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Ear infections

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of ear infections.

Alternative Names

Otitis media

Home Remedies

Careful monitoring of the child's condition (watchful waiting) along with home remedies and common over the counter cold medicines may be a viable alternative to antibiotic treatment for many children with a first episode of acute otitis media.

• In one 2000 study, 240 children under age 2 who were diagnosed with acute otitis media were treated with watchful waiting. After 4 days, only 3% of the children required treatment with antibiotics, while the infection cleared in the other 97%.
• High fever, severe pain, or other signs of complications should warrant immediate attention by a medical professional.
• Parents of infants should contact their doctor immediately if they have any fever, regardless other symptoms.

Natural Remedies for Ear Aches

Before antibiotics, parents used home remedies to treat the pain of ear infections. Now, with current concern over antibiotic overuse, many of these remedies are again popular.

• Depending on regional cultures, parents may have pressed a warm water bottle or warm bag of salt against the ear. Such old-fashioned remedies may still help to ease ear pain.
• Drops of tea tree oil may be beneficial. This herbal treatment has mild anti-bacterial properties, but it may irritate the skin.
• Studies have reported that Otikon, an extract made of various plants, including garlic and St. John's wort, is an effective anesthetic in treating the pain associated with ear infections. Plants contained in Otikon may have side effects.
• Due to the high risk of burns, ear candles should not be used to remove wax from ears. There is no evidence to indicate that these candles are safe or effective for treatment of AOM or other ear conditions.

Herbal remedies are not standardized or regulated, and their quality and safety are largely unknown. Parents should never give their child herbal remedies, including oral remedies, without approval from a doctor.

Valsalva's Maneuver. A simple technique called the Valsalva's maneuver is useful in opening the Eustachian tubes and providing occasional relief from the chronic stuffy feeling accompanying otitis media with effusion. It may also be useful for unplugging ears during air travel descent as well. It works as follows:

• The child takes a deep breath and closes the mouth.
• He or she then blows the nose gently while, at the same time, pinching it firmly shut.
• The parent should be sure to instruct the child not to blow too hard or the eardrum could be harmed.

This technique should not be used if an infection is present.

Pain-Relievers

A number of pain relievers are available to help relieve symptoms.

• Either acetaminophen (Tylenol) or ibuprofen (Advil) is the pain-reliever of choice in children.
• Older children may be able to take prescription pain relievers that contain codeine if the pain is severe.
• Eardrops containing anesthetics (Auralgan) are also available by prescription. In one study, Auralgan provides effective short-acting pain relief and helps children endure ear discomfort until an oral pain reliever takes effect. In one study, 89% of children who took eardrops were able to avoid antibiotics. Parents should check with a doctor before using them. Eardrops could cause damage in children who have a ruptured eardrum. This might be indicated by fluid drainage from the ear canal.

Note: Aspirin and aspirin-containing products are not recommended for children or adolescents. Reports of Reye's Syndrome, a very serious condition, have been associated with aspirin use in children who have chicken pox or flu.

Cold and Allergy Remedies

Many non-prescription products are available that combine antihistamines, decongestants, and other ingredients, and some are advertised as cold remedies for children. Researchers have found little or no benefits for acute otitis media or for otitis media with effusion using decongestants (either oral or nasal sprays or drops), antihistamines, or combination product.

Precautions when Swimming Swimming can pose specific risks for children with current ear infections or previous surgery. Water pollutants or chemicals may exacerbate the infection, and underwater swimming causes pressure changes that can cause pain. The following precautions should be taken: Children with ruptured acute otitis media (drainage from ear canal) should not go swimming until their infections are completely cured. Children with AOM that is not ruptured should not dive or swim underwater. Some doctors recommend that children with implanted ear tubes should use earplugs or cotton balls coated in petroleum jelly when swimming to prevent infection. Others say earplugs are only necessary if the child will be diving underwater. Parents should consult their child's doctor.

• Review Date: 3/6/2007
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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