Ear Infections: Causes and Holistic Care

by Linda Folden Palmer, DC– ICPA.org:ear infections

Causes of Ear Infections

Middle ear infections are on the rise. The ailment, also known as otitis media, has become far more prevalent in children throughout the twentieth century, increasing 150 percent between 1975 to 1990 alone. This dramatic increase illustrates the parameters of wise antibiotic use and its abuse, while at the same time revealing the effects of breastfeeding and formula.

The middle ear is the part of the ear that is enclosed behind the eardrum. A tiny tube, called the eustachian tube, drains any fluids from the middle ear into the throat. Colds and episodes of allergic runny nose, due to airborne allergens or allergies to cow’s milk or other foods, block this eustachian tube with mucus and inflammation. When this tiny mucous-membrane-lined canal is closed off, inflammatory fluids build up in the middle ear cavity (serous otitis media), sometimes referred to as effusion. Over time, passage of nasal and throat bacteria into this tube, from pacifier use or especially when a child is lying on his back, can seed the middle ear. Bacteria can then multiply to large numbers when finding a friendly fluid-filled middle ear environment, creating painful infection (acute otitis media).

The major source of these infections is threefold: the withholding of protective mother’s milk; antibiotic treatment for mild or non-bacterial ear conditions; and inflammatory reactions to certain foods, particularly cow’s milk.

The occurrence of otitis media is 19 percent lower in breastfed infants, with 80 percent fewer prolonged episodes. The risk of otitis remains at this reduced level for four months after weaning and then increases. By 12 months after weaning, the risk is the same as in those who were never breastfed. In addition to providing general immunities to the infant, breastmilk also provides specific antibodies that prevent otitiscausing bacteria from attaching to the mucous walls of the middle ear.

 

Misguided Concerns About Infection

The presence of fluid in the middle ear from chronic or acute conditions reduces a child’s capacity to hear. This fluid muffles sounds but does not damage the hearing mechanism, so hearing returns once the fluid is gone. While permanent hearing damage does not occur from acute or chronic otitis, chronic interference with hearing can delay language development.

In some cases of acute infection, treated or not, the eardrum may rupture. While fear is generated around this possibility, the rupture allows the pus to drain and the middle ear to dry, most likely resolving the infection. The eardrum will then heal with some scar tissue, just as it would have after tube insertion. This scar tissue, found in many an eardrum, typically affects hearing very minimally or not at all. (Drainage from an ear can also be an outer ear infection. This is common after swimming, and the condition will respond to ear drops. Drainage from the ear for more than two days, especially when associated with hearing loss, requires prompt medical attention.)

The major concern with ear infections is that infection could develop in the mastoid air cells behind the ear. This rare condition is called mastoiditis, and is primarily of concern because of the proximity to the brain. Mastoiditis, seen as redness behind the ear and protrusion of the outer ear, can occasionally lead not only to permanent hearing loss, but to brain damage as well. Although claims are made that the incidence of mastoiditis has been greatly reduced since the introduction of antibiotics, this is not clear from a review of the literature. After the advent of antibiotics and CT scans, however, it is apparent that serious complications of acute mastoiditis have been reduced, and that the number of mastoid removals (mastoidectomies) has been reduced as well. In fact, antibiotic therapy for cases of mastoiditis appears to be valuable for preventing surgery in 86 percent of cases.

Just over half of all mastoiditis cases occur following bouts of acute otitis media. While there are other causes of mastoiditis, fewer than 4 percent of the rare deaths from mastoiditis complications occur in cases that originated as ear infections.

Some mastoiditis is blamed on poor antibiotic treatment of ear infections; other cases are blamed on antibiotic therapy itself. At the 1998 meeting of the American Academy of Otolaryngology, it was reported that serious cases of mastoiditis are rising as a direct result of strongly resistant bacteria developed through the common use of antibiotic therapy for ear infections.

Additionally, “masked mastoiditis,” in which the clearing up of the visible symptoms of the middle ear infection mask the existence of the mastoiditis, is a highly worrisome, occasionally seen condition that is directly caused by antibiotic treatment of ear infections. The behavior of the bacteria that promote this condition makes it very difficult to discover, and the condition has a high rate of dangerous complications.

 

Antibiotic Ills

The standard treatment for acute middle ear infections is antibiotic therapy. Alas, antibiotics are prescribed very often when simple fluid buildup is present without infection, as described earlier, or when the eardrum just appears red, suggesting inflammation. At times the eardrum can appear very red just from crying, allergies or a fever of other origin. It is impossible to accurately diagnose infection without puncturing the eardrum and taking a fluid sample. This leads doctors to suspect infection based upon the presence of symptoms, and prescribe antibiotics.

One-third of all ear infections are viral, and the distinction cannot be made upon examination. Antibiotics do not kill viruses, and can make viral infections worse by wiping out competing bacterial flora and encouraging secondary bacterial infections of resistant strains. Although seldom recognized, a number of chronic ear infections are actually fungal in nature (candida), produced when multiple courses of antibiotics disrupt the normal floral balance and encourage fungal growth.

Many large studies have shown that antibiotic treatment provides only a small benefit over no treatment at all for short-term resolution of ear infections. A 1994 analysis reviewed 33 studies, covering 5,400 cases of acute otitis, and found that spontaneous recovery without medical treatment occurred in 81 percent of acute cases. Short-term recovery occurred 95 percent of the time when antibiotics were used.

At least one third of children on antibiotics experienced side effects. Although their rate of short-term resolution was slightly improved, there was no long-term benefit to antibiotic therapy: Medicated children demonstrate no less otitis four weeks after antibiotic treatment than those treated with placebos. In fact, there was a higher rate of returning acute ear infection seen in those who received antibiotic therapy, and the return of serous otitis was two to six times higher in those treated with antibiotics.

However, when language development is retarded due to prolonged middle ear fluid, the temporary hearing improvement provided by the tubes might be worth the risks.

Generally, fever or great localized pain accompany signs of drum inflammation (redness) and fluid buildup (bulging of drum) in a true acute infection. The most sensible modern recommendation regarding ear infection treatment is to use antibiotic therapy only in genuinely acute infections that do not resolve on their own within a few days. This regimen is currently followed in several European countries with positive results; it also reduces the development of bacterial strains resistant to antibiotics. A heating pad over the ear affords some relief, and many feel that recovery can be hastened by warm garlic or tea tree oil drops in the ear. Favorite antimicrobial supplements, such as goldenseal or grape-seed extract, may prove beneficial. Fever should not be reduced, as it is the body’s own powerful process for killing infecting microbes.

The value of surgical insertion of tubes through the eardrum to treat chronic ear conditions is widely debated. There are many risks involved, including a much greater return of infection once the tubes are gone.
In conclusion, medical treatments complicate the picture of middle ear infections without providing long-term benefits. Removing the chief causes of middle ear infections should be the preferred goal. This can be achieved by providing breastmilk, avoiding overuse of antibiotics and recognizing, treating and avoiding exposure to allergens, especially food allergens.

Article originally posted at ICPA.org.

Antibiotics and Ear Infections

by Linda Folden Palmer, DC – ICPA.org:antibiotics and ear infections

In cases where the immune response lags behind a bacterial infection that is dangerously decimating the body, the 1950s advent of antibiotic medications saved the lives of millions of people who would have otherwise succumbed. However, the overzealous use of these wonder drugs has now created a new realm of powerful diseases we are unable to fight with existing antibiotics.

Once a resistant bacteria has been created in response to antibiotic therapy, it has the power to transfer its resistance to other microbes, developing new resistant strains. This has been an especially significant issue for the young, who have been chief targets for antibiotic misuse because they are more susceptible to infections and infections are more worrisome in them. Powerful, antibiotic-resistant strains spread easily around day care centers.

Tuberculosis and pneumonia were once conquered with antibiotics, but we are now threatened again by TB epidemics and increased pneumonia deaths. The excitement over antibiotics has also led to reduced hygiene in hospitals. Hospital sanitation peaked decades ago, when its importance was first widely recognized. Now 10 percent of the patients in hospitals acquire infections, a large portion of which are resistant to antibiotics due to their expansive use in hospitals. Three percent of these patients die from their infections.

Antibiotics have many possible side effects, including diarrhea, malabsorption, cramping, yeast infections, agitation, rashes and blood disorders. By wiping out much of the normal flora throughout the body, antibiotics leave patients, especially children, far more vulnerable to other infections, such as thrush (oral yeast), and dangerous intestinal microbes that cause diarrheal illness. Infectious diarrhea follows antibiotic use at rates ranging from 5 to 39 percent, depending on the drug. The most common intestinal infection caused by antibiotics is colitis from clostridium infection, which has a 3.5 percent mortality rate.

Significantly, antibiotics are generally inappropriate for treating ear infections. They have no effect on viruses and are certainly inappropriate for colds and flus, where they can lead to secondary infection. Yet the majority of children visiting physicians with these complaints will receive antibiotic prescriptions. This is unfortunate. Most of the time, children are better off left to fight illness with their own immune systems, while their parents and physician provide careful monitoring.

Article originally posted at ICPA.org.

Taking Charge of Your Family’s Natural Wellness

by Andrea Candee – ICPA.org:natural remedies

“Self empowerment” is the buzz word of our time. Yet, many feel disempowered when it comes to the care of their family’s health. Integrated medicine, taking the best of all worlds, is a sensible, responsible approach to healthcare. Here’s more from Andrea Candee, author of Gentle Healing for Baby and Child.

Trying Herbs

Grandparents recognize this as the health care approach of their youth: administer natural remedies at home unless the situation requires more professional help. Perhaps this is why grandparents seem to be the biggest purchasers of books on natural wellness for children, offering it to their adult children for the care of the grandchildren.

Turning to the health food store or even the kitchen pantry, and given a medical diagnosis, a parent educated in medicinal herbs can return a youngster to health or soothe discomfort until seen by the family care provider. And what better way to empower a child about their own wellness than to engage them in their healthcare, creating an awareness that will stay with them for their entire lives. They learn that taking care of their bodies preventatively is every bit as important as consulting a doctor when they are sick.

Statistics indicate that 75 percent of children have at least three ear infections before the age of six. Most of us either have or know a child who repeatedly suffers from what we have tacitly come to accept as a common childhood illness. Doesn’t it make you wonder why, with all the advances of modern medicine, children seem to suffer from ear infections more, rather than less than they did even 20 years ago?

Some children respond well to antibiotics; others are put on a round robin of antibiotic treatments (sometimes for years); and others still require surgery. A study reported in The Journal of the American Medical Association found that children given antibiotics for ear infections were two to six times more likely to develop a recurrence than children who did not receive the antibiotic treatment.

I am not the only one asking the question: What long-term effects do antibiotics have on developing immune systems?

“We found that, in the case of ear infections, sometimes the prescribed medicines created other problems and occasionally didn’t even cure…We have had the opportunity…to observe how effective, gentle and well tolerated these (herbal) remedies are in children.” (Larry Baskind, MD, FAAP, Riverside Pediatrics, Croton on Hudson, NY; excerpted from the foreword of Gentle Healing for Baby and Child [Simon & Schuster] ).

First Signs of Ear Discomfort

I recommend the following courses of action at the earliest signs of ear discomfort:

• Limit the intake of sugar. Processed sugar is a challenge to the body and feeds fungal, parasitic, and bacterial infections. Reduce fruit juice intake by diluting with water. Learn how to use echinacea, an invaluable immune system support found in health food stores, at the first sign of infection. Colds usually wind up in the ears of children predisposed to weakness in this part of their body. If you can prevent a cold from blossoming, you will have prevented another ear infection from developing.

• If a cold does take hold, you may choose to introduce an herbal decongestant.

• Add garlic to your child’s diet. Garlic is naturally anti-bacterial, as well as anti-fungal, anti-viral, and anti-parasitic. A fresh clove can be chopped into mashed potatoes or put on toast with butter.

• If infected fluid has settled in the ear, and there is no perforation of the eardrum (check with your family practitioner to be sure of this) add a drop or two of anti-microbial garlic oil in each ear, along with a drop or two oil of mullein flower. Mullein flower is well known for its anti-inflammatory, decongestant action in the ear. The easiest time to administer ear drops is when a child is sleeping.

• If there is pain in the ear, add a drop or two of St. John’s Wort oil. Its ability to calm nerve sensitivity may help to diminish the discomfort.

• For many children, chiropractic adjustments have been instrumental in preventing recurrent ear infections. If there is a misalignment in the spine affecting nerve and muscle function, chiropractic adjustments could help by enhancing proper drainage and function.

Don’t be afraid to implement all of the above protocols even if your child is on an antibiotic (To maintain the integrity of the intestinal tract, if your child is ever on an antibiotic, be sure to provide your child with a good source of probiotics). When a parent is informed and courageous enough to take charge of the situation, I have seen even the most chronic ear infections turned around—indeed eliminated—from the child’s life.

View article references and author information here:
www.pathwaystofamilywellness.org/references.html

Ear Infections

Van D. Merkle, DC Says:

1. Become informed about Prevnar vaccine (PCV7), also known as the pneumococcal strep vaccine, or ear-ache vaccine. The literature does not support its use.
2. Avoid ALL dairy products, sugar, and congestive type foods.
3. Try Monolaurin, an immune system enhancer.
4. Echinacea: 3/day. For infants 4 months to 25 lbs use 1 echinacea per day; open the capsule and put in food or water.
5. Chiropractic adjustments have been shown to be of great benefit.

Management of Acute Otitis Media Summary

1. Nearly two thirds of children with uncomplicated ear infections recover from pain and fever within 24 hours of diagnosis without antibiotic treatment. Over 80% recover within 1 to 7 days.
2. More than 5 million cases of acute ear infections occur annually, costing about $3 billion.
3. The report points out that in other countries otitis media is not always treated with drugs at the first sign of infection. Rather, in children over the age of 2 years, the norm is to watch and see how the infection progresses over the course of a few days.
4. The report notes that in the Netherlands the rate of bacterial resistance is about 1%, compared with the US average of around 25%. 1

What Causes Damage to the Ear and/or Ear Infection?

Ear Wax: “During more than 25 years in pediatric medicine, I have never seen a case of permanent hearing loss as a result of ear infection…Parents and doctors can be responsible for injury to the ear canal and the eardrum because of the efforts to remove wax from the ear. It is inadvisable for you or your doctor to use ANY kind of instrument to remove wax forcibly from your child’s ears, even a cotton swab.” – Robert S. Mendelsohn, MD

The best was to remove ear wax is by inserting a few drops of hydrogen peroxide into the ear twice a day for 2 or 3 days. Let the peroxide remain in the ear for several minutes and then rinse the ear with gentle bursts of water from a syringe.

Pacifiers: Pacifier use was found to cause a 40% increased risk of ear infections in infants, as well as higher rates of tooth decay and thrush, according to Dr. Marjo Niemela and associates from the University of Oulu in Finland. Pediatrics September, 2000;106:483–488.

Don’t Drink Your Milk!: Ear specialists frequently insert tubes into the ear drums of infants to treat recurrent ear infections. It has replaced the previously popular tonsillectomy to become the number one surgery in the country. Unfortunately, most of these specialists don’t realize that over 50% of these children will improve and have no further ear infections if they just stop drinking their milk. This is a real tragedy. Not only is the $3,000 spent on the surgery wasted, but there are some recent articles supporting the likelihood that most children who have this procedure will have long-term hearing losses. http://www.mercola.com/article/milk/no_milk.htm

“The most common culprit [that causes ear infections] is cow’s milk, in its natural form or as found in infant formula. It causes swelling of the mucous membranes, which interferes with the drainage of secretions through the eustachian tube. Eventually infection results because of the accumulated secretion.” – Robert S. Mendelsohn, MD

What About Antibiotics?

Although more antibiotics are prescribed today for children’s ear infections—and for longer periods of time—in the US than anywhere in the world, several recent, independently financed studies have found that for the vast majority of ear infections, antibiotics are little more effective than no treatment at all. http://www.mercola.com/2001/jan/14/whistle_blower.htm

Experts say the routine use of antibiotics against pediatric ear infections produces little health benefit while contributing to the spread of drug-resistant bacteria, and recurrent ear infection. The article evaluated the results of seven different studies conducted over the past 30 years. They found that while antibiotics were linked to short-term decreases in the duration of pain or fever in patients in a few (but not all) of the studies, no long-term (more than six weeks) benefits are reported. All seven studies concluded that children recovered from ear infections at roughly similar rates, regardless of type of treatment. JAMA November 26,1997;278(20):1643–1645

When Is Tympanostomy (Tubes in the Ears) Justified?

“In all my years of practice I have never seen a case in which a punctured ear drum did not heal itself. The principle justification for the procedure [tympanostomy] is to prevent hearing loss, which is no justification at all. Controlled studies have shown that when both ears are infected, and a tube is inserted in only one of them, the outcome for both ears is almost identical. Meanwhile the procedure itself carries many risks and side effects. Justified as means of preventing hearing loss, tympanostomy can cause scarring and hardening of the eardrum, resulting in hearing loss.” – Robert S. Mendelsohn, MD

Prevnar, Pneumococcal (Strep) Vaccine Does NOT Prevent Ear Infections and Has Major Side Effects

Abstracted from lecture by Erdem Cantekin, PhD, Professor of Otolaryngology at the University of Pittsburgh at the Second International Vaccine Information Center Conference September 9, 2000; Washington DC.

Prevnar is a new vaccine against pneumococcus. This is the most expensive routine vaccine to date. The wholesale cost is about $58.There are over 90 different strains of pneumococcus. The vaccine only has 7 strains assumed to be the common ones, but this is an uniformed experiment at best as there is no way to know if this will be covering all of the strains.

The FDA approval states the drugs is ONLY approved for invasive cases of pneumococcal disease such as bacteremia and meningitis. It is NOT approved for ear infections. This is most peculiar as it is commonly recognized that bacterial meningitis is primarily seen in adults not in infants for which this vaccine is recommended. The HMO trial in which Prevnar was approved had no placebo group. The control group received another experimental vaccine for mennigococcus. This was the ONLY trial that was done to establish the safety and efficacy to recommend this vaccine for every newborn in the US.

Just how well did the vaccine work in the HMO trial? In the first 17 cases of bacteremia it worked perfectly. However it was NOT effective for any cases of ear infections. If Prevnar could have stopped this or even reduced this problem it would have been great. But that is not the case. The FDA data from the HMO trial and that in Finland showed that the prevention benefit is less than 4%. The efficacy claims of Prevnar in ear infections and pneumonia remain unproven.

What About Adverse Side Effects of Prevnar?

The children who received Prevnar in the trial were:

• 4 times more likely to have seizures
• 4 times more likely to have stomach problems

Also, significantly more children who had been given Prevnar developed asthma. There was also one death in the Prevnar group and none in the other. Prevnar also alters the developing immune system. Additionally it will put selective pressure on the pneumococcal strains and has the potential to change the natural pattern of strep infections.

Over one trillion dollars of health care system are under the watchful eyes of the FDA, CDC, and the NIH. These three pillars of our public health care system have become to be more and more controlled by “expert panels” advisory committees. Such experts dictate policy and control the complex biomedical system. They directly influenced taxpayers health and wealth. However there is a huge conflict of interest as most of these experts served the special interest groups who profit in their decision. Many are in financial relationships with various manufacturers and are registered as their paid speakers or as some people might say paid lobbyists.

In Summary…

Ear infections will not cause permanent hearing deficits, and mastoiditis is so rare a condition that most contemporary physicians have never seen a case. Conventional treatment with antibiotics, other drugs and the surgical procedure known as tympanostomy is no more effective than the body’s own defenses in dealing with the problem.

Dr. Robert S. Mendelsohn’s Recommendations for Earache

1. Wait 48 hours before you call your physician.
2. Relieve the pain with a heating pad, two drop of heated olive oil (not hot) inserted in the ear canal, and the appropriate dose of acetaminophen if the pain becomes unbearable.
3. If the pain persists after 48 hours, see a doctor—not to treat infection, if that’s what it proves to be, but to rule out the possibility of trauma or the presence of a foreign body.
4. Don’t allow your doctor to use an instrument to remove wax from your child’s ear, and don’t try to do it yourself.
5. If your doctor examines your child and finds a viral or bacterial infection, question the need for antibiotic use. If he finds a foreign body, let him remove it, but again question the need for antibiotic use. If your child has a self-inflicted injury to the eardrum, your pediatrician may refer you to an ear and throat specialist. Be suspicious and question the need if he recommends surgical treatment or antibiotics. In all my years of experience I have never seen a case in which either was necessary.
6. If your child has chronic, recurrent middle ear infection, it is probably because of allergies or the antibiotics he was previously given. If your doctor recommends tympanostomy, don’t permit it without obtaining a second opinion. This procedure has replaced tonsillectomy as the favorite of pediatricians, but there is no reliable scientific evidence that it will do any good, and there’s considerable evidence that it may cause further harm.

Article originally posted at ICPA.org.