

Behind the eardrum lies a tiny cavity within the bones of the skull that is filled with air. This is the middle ear. It contains three small bones that transfer sound from the movement of the eardrum (the tympanic membrane) to the inner ear, where nerve fibers detect these movements and communicate them to the brain. The brain then translates them into intelligible sounds. This little miracle depends upon a happy and functional middle ear. If all goes well, this apparatus works unhindered and without mishap.

The proper function of the eardrum and the transfer of sound by the bones of the middle ear depend upon the presence of air in the middle-ear cavity. This air is provided by the auditory tube, most commonly known as the Eustachian tube (after a sixteenth-century anatomist, Bartolomeo Eustachi). This tube connects the middle-ear cavity with the throat. It remains closed most of the time and opens with a small click during swallowing. The swallowing motion pumps air into the middle ear. The Eustachian tube also drains any fluid from the middle ear, such as liquid that may collect there during a cold.

In babies, the Eustachian tube does not tend to work so well. The pumping action of the tube depends upon a series of contractions of small muscles attached to the tube. Like other muscles in a baby’s body, their coordination tends to develop gradually over time. The Eustachian tube works better in older children than in infants and toddlers. If the Eustachian tube does not open consistently, then the mucus membranes that line the middle ear will use up the oxygen in the cavity and create a partial vacuum relative to the air pressure on the outside of the eardrum. This negative pressure pulls on the eardrum, making it less pliable and responsive to the movement of sound waves. This can diminish hearing. The mucous membranes that line the middle ear can also secrete mucous during a respiratory infection, and this fluid can collect there if the Eustachian tube is not draining the middle ear effectively. This fluid will tend to press against the eardrum, impairing its ability to move well and again diminishing hearing. Fluid in the middle ear can also become a breeding ground for bacteria, resulting in infections and more mucus production, com¬pounding the problem.

When babies have colds the eardrum tends to get inflamed, along with the membranes of the nose and throat. Sometimes this inflammation in the middle ear results in pain because the eardrum has many nerve endings and tends to be exquisitely sensitive. Some doctors who look at the eardrum and see that it’s red may be quick to prescribe antibiotics for what is interpreted as an ear infection (known as otitis media). But antibiotics tend to cause problems.

Antibiotics kill off the beneficial bacteria in the body, making babies more prone to infections. Billions of bacteria in the body coexist in a harmonious balance. There are more bacteria in and on the surface of our bodies than the total of human cells in our bodies. Many of these bacteria are protective, or they are essential for digesting food and extracting nutrients from food. Antibiotics destroy the protective bacteria of the intestines, allowing an overgrowth of harmful yeast and causing diarrhea because of bacterial disruption, and sometimes producing leaky gut syndrome. And antibiotics can also encourage bacteria to build up resistance to the antibiotics so that more serious infections may occur later. A more insidious effect of antibiotics is explained by Jake Fratkin, OMD, in his article “Pediatric Ear Infections and Chinese Medicine” (2004):

… Antibiotics also injure the production of white blood cells by destroying mitochondria. When an infection occurs normally, white blood cells multiply to help the body’s immune response. Inflammation and mucus secretion [are] part of its natural mechanisms. When antibiotics inhibit … WBC production, the body is slow to return to normalcy. This period of lowered immunity allows a reinfection. (This [destruction of the white blood cell response] is the reason why antibiotics seem to reduce sore throat, fever, and phlegm quickly, even when there is no bacterial infection.)

For these reasons, the American Academy of Pediatrics (2004) recommends that most children with acute ear infections can be observed for a period of forty-eight to seventy-two hours without antibiotics. This recommendation is based on the understanding from clinical studies that 61 percent of children with acute ear infections are better within twenty-four hours and 75 percent have complete resolution of symptoms within seven days without the use of antibiotics (Rosenfeld and Kay 2003).

Although the American Academy of Pediatrics recommendation suggests that clinicians take a wait-and-see attitude toward ear infections, they still advocate antibiotics for persistent symptoms. I do not recommend antibiotics for ear infections. They can nearly always be managed with holistic treatment, avoiding the many problems that antibiotics themselves create. Antibiotics are not an effective, safe, or appropriate first-line treatment for ear infections or other simple respiratory infections.

home treatment

Letting ear infections heal on their own is one way to approach them, but holistic care offers several effective options for treatment of the infection that will relieve pain and help to prevent the collection of fluid in the middle ear. Babies cry for a number of different reasons, pain being only one of them. But you will usually know if your baby has pain. Earaches can be excruciating to babies, and it’s always good to know whether a child’s ears are hurting. By six months of age your baby can indicate the source of pain by putting her hands to her ears with an earache or in her mouth if the pain is due to teething or a sore throat. Prior to that age, babies have no way to indicate the cause of the trouble.

You can use an inexpensive home otoscope to examine your child’s ears yourself. These are simplified versions of the tools that doctors use to look in children’s ears, and they are available through many online resources. A bit of practice when your baby is healthy will reveal a whitish gray eardrum. If you see red, then the discomfort your baby is experiencing may be coming from the ear. However, a pink or red eardrum does not necessarily mean there is an infection. It does mean there is some inflammation, but this often occurs when babies are fighting off a virus or even when they are crying.

Treatment for an earache is straightforward. If your baby is crying in pain, then a few drops of any type of cooking oil warmed to body temperature placed into the ear canal can be very soothing.

excerpt from The Holistic Baby Guide: Alternative Care for Common Health Problems by Randall Neustaedter OMD