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Middle ear infection in infants and children

middle ear infection in toddlers and children

"Middle ear" refers to the medical terminology in which there are three parts: The external ear, the middle ear - a space bordered on the outer side by the tympanic membrane (ear drum) and the inside by the inner ear. Eustachian tubes lead from this space into the naso-pharynx.

In years past, otitis media (O.M., or inflammation of the middle ear) in an infant or child was the foremost cause for a doctor visit. Why? Because the resulting earache can be severe. Anything that causes post-nasal drip (a head cold, nasal allergy, irritants in the air or food particles) can cause swelling and occlusion of the ends of the Eustachian tubes. Those bad germs that love damp, dark areas for breeding, love the middle ear. As the process continues, it creates pressure. The more pressure, the greater the pain. An older child, adults included, can locate the pain; an infant merely cries, letting Mom or Dad know something is drastically wrong. An infant has shorter and more horizontally positioned Eustachian tubes than older children, and has more of a lump of tonsil-like lymphoid tissue, the adenoid, sitting between the Eustachian tubes, that further inhibits normal drainage and relief of the building middle ear pressure.


What to do

  • To relieve the pain, prop up the patient. If an infant, a child's car-seat can prove useful. Swallowing and chewing motions can both aggravate and relieve stopped- up ears, so infant feeding should be done in the upright position.
  • For the infant, use a rubber bulb syringe to draw mucus out of the nose, particularly before feeding. After doing this, test the airway by holding a wisp of cotton in the air stream as you look for movement of it. If still, there is a poor airway, infant nose drops such as pediatric strength Afrin or Neosynephrine can provide good relief.


When to go to the doctor

For mild symptoms:

If symptoms are mild, one can afford to wait before rushing to the doctor. But when fussiness is severe enough that the child needs attention, professional treatment is needed. Diagnosis is done with an otoscope - an instrument with a light that shines through a replaceable tip that is inserted into the ear canal and allows the doctor to see the ear drum.  Sometimes, another instrument is used to check the mobility of the ear drum, by pumping air onto it.


Professional medical treatment for more severe conditions:

Middle ear infection can expand to the adjacent mastoid area or even on to the covering of the brain (meningitis); so any new signs or symptoms should be promptly reported. If pain accompanied by bulging is severe, immediate relief can be had by a myringotomy. This procedure is done with a small knife that goes through the otoscope speculum in order to puncture the drum and relieve the pressure.


What to do after the treatment

A follow-up visit is necessary. The infection might have responded well to the antibiotic, or it may have worked just well enough to get over the acute phase as shown by disappearance of irritability, but still leaving material behind the drum that could reduce mobility and cause hearing loss. This material could result from a subacute persistence of infection or from non-descript "gunk" (normal mucus secretions not able to escape through still partially blocked tubes). Efforts to keep drainage adequate should continue. If unsuccessful, a "glue ear" might develop due to a drying out (what doctors call, inspissation) of this material and necessitating an operative procedure. These complications are not common, but must be avoided due to their severity.


Prevention with Vitamin C

As with other infections, many natural preventative and treatment measures are effective.

  • Increase vitamin C intake at the very first sign of a cold or any sign of a stuffy nose or "gunk" forming in the throat. The daily dose should be proportional to body weight; 50-150 mg/pound/day, or for infants and children, 1000 mg for every year of their age, in divided doses: 1 year, 1000 mg/day, 350 mg/meal. You can break or cut tasty chewable tablets in half or quarters to divide the doses. Crushing a chewable between two teaspoons gives you a fine powder to feed on a moistened fingertip, or in food or liquid.


Vitamin C supports the immune system, and can help to limit or prevent bacterial and viral infections. Besides being an antioxidant that removes free radicals and toxins from the body, vitamin C is also essential for many important biochemical pathways, including the synthesis of collagen, an important protein in skin, blood vessels, muscles and tendons, joints, and mucus membranes. An adequate level of vitamin C helps the tissues lining the mucus membranes recover from an infection.¹

It is important for an infant or toddler to have adequate doses of all the vitamins (A, B1-B6, folate, biotin, B12, C, D, E), along with provide adequate doses of minerals. A children's multivitamin is easy to administer because it comes with a dropper that measures the right dose. When an infection starts, give two droppers of multivitamin to the infant rather than just one, and for an older child, also double up the vitamin intake. Probiotics are often very effective in alleviating symptoms of an infection. The cheapest, best tolerated probiotic of all is plain, unsweetened yogurt. Talk to your doctor about contra-indications for vitamin and mineral supplements.

Article sourced from Orthomolecular Medicine

¹ Case HS. Vitamins & Pregnancy: The Real Story: Your Orthomolecular Guide for Healthy Babies & Happy Moms. Basic Health Pub. (2016) ISBN-13: 978-1591203131
² Grant WB. Top Twelve Vitamin D Papers for 2017.

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