**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.
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!