What is Otitis Media?

Otitis Media is fluid and swelling in the middle ear. It is commonly known as a Middle ear infection.

Is it common?

Otitis media is the second most common disease of childhood. Two thirds of children have at least one episode by 3 years age. 50% of children have two or more episodes. It is most common during the winter months as many episodes are associated with an   upper respiratory tract infection such as a cold.

Why is it most common in children?

The tube that normally drains and ventilates the  middle ear (Eustachian tube) is shorter, narrower and more horizontal than in adults, and therefore more likely to get blocked. If blockage occurs, pressure builds up in the middle ear, encouraging swelling. This fluid can contain bacteria and or viruses.

Why does it occur?

Infections, allergies, obstructive adenoids, deep water diving or flying can result in negative middle ear pressure and Eustachian tube dysfunction. Some people are born with Eustachian tube dysfunction or it can be damaged as a result of the birth process .

Cranial bone dysfunction may causes Eustachian tube dysfunction and  poor drainage from the middle ear. Babies born with cranial bone distortion (cleft palate) are more prone to tube dysfunction and ear infections (1).

Will Otitis Media resolve naturally ?

In approximately 85% of cases otitis media  will resolve  after 2-7 days without the use of antibiotics.(2) There is no sound evidence that untreated otitis media results in speech or language delays or deficits. (3)

What about Antibiotics?

  • The Royal Children’s Hospital guidelines are that antibiotics should be delayed and avoided where possible . They are generally overprescribed and can lead to resistant bacteria as well as side effects (4).
  • Use of antibiotics destroys helpful intestinal bacteria which affects digestion, immune function and   synthesis of certain vitamins, increasing the likelihood of further infections. Antibody production  is also decreased for up to 20 days after use, increasing the likelihood of recurrent infection once use of antibiotics has stopped.
  • The more a child uses antibiotics the greater the risk they will develop an infection with antibiotic resistant bacteria. This is bacteria that does not respond to antibiotics and can cause a simple infection becoming serious.
  • *Antibiotics can reduce the absorption of  nutrients such as vitamin k, B12, folic acid, calcium and magnesium

A study of 4,860 children with acute otitis media treated with nose drops and pain killers for 4 days revealed that more than 90% recovered within a few days with no further need for treatment. Only 3% of these children required antibiotics. (6)

 

Why should children with Reoccurring Ear infections see a  Chiropractor?

German paediatricians, who use chiropractic techniques to treat middle ear problems, found dysfunction of the upper cervical spine as the primary cause of middle ear fluid build up and subsequent  infection. (7)

The Fibrocartilaginous portion of the Eustachian tube entering the nose and throat (nasopharynx)  is attached to the skull base in a groove between the temporal bone (petrous part) and the sphenoid (greater wing) . The Eustachian tube is closed at rest and opens only on swallowing, yawning and focefully inflation. Dysfunction of the sphenoid or temporal bones may cause dysfunction of the Eustachian tube leading to a build up of mucous and subsequent infection.

Correction of  cranial bone dysfunction allows  fluid to drain via the Eustachian tube from the middle ear, helping prevent re-infection. A study  published in the Archives of Pediatric and Adolescent Medicine (2003;157:861–6) showed cranial bone correction reducing the frequency of infections and preventing the need for surgery.

A study examining the effectiveness of chiropractic care for ear infections found that:

  • 93% of all episodes improved
  • 75% in 10 days or fewer, and 43% with only one or two treatments. (3)

 

(1)http://en.wikipedia.org/wiki/Eustachian_tube

(2) Feldman HM, Paradise JL, Dollaghan CA, etal. Early Vs delayed tube placement for persistent middle-ear effusion (MEE) in the first 3 years of life: effects on intelligence, receptive language, and auditory processing at age 6 years. Presented at the paediatric Academic Societies’ Annual Meeting; May 4 –7 2002.

(3) Froehle RM. Ear infections: a retrospective study examining improvement from chiropractic care and analyzing for influencing factors.

(4) http://www.rch.org.au/kidsinfo/fact_sheets/Ear_infections_and_otitis_media/

(6) Van Buchem FL, Peeters M, Van’t Hof MA. Acute Otisis Media: a new treatment strategy. Br Med J, 1985. 290(6):1033-37.

(7) Gutman G.   German Manuelle Medizin (1987)  25:5-10.

 

Ear Infections in Children

What should you know?

Ear infections are very common in babies and small children because they have narrow tubes that connect the middle ear to the throat. These tubes also run more horizontal for the first 7 years, making it more difficult for any fluid to drain down to the throat.  This build up of fluid makes them more prone for germs to reach the middle ear from the nose and throat during colds.

The two types of ear infections commonly seen in children are middle ear infection (otitis media) and outer ear infections (otitis externa).

Infection of the outer ear (or auditory canal,) or Otitis Externa are bacterial infections usually due to excess moisture in the canal, eg. after swimming, or damage to the canal after use of cotton buds or scratching.

How Do I Know If My Child Has An Ear Infection ?

Your child may experience the following:

  • Irritability and unsettled behaviour
  • Usually they have a fever
  • They may pull at their ears or stick their fingers inside their ears.
  • Often ear infections follow a cold or upper respiratory tract infection.

What Causes Ear Infections of the inner ear (Otitis Media)?

Ear infections are caused by a build up of fluid and /or mucus in the eustachian tube. This can be due to Infections, allergies and or obstructive adenoids. Allergies or intolerances to cows milk protein or wheat, may cause an increase in mucous production in the eustachian tubes, paving way for infection.

A misalignment in the sphnoid or temporal bone  (chiropractic subluxation) may cause Eustachian tube dysfunction and  poor drainage from the middle ear. 

Treatment

Recommendations by the Royal Children’s Hospital Melbourne are as follows:

  • Antibiotics do not usually help ear infections. Many middle ear infections in children clear up on their own, without antibiotics, over a few days.
  •  If your child is in pain give them a pain-reliever such as Paracetamol or Painstop.
  • If the doctor prescribes antibiotics, ask if they are really necessary?

Recent research has found that antibiotics are prescribed in 1 out of 5 pediatric acute-care visits. And of the 49 million prescriptions for antibiotics given annually, some researchers estimate that 10 million of those are unnecessary (1)

Antibiotics can cause side-effects  (2).

Side effects include: Thrush, poor immune system, irritable bowel and diarrhoea, as the good bacteria of the gut are killed off.  Often a reoccurring ear infection or cold occurs within 3 weeks after antibiotic use.

A new study shows antibiotic use may set us up for chronic disease. And this may be especially true when antibiotics are used in infants and young children (2).

 Natural Remedies For Ear Infections

Acute Ear Infections: Can use individually or in combination.

  1.       Chiropractic correction of any Temporal or Sphnoid  bone misalignments .

        2.       Drops of oil and garlic into the ear. Take 1-2 tablespoons of cold-pressed olive oil and mix in a cup with a crushed clove of Garlic. Leave it for 30 min, strain oil through a sieve. With the sieved oil, warm to room temperature by standing the cup with the oil in a dish of warm water. Add 1 teaspoon of tee tree oil for extra potency.  Use 4 drops every hour. Make fresh every day. 

       3.      Mix 1 tablespoon of warm water and ½ teaspoon of salt.  Warm to room temperature then use 4-5 drops inside the ear 3 x day.

       4.      Cover ears with a beanie to keep warm

       5.        Use herbal teas such as chamomile, calendula, marjoram, eucalyptus and thyme – all have antiseptic and anti-inflammatory properties

       6.      Onion remedy: Chop a white onion finely and wrap it in a piece of cotton cloth. Put it in a microwave or oven and warm it to a tolerable heat. Put it on the infected ear and secure it using a hat or beanie. You can use a piece of glad wrap between the onion wrap and the hat, so the onion juice does not soak the hat. Keep it on the ear until it cools down. Warm it up again and repeat the procedure. After the procedure, keep the warm hat on your child and let them go to sleep on the side of the affected ear to keep it warm.

 Chronic Reoccurring Ear Infections:

     1.      Diet: Identify any intolerances and eliminate these (commonly wheat, diary, porriage, peanut butter).

     2.      Supplements:  Improve the immune system

                                       Use probiotics directly in the mouth

                                       Meta Zinc with Vitamin C

                                        Cod Liver Oil

 

References:

(1)http://seattlemamadoc.seattlechildrens.org/antibiotic-use-may-increase-risk-for-ibd/

(2)http://www.rch.org.au/kidsinfo/fact_sheets/Ear_infections_and_otitis_media/