What is a Middle Ear Infection?
The ear has three main parts: the outer, middle, and inner ear. A middle ear infection, also called otitis media, occurs when the middle ear cavity becomes inflamed and filled with fluid. This fluid buildup can cause pressure and discomfort.
How Do Infants and Children Get Ear Infections?
Ear infections often follow upper respiratory infections, such as a cold. The eustachian tubes, which connect the middle ear to the back of the nose and throat, help drain fluid. In young children, these tubes are shorter and more horizontal, making it easier for germs to travel up to the ear and cause an infection. After the age of 2-3 years, these tubes take a more vertical angle, allowing for easier drainage and lower susceptibility to middle ear infections.
Symptoms to Look Out For:
While older children can tell you their ear hurts, infants and toddlers may not be able to verbalise their discomfort. Here are some signs to watch for:
- Fussiness and crying, especially when lying down
- Tugging or pulling at the ears
- Difficulty sleeping
- General fatigue or low energy
- Fever (especially in younger children)
- Drainage from the ear
- Difficulty hearing or responding to sounds
- Loss of balance (often in older children)
- Tinnitus (older child may be able to tell you about "ringing in ears")
Assessment and Diagnosis:
If you suspect your child has an ear infection, you can see your GP or family doctor for a diagnosis. They will examine the ears using a special instrument (otoscope) and assess symptoms. Tympanometry is another helpful assessment tool for middle ear function. This test is usually performed by an audiologist and can assess changes in middle ear function; it is a good way to monitor the progression of recurrent or persistent middle ear infections.
Traditional Treatment Options
Many ear infections, especially those caused by viruses, improve on their own within a few days and antibiotics are not needed. Pain relief medication like acetaminophen or ibuprofen can help manage discomfort [1].
In cases of otitis media with effusion (not an acute infection, but rather ongoing fluid in the ears that may follow an infection) spontaneous resolution is expected with in 2-3 months in most cases.
Antibiotics and Long-Term Health
While antibiotics are sometimes necessary for bacterial ear infections, overuse can contribute to antibiotic resistance, making future infections harder to treat. Studies also suggest a link between childhood antibiotic use and an increased risk of conditions such as allergies, obesity, and even certain autoimmune diseases [2]. This is because antibiotics can disrupt the delicate balance of bacteria in a child's gut, which plays a vital role in immune function and overall health.
Research from the American Academy of Pediatrics in 2013, as well as retrospective data collection from 2019, suggests a "watch and wait" approach for mild to moderate ear infections, with antibiotics reserved for severe cases or those not improving after a few days [3].
Tympanostomy Tubes
In cases of frequent or persistent ear infections with fluid build-up, tympanostomy tubes (grommets) may be recommended. These tiny tubes are inserted into the eardrum to help drain fluid and prevent pressure buildup. However, there is limited evidence supporting the efficacy of grommet use in children [4]. Several studies also show an increased risk of adverse effects after grommet placement, including; scarring on the ear drum, hearing loss, continued recurrence of ear infections, and risk of further surgery or chronic ear disease [5, 6, 7].
Here are some ways to support your child's body and potentially reduce the severity or frequency of ear infections:
- Breastfeeding: Breastfeeding has shown to be protective against infection in infancy and childhood. It provides valuable antibodies that can help strengthen your infant's immune system. Exclusive breastfeeding was shown to be the most beneficial, with those benefits increasing as the length of breastfeeding increased [8,9,10].
- Supporting the Immune System: A healthy immune system is your child's best defense against infections. Ensuring proper nutrition, adequate sleep, and managing stress can all contribute to a strong immune response. Getting enough sleep allows the body to rest and repair itself, which can bolster the immune system and has shown links to reduced risk of infections [12].
- Eliminate Exposure to Pollutants: Exposure to cigarette smoke and other carcinogenic pollutants increases the risk of ear infections [11].
- Chiropractic Care: Some studies and case reports suggest that chiropractic adjustments may improve Eustachian tube function and drainage, potentially aiding in ear infection management [13,14]. Emerging research suggests a potential link between chiropractic adjustments and improved immune function as a whole [15]. Chiropractic care focuses on optimizing the nervous system [17], which plays a vital role in regulating the immune response to support overall health, well-being, and immune function.
In Summary
Ear infections are a common childhood concern, but with proper knowledge and management strategies, you can help your little one feel better and prevent future occurrences. Remember, consult your doctor for diagnosis and treatment recommendations. If you're interested in exploring chiropractic care as a complementary approach to supporting your child's overall health, give our team a call today!
References
[1] An Evidence-Based Approach To Managing Acute Otitis Media https://www.ebmedicine.net/topics/heent/pediatric-otitis-media
[2] Preventing unnecessary tympanostomy tube placement in children https://www.sciencedirect.com/science/article/pii/S0163445322000044?via%3Dihub#sec0023
[3] Preventing unnecessary tympanostomy tube placement in children https://www.sciencedirect.com/science/article/abs/pii/S0165587619301582
[4] Grommets (ventilation tubes) for recurrent acute otitis media in children https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012017.pub2/full
[5] Association of Tympanostomy Tubes With Future Risk of Advanced Ear Surgery—A Population Study https://journals.lww.com/otology-neurotology/abstract/2019/04000/association_of_tympanostomy_tubes_with_future_risk.15.aspx
[6] Tympanic Membrane Abnormalities and Hearing Levels at the Ages of 5 and 6 Years in Relation to Persistent Otitis Media and Tympanostomy Tube Insertion in the First 3 Years of Life: A Prospective Study Incorporating a Randomized Clinical Trial https://publications.aap.org/pediatrics/article-abstract/114/1/e58/64784/Tympanic-Membrane-Abnormalities-and-Hearing-Levels
[7] Association of tympanostomy tubes with future assistive hearing devices–a population based study https://link.springer.com/article/10.1186/s12887-020-1977-6
[8] The Role of Breastfeeding in Childhood Otitis Media https://link.springer.com/article/10.1007/s11882-016-0647-0
[9] Breastfeeding and Risk of Infections at 6 Years https://publications.aap.org/pediatrics/article-abstract/134/Supplement_1/S13/33071/Breastfeeding-and-Risk-of-Infections-at-6-Years
[10] Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review https://www.mdpi.com/1660-4601/19/22/14804
[11] Associations between Particulate Matter and Otitis Media in Children: A Meta-Analysis https://www.mdpi.com/1660-4601/17/12/4604
[12] The relationship between duration and quality of sleep and upper respiratory tract infections: a systematic review https://academic.oup.com/fampra/article/38/6/802/6276667?login=false
[13] Chiropractic treatment of otitis media with effusion: a case report and literature review of the epidemiological risk factors that predispose towards the condition and that influence the outcome of chiropractic treatment https://www.sciencedirect.com/science/article/abs/pii/S1479235404000203
[14] Otitis media and spinal manipulative therapy: a literature review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437347/
[15] Chiropractic & The Immune System https://therealitycheck.com/wp-content/uploads/2020/05/SA-ChiroImmune.pdf
[16] Functional Neurology, Rehabilitation, and Ergonomics https://www.researchgate.net/profile/Gerry-Leisman/publication/324087889_Cortical_Asymmetry_and_the_Optimization_of_Learning/links/5abcf5ef45851584fa6f083d/Cortical-Asymmetry-and-the-Optimization-of-Learning.pdf#page=197
[17] Changes in Effective Neural Connectivity Following a Chiropractic Adjustment https://getd.libs.uga.edu/pdfs/sullivan_stephanie_g_201808_phd.pdf
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