A couple of weeks I posted on my PTPA blog that my daughter was suffering from a chronic ear infection and that I was at a complete loss as what to do. We did a few course of antibiotics, she would have a week break, get sick all over again and back to square one. Pediatrician told us that she has fluid built up on her ear. In 2 months we virtually did 4 courses of antibiotics and would have done at least 2 to 3 more, instead we wanted to see what else was out there. We turned to our Homeopath, Osteopath and Naturopath.
Well, she has gotten over the illness and I have been seeing some of the above mentioned professionals and doing some great treatments with her and so far so good. I am hoping that with all the Vitamin C, D and Zinc she is taking that we can increase her immune system and allow her to remain healthy for long enough allowing the fluid to drain from the ears naturally. I will keep you posted as to our progress with the Osteopath and Naturopath and how those treatments have helped us. But I am happy and hopefully and for right now following what I believe is a great path. I want to try and help my little girl get through this with out constant antibiotics and without having to place unnecessary tubes in her ears.
Again, if you are like me.. you need to understand ear infections before you can figure out what direction to go and here is some great information from a traditional medicine perspective that I found on the website: http://www.keepkidshealthy.com/welcome/infectionsguide/earinfections.html explaining them and what common treatments and complications are:
Ear Infections in Children
Ear infections are very common in children, especially those younger than two years of age, and are a common reason for visits to the Pediatrician.
There are two main types of ear infections in children, outer ear infections and middle ear infections. Risk factors for getting a lot of middle ear infections include being exposed to a lot of other children (like in a large day care), having a parent or other family member that smokes, having another family member that had a lot of ear infections and laying down while drinking a bottle. Ear infections are less common in children that breastfeed.
Outer ear infections (also called otitis externa or swimmers ear) usually occur when your child gets water in his ear, which may lead to inflammation and infection. Your child will have symptoms of an earache, that is worse when you move his outer earlobe. He may also have discharge from the ear and he should not have a fever. These infections are usually treated with antibiotic ear drops.
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Since there are other conditions that can make an ear drum look red, including fever or just a crying child, it is important that your Pediatrician check the mobility of the ear drum when he evaluates your child for an ear infection. An ear drum that is red from crying or because of a fever will still be mobile when tested, and this is a good way to prevent misdiagnosis or over diagnosis of ear infections. A tympanogram can also be used to test for the mobility of the ear drum.
Ear infections are treated with antibiotics, although some may get better on their own. Unfortunately, ear infections are becoming more difficult to treat as the bacteria that cause ear infections are becoming resistant to antibiotics (meaning that the antibiotics don't work anymore). Resistance is most likely in younger children, especially if they have recently been on antibiotics, or they are in day care and have been exposed to other children that have been on antibiotics recently. The bacteria Streptococcus pneumoniae (Pneumococcus) is among the bacteria which have developed resistance to multiple antibiotics.
For children who are at risk of having an ear infection with a bacteria that has resistance to commonly used antibiotics, your Pediatrician may decide to prescribe a high dose (about twice the normal dosage) of Amoxicillin as treatment. Other strategies include prescribing a regular dose of Amoxicillin and also prescribing Augmentin, which is made up of Amoxicillin and Clavunatate (a medication that fights resistant bacteria). This combination gives your child the high dose of Amoxicillin and adds in another drug to fight resistance. Other antibiotics as recommended by the CDC for treatment of persistent ear infections include Ceftin (Cefuroxime axetil) or a shot of Ceftriaxone (Rocephin). Many other antibiotics do not work well against resistant bacteria and should be avoided. A longer course of therapy, such as ten days to two weeks, may also be required for resistant bacteria, especially in younger children.
Some children with persistent infections can benefit from tympmanocentesis, which is an office procedure that involves puncturing the ear drum with a needle, and draining some of the fluid and pus behind the ear drum. In addition to relieving pain that your child may be having, draining the fluid allows it to be tested to see what bacteria is causing the infection and which antibiotic the bacteria is sensitive to. This procedure is usually performed by a Pediatrician who has training in performing tympanocentesis or by an ENT specialist.
After a middle ear infection, your child's ear drum will typically have fluid behind it for one to three months (otitis media with effusion). This is normal and the fluid will usually clear up on its own, but it may normally take up to three months. It is not an infection and the fluid does not usually require antibiotics to clear up. In young children, your doctor will typically recheck your child's ears every 4-6 weeks until all of the fluid has cleared up.
While an effusion does not cause any symptoms, such as pain or fever, it can cause a temporary hearing loss, until the fluid goes away. Effusions are often mistaken for ear infections. If your child has a persistent ear infection, but does not have any symptoms, such as ear pain, irritability or fever, then you may want to ask your Pediatrician about the possibility that it is just an effusion and not a true ear infection.
The difficulty occurs when a child with otitis media with effusion gets an upper respiratory tract infection and develops signs and symptoms, including fever and irritability. It can sometimes be very difficult to tell if the child's symptoms are just from the upper respiratory tract infection and he continues to just have an effusion in his ear (which wouldn't require an antibiotic prescription), or if the child has now developed a true ear infection.
In addition to observation and tympanostomy tube placement for persistent effusions in both ears that is lasting more than 3-6 months and causing a hearing loss, other more controversial treatments include antibiotics and steroids. It can be more difficult to decide what to do with a child that only has hearing loss in one ear, or who has a persistent effusion, but no hearing loss.
For some children, if their ear infection does not clear up with repeated courses of antibiotics, if they have fluid in both ears for more than 3-6 months and it is affecting their hearing, or if they have recurrent ear infections, then they may require a referral to an ENT specialist (otolaryngologist) and the placement of tympanostomy tubes.
Tubes are usually placed as an outpatient surgical procedure with a brief general anesthetic. They usually stay in the ear for about a year and then come out (or extrude) by themselves. Complications can include otorrhea (drainage from the ear), having a tube that doesn't come out and needs to be surgically removed, cholesteatomas and a persistent perforation of the ear drum.
The usual guidelines for referral to an ENT specialist include having more than 4-6 ear infections in one year or having more than 3-4 ear infections in a six month period. These are just general guidelines though. Reasons to get a referral earlier include beginning to get recurrent ear infections at a young age (such as less than 4-6 months old), having a hearing loss, getting a lot of ear infections in the summer months (when you would expect less), or having complicated ear infections that are very painful and require multiple courses of antibiotics to clear up. Some reasons to wait longer include it being the late Winter or Spring (after which you would expect less ear infections), having uncomplicated ear infections that quickly clear up with single course of antibiotics, or recurrent ear infections in an older child.
Ear tubes are not a magic cure for ear infections. Although they do help most children, some continue to get ear infections, even with the tubes. A child with an ear infection who has an open or patent tympanostomy tube should have purulent drainage from his ear, which makes it easy to know when he has an ear infection. Also, because the infected fluid is able to drain out, pressure does not build up behind the ear drum, so there is usually no ear pain. And antibiotic ear (otic) drops are usually prescribed for ear infections with an open tube, allowing the antibiotic to get right at the sight of the infection (vs. using an oral antibiotic which has to get absorbed in the stomach and get into the blood stream first).
Children with tympanostomy tubes who continue to get recurrent ear infections may benefit from an adenoidectomy, which is surgery to remove the adenoids, which is especially helpful if they are enlarged.
Ear infections, especially if they are chronic, can rarely lead to serious complications, including meningitis, epidural abscesses, brain abscesses, mastoiditis (an infection of the bones behind the ear), facial nerve paralysis and hearing loss with or without speech delays. Another complication is chronic suppurative otitis media, which is an ear infection that chronically drains. It is to prevent these complications that many Pediatricians and ENT specialists are against just observing ear infections and not using antibiotics.
Ear infections are less common as your child gets older. They are also less common in children who are not in day care.
A new immunization called Prevnar protects against infection with the Pneumococcus bacteria, which is a common cause of ear infections. Although not specifically approved as a therapy to reduce ear infections, this vaccine may reduce the number of ear infections in children prone to getting ear infections. It is currently recommended that all children under age two years get this vaccine and you should especially consider it if your child is prone to ear infections or other family members get recurrent ear infections.
Ear Infections Internet Resources:
- Chronic Ear Infections: American Academy of Pediatrics guide to chronic ear infections in children
- Ear Infections: American Academy of Pediatrics guide to ear infections in children, including treatments and risk factors.
There are plenty of resources out there.
If you are interested in alternative treatments, etc, here is some more great info for you from the website: http://www.naturalparenting.com.au/flex/osteopathy-for-recurrent-ear-infections/7803/1
Osteopathy For Recurrent Ear Infections
Osteopathy in the Cranial Field is a very gentle manipulative therapy. It is commonly associated with the treatment of infants with digestive issues such as colic, reflux and constipation but it can also be very effective for treating children suffering recurrent ear infections. Middle ear infection is a common complaint occurring in up to 20% of children under six.
A Typical StorySix year old Michael had suffered recurrent ear infections for years and was soon to have his third set of grommets inserted. He had taken repeated courses of antibiotics but was still struggling with the pain and mild hearing loss due to the infections. A friend of his mother suggested treatment with their local osteopath. After taking a detailed history the Osteopath explained there may be restriction in the head and neck that could be affecting the drainage of the ear, contributing to his recurrent infections.
Brisbane Osteopath Trent Sigley who uses Osteopathy in the Cranial Field explained, "In a healthy ear the Eustachian tube drains fluid that collects in the middle ear. When the ear's drainage is poor, recurrent infection is more likely as bacteria thrive in the static fluid within the ear. This drainage is more of a problem in younger children as the Eustachian tube is still quite horizontal. As the child grows, the tubes become more vertical and drainage is therefore aided by gravity."
Osteopathic examination showed there was decreased motion in the left side of Michael’s head and at the base of his skull. "Normal motion in the head has a pumping effect on the Eustachian tube which assists the drainage of the middle ear," Trent continued.
Over a period of four osteopathic treatments normal motion was restored to the head and neck, helping with drainage. Healthy function of the nervous system was also encouraged, affecting the nerves supplying the ear. This improvement makes secretions to the middle ear less viscous, hence a less attractive environment for bacteria. When Michael next visited his Ear Nose and Throat Specialist his hearing had returned to normal and there was no longer a need for grommets. Michael made it through the next winter free from infection for the first time.
Osteopathy:
Osteopathy is focused on improving the function and balance of the body so the skeletal, nervous and circulatory systems all operate smoothly – this is known as homeostasis. Common childhood problems can often be traced back to previous trauma or the birth process. The soft bones in a baby’s skull have pliable joints between them and these allow for the distortion that must occur during birth. Sometimes the baby's skull does not spring back normally and this may cause tightness in parts the skull and also give irritation to important nerves and blood vessels in the head.
Osteopathy in the Cranial Field is a very gentle treatment approach; it is perfect for babies and children. The child lies on the treatment table while the practitioner gently uses small pressure through their sensitive hands. The child is completely safe and comfortable as the Osteopath balances different strains and forces in the body and some children even fall asleep. Once balance is achieved in the treatment, the body's self healing mechanism is able to function more efficiently. Approximately three or four treatments often see problems resolved, although with chronic conditions, a longer series of treatment may be required.
In the case of recurrent ear infections, osteopathic treatment is aimed at releasing strain and tension around the head, neck and face. This allows the normal pumping and drainage action of these areas to occur with the person's breathing. By assisting the fluid drainage through the Eustachian tube the child’s immune system has an easier time resolving the infection and there is less pain. Treatment also influences the sympathetic nervous system. Hence the thick, mucous ear fluid becomes more thin and watery and therefore the fluid can flow and drain more freely. Treatment using antibiotics focuses on the symptoms of the blockage, infection and pain, and the use of grommets releases the fluid to the external ear. With these treatments children are prone to a recurrence of infection six to eighteen months later. Osteopathy however, addresses the cause of the blockage of fluid in the Eustachian tube and the lack of healthy movement in the head and neck, allowing the fluid to drain normally and helping to prevent recurrent infections. Osteopathy can also, of course, be used in conjunction with grommets and antibiotic treatment.
Middle ear infections:
Eustachian tube function is vital in creating even pressure between the outside world and the middle ear. In children, middle ear pressure is slightly negative. This causes an increased likelihood of nasal secretions or bacteria being sucked back through the tube to the ear. If the tube becomes blocked, infection can quickly develop. The condition is quite painful for children, not only from the inflammation caused by the infection but also by the inability to equalise the pressure in the middle ear. This is the same pain people experience during take off and landing of an aircraft, where the pressure inside the ear is less than outside, causing a crushing sensation deep in the ear. Studies show that 40% of children experiencing middle ear infections will still have fluid in the middle ear one month after the initial infection clears, and 10% after three months. There is a strong correlation between persistent fluid in the middle ear and recurrent infection.
Rebecca Reed, fellow Brisbane Osteopath, reported that children suffering chronic ear infections not only experience pain and other symptoms associated with infections like fevers, but can also have difficulty with speech, language and learning. She explained, "When the child's ears are full of fluid it leads to a conductive hearing loss. This means the sounds perceived by the brain are more muffled and the child has trouble distinguishing between voices and background noise. This can make some children misbehave or become frustrated because they are unable to understand what is going on around them. The longer that the fluid remains in the ear the more pronounced the problem can become". She added, "The good thing about Osteopathy is that treatment can be effective from birth through to older children, the body is always ready to be helped in functioning the way it was designed to. The body has an incredible ability to recover from illness, our patient results speak for themselves”.
I will keep you posted with our progress.
Good luck!
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