**UPDATED JANUARY 2019**
To reduce ear infections, parents need to better understand what causes them. Most middle ear infections are caused by viruses, and I have discussed several ear infection myths in a previous blog. Additionally, I highlighted 7 important ear infection facts. Uncommon but serious ear infection complications should be known by parents who have kids with repeated infections.
Before I outline methods to reduce ear infections, it is always helpful to understand a bit more about your child’s ear anatomy. Each ear has three main parts — the outer, middle, and inner ear. The middle ear is the area that is behind the eardrum. This is the most common location for ear infections in children.
When the eustachian tube — a small tube that connects the middle ear to the back of the nose — becomes swollen and irritated (usually because of upper-respiratory infections or allergies), air is not allowed to get behind the eardrum.
As a result of this swollen eustachian tube, the fluid that normally drains out of the ear becomes trapped. Germs, viruses, and bacteria, grow in the collected fluid, setting the stage for otitis media, which is the medical term for middle ear infections.
Babies and toddlers are especially at risk for these infections because their eustachian tubes aren’t fully developed yet. They are shorter and less angled, making it harder for fluid to drain out.
Most parents know about options for treating ear infections. Many physicians choose to observe them with no special treatment if symptoms are mild. Antibiotics are also a common method for treatment. More difficult or recurrent infections may require an evaluation by an Ear, Nose and Throat (ENT) specialist physician, like me!
ENT specialists evaluate the number of infections that require antibiotics and the length of time a child keeps ear fluid behind the eardrum. There are many reasons pediatricians consider ENT consultation for possible placement of ear tubes, but a common set of guidelines include:
— 3 ear infections in 6 months
— 4 ear infection in 12 months
— Ear fluid that does not drain for 3 months.
But instead of focusing on treatment, parents prefer to understand how to reduce ear infections. Hand washing and personal hygiene remain the number one best way to prevent most infections. The following tips are methods parents can immediately start practicing in order to reduce ear infections in their kids.
8 Practical Ways Parents Can Help Reduce Ear Infections In Kids
1. Nasal saline washes.
Let me say that a few more times: Saline. Saline. Saline. Yes, I understand that kids do not like this. I mean, they often fight with all their strength! Flushing the nose of young kids reduces nasal inflammation and the collection of mucus, regardless of the cause.
Check out my posts that share the huge benefits of nasal salt water washes and my tips for successful use of saline nasal washes.
I often ask parents in my office if their kids fight when they first start brushing teeth. The answer is almost always: OH YES!! But parents continue to insist on brushing teeth because they understand the long-term damage that could occur if it is not done.
I firmly believe that for children with recurrent nasal congestion, the long-term effects of not washing the nose may also be severe. Ear infections, sinus infections, nosebleeds, and headaches are very common in my patients with a frequent runny nose and congestion. Nasal mucus helps to keep us healthy, but when too much is produced or poor drainage occurs, the mucus needs to be treated.
2. Do not drink while lying flat.
The eustachian tube in young children is short and points almost directly to the back of the nose. If children lay on their backs and drink, the fluid can roll up behind their nose and make the swelling worse for ear drainage.
This lying flat position should be kept in mind for bottles, sippy cups or breastfeeding. Raising your baby’s head will reduce the risk of adding extra fluid to the back of the nose, which can worsen ear infections.
3. Manage stomach acid reflux.
Many babies have mild vomiting after feeding. Some babies have significant vomiting after and between meals. Babies often vomit out of their mouth AND nose. This stomach acid in the back of the nose can cause more swelling…which may worsen ear infections.
If your child has recurrent ear infections and tends to spit up more often than you think is normal, discuss your concerns with your pediatrician.
4. Diagnose and manage allergies, especially food allergies.
Infants can absolutely have allergies! Some breastfed babies develop food allergies due to reactions to foods that their mothers are eating.
Food allergies have a wide range of symptoms. Stomach and digestion problems are common symptoms, but nasal congestion, runny nose, cough, eczema, and rashes are also common.
In fact, check out some of the surprising symptoms to allergies many parents are not aware of!
5. Smaller size daycare.
Daycare does NOT cause ear infections. Repeated viral infections cause nasal congestion, which can lead to eustachian tube dysfunction. The more children present in a daycare, the more viral illnesses are shared.
Many babies who stay at home, or who have siblings, will still have viral infections and ear infections. Reducing the number of viral infections children are exposed to on a daily basis may benefit some kids.
6. Breastfeed 6 months.
Breastfeeding provides many benefits to both infants and mothers. Infants do not have a strong immune system, and they benefit from infection-fighting proteins found in breast milk.
Breast milk contains antibodies that help your baby fight off viruses and bacteria, so breastfeeding lowers your baby’s risk of developing infections in their upper and lower respiratory tract as well as their stomachs.
7. Avoid cigarette smoke.
Second-hand smoke is irritating to the respiratory tract. In young kids, this inflammation can narrow the airway leading to more nasal congestion, ear infections, sinus infections, cough, wheeze, and bronchitis.
A sad new trend has been the use of e-cigarettes. There is growing evidence that besides nicotine addiction, children exposed to JUUL and other forms of vaping is harmful to kids.
It is very important to stay up-to-date with vaccinations for influenza, pneumonia, and meningitis. The viruses and bacteria that these vaccines protect your child from are also the main causes of ear infections.
In fact, pneumococcal bacteria, which can cause both pneumonia and pneumococcal meningitis, also causes about half of the middle ear infections, according to the Centers for Disease Control and Prevention.
There is never a way to 100% prevent any illness. However, by implementing some of the above tips, parents may find a way to reduce ear infections in their children.
One benefits of my 30-years of experience as a physician, I have witnessed the remarkable health benefits of vaccines in reducing many severe and life-threatening medical problems. That’s right, not only has research proven their massive public health benefits, but I have personally witnessed their successes!
As always, much love for supporting my work. I will be adding many more posts to highlight parenting and healthcare tips, so be sure to consider subscribing to my podcast or to my blog to avoid missing a post!
These are all really good tips. We have been lucky to avoid ear infections so far with our little one, but I definitely want to keep this tips in mind!
Great! Many kids will never have ear infections. But the ones that do, tend to have them repeatedly. So just having some tips to try to reduce them can be so important to them.
You are so right about the saline! I’ve been using that for my 1.5 year old and it’s helped SO much! XO
Saline is my favorite treatment for many ENT problems. Great stuff.
I actually agree with most of these tips except for the last one – but the saline is good for adults too 🙂
Yes the last one is bothersome to so many people. I started my ENT training in the mid 80s and learned to operate emergently on ear abscesses that came through the bone in the back of the ear and sometimes went to the brain. It was common to have emergency ear tube placement in the middle of the night to avoid these pending problems. Over the past 25 years, I can personally tell you that the field of ENT has been drastically changed by vaccines. I get all the controversy, just like co-sleeping. But with the development and implementation of the vaccines against the 2 major bacteria causing ear infections, we now have routine ear tubes and rare bone infections. This is a fact most people do not know.
These are all important ways wherein you can lessen the threat of ear infections with the kids. I’m sure this will help a lot of parents and I do hope a lot of people would read this.
I am glad you think this will be helpful!
So far I have avoided ear infections with both my boys *knocks on wood*. My mom said I had a lot of ear infections when I was younger but I was in the pool all the time and it was mostly from that. We do a lot of these. My boys have never been flat while drinking, they go to a small preschool, they are up to date on all their immunizations, I never let them around smoke, and they have no allergies that we’ve identified so far to manage. But these are all great tips, I know so many little kids who get multiple ear infections.
Great that you have naturally been using these tips. I need to share them every day to parents in my practice. Keep up the great work!
When I was growing up I remember having chronic ear infections and I remember the pain being unbearable. My kids however rarely had one. This is a really great list of ways to prevent them altogether.
Yes, once kids show they will get ear infections, they have a risk of recurrence so these tips are helpful. Most kids never get any.
These are all such great tips! It’s that time of year when we need to keep our kids healthy!!
Yes, moving from allergy season to viral season, lots of runny noses lead to ear and sinus infections. Prevention is key in the kids who tend to get infections.
This is so helpful! Even though my kiddos are now older they still suffer from ear infections and the saline tip is very helpful for me to remember!
Especially for older kids, saline should be a major part of your life. Older kids are the ones who keep coming back to me! Gotta figure out what is causing them but in the meantime, rinsing out pollen, dust, mold, and viruses each night will definitely be helpful!
Thanks for the tips. Will definitely remember them. Sometimes my siblings and daughter do have ear infection.
Glad these tips may prove helpful. Thanks for reading.
I have never dealt with an ear infection, so I didn’t know any of this. Interesting how drinking while laying back could cause problems.
Most people will never need this information and that is a great thing. But one day, someone may have a conversation with you and then in the back of your mind, you will have this little bit of information that may help someone else. Thanks for reading
Hi Dr B! my youngest use to get a lot of ear infection but after having tubes put in she doesn’t have them anymore
Woohoo! Love a great success story. 80% of kids with tubes have this story. My practice is filled with the other 20%! Keep keeping your kids well.
You have great tips here! My brothers and I suffered a lot from ear infections growing up.
Ear infections due tend to run in families. So if any other family members develop problems, prevention may be key.
So helpful for those with little ones! Ear infections are horrid.
Yes they are very painful. And when they happen repeatedly, they can affect speech. Whatever we can do to prevent them is great.
Wow, this is some great information. I never knew the middle ear infections are caused by viruses. I’m sending this link to my sister who has a 4 month year old baby.
Thanks for sharing with her. I am hopeful that my posts will help young moms with little kids who often have ENT problems.
My kids didn’t have very many ear infections. When they did I knew the signs immediately and early.
It is great when you can tell an infection occurs and get it treated early. some kids don’t show typical signs and develop chronic ear problems. Hopefully, these tips will help others who have more frequent infections.
These are all really great tips! My daughter hasn’t yet had any problems with her ears, but it’s always good to be informed and do what you can to reduce risks.
Fingers crossed she never gets any! And most kids who do get them, outgrow them. I just like to try to help those that keep getting them.
Only the kids that had vaccinations ever got ear infections. When we stop vaccinating, all ear infections disappeared from our house. My two youngest have no shots at all and they have never been sick but the two oldest who got their shots were in and out of the doctors office for everything. It wasn’t just ONE kid, two kids! If your kid is getting lots of ear infections, I would seriously stop vaccinating.
I cannot disagree with this statement strong enough. It is just false. It is like saying that your grandfather smoked 2 packs of cigarettes a day and never got cancer. Does that mean smoking does not cause cancer? Many parents say kids never had ear infections until going to daycare…but thousands of kids in daycare never get ear infections. It is NOWHERE near as simple as you make it. You have a small sample size of 4 kids. I have been doing this for 25 years. And I have lived on West Coast to East Coast. There are many variables that you are not considering. This is where real science comes in, not just a small sense of what worked for your family. I hope your family stays well. There are many families who smoke in the home, kids go to daycare, get vaccinations and eat junk food daily…and their kids are healthy. So which of these should we recommend to others?
Earaches are the worst! I’m so grateful that my daughter didn’t have very many growing up.
Yes, they are so common and I see them everyday in my practice. Neither of my two girls had them, but we did have to deal with allergies. There is always something to monitor in kids. Thanks for reading!