Ear infections account for more than a third of all visits to GP’s. Around two thirds of all children in the Western World have ear infections at some time every year, with one third having more than four ear infections a year. Why do we have this epidemic? Why do so many children end up with grommets after endless courses of antibiotics for acute ear infections? To understand this phenomenon we have to look at the structure of the ear (see above).
Ear infections happen in the middle ear, which is quite a small closed space. Its main function is to pass the sound from your eardrum to the inner ear, which it does every efficiently with the interconnected tiny bones called the hammer, anvil and stirrup. Your middle ear is filled with air and is separated from the outer ear canal by the eardrum. However it is connected to the outside world with a tube call the eustachian tube. This tube is the most important player in ear infections and glue ear. The major function of this tube is to equalise pressure in the middle ear with the atmospheric pressure. The body guards the eustachian tube in several ways
- The eustachian tube is guarded by the tube tonsils, they are part of the immune system and their function is to prevent infectious agents from the nose and throat entering the the eustachian tubes and your middle ear.
- The mucus membranes of the eustachian tubes are covered with tiny hairs pointing away from the middle ear towards the nose to direct food debris or air trying to get into the middle ear away thus protecting it.
- The mucus producing cells in the mucosa of the eustachian tubes are constantly cleaning the tubes with their secretions down into the back of your nose.
- The lymphatic follicles of in the walls of the eustachian tube launch attack on any invaders which are able to penetrate the mucus
This combination of factors provides a pretty formidable defence for the middle ear. In healthy children it works very well indeed. Why don’t these defences work in so many children? How does the infection get through all these barriers? Why do we have an epidemic of ear infections and glue ear? Here we come to a very important point. The mouth, nose, throat, eustachian tubes and middle ear of a new born baby are sterile. Soon after birth, they get populated by a varied mixture of microbes coming from the environment, Mum, Dad and anybody else who is in contact with the child. Just as it happens with the gut many develop abnormal flora in this area. This will cause two things
- First the epithelium of the eustachian tubes will start producing too much mucus in order to protect and clean itself.
- Second the tube tonsils will be in a chronic state of inflammation, blocking the entrance into the tubes and not allowing the mucus to drain out.
Fairly quickly the middle ear fills up with mucus. this situation is called glue ear. The mucus which fills their middle ear would provide a good growing environment for any infection which may come along front he back of the nose . When that happens the child gets typical symptoms of ear infection. Pain and fever and antibiotics are usually prescribed. Antibiotics clear away the infectious agent, but do not remove the glue ear. In fact, in the long run, they make the situation worse by altering the bacteria flora in the nose and throat even further. So the middle ear still filled with mucus, predictably the ear infection happens again and again. Having suffered many infections children finish up with little pipes called grommets, put through their ear drum in order to provide another channel for draining the mucus form the middle ear. This operation treats the symptoms only, but usually resolves the problem of glue ear and stops the chain of constant ear infections. So the epithelium of the middle ear and eustachian tube will still be producing a lot of mucus and the natural channel for draining this mucus will still be blocked, but the mucus will now drain through an artificial pipe – grommet – into the outside. Grommets are a symptomatic measure and do not remove the real problem. The real problem is the abnormal flow that has developed in the mouth, nose and throat. Practise shows that when the flora is normalised, the glue ear and the ear infections disappear. Two things have to be done to normalise bacterial flora in that area
- The diet should not provide food that abnormal bacteria can feed on i.e. sugars, milk and processed carbohydrates. Its amazing how quickly glue ear resolves, when these foods are taken out
- Second a strong therapeutic probiotic should be added to the child’s regime. The beneficial bacteria in the probiotic help to crowd out pathogenic flora and re-establish normal healthy flora in the mouth, nose and throat, which will keep the child clear from ear infections.
Putting probiotic powder on the child’s tongue last thing at night before bed, after the child has clean teeth and is not going to eat or drink anymore. This way the probiotic bacteria will have a chance to reach the back of nose and throat where the tube tonsils are and deal with any pathogenic bacteria in that area. As a result the inflammation will subside and the tube tonsils will resume their normal size and not block the eustachian tubes anymore, allowing mucus to drain from the middle ear. This will resolve glue ear and the constant chain of ear infections.
Another common contributing factor to ear infections is food allergies, particularly allergy to milk. It is helpful to remove cows milk as another measure to reduce inflammation. It takes time to change a child’s diet and to establish normal bacterial flora in the throat. What do we do as an immediate response to an ear infection?
- Keep your child indoors and warm when they have an ear infection. Put a knitted woollen hat on your child and a warm jumper, even whilst inside.
- Give your child plenty of hot drinks. Hot water with a slice of lemon and a spoon of honey. Give probiotics after wards. Remember probiotics contain live bacteria, which are damaged by heat.
- Take 1-2 tablespoons of cold pressed olive oil and add in a crushed clove of garlic. Leave it for 30mins, strain trough a sieve. Put a few drops of this oil into your children ear every hour, particularly before bed. Keep oil at room temp and warm it slightly before putting in ear (by warming a spoon in hot water then adding oil onto the warm spoon, test oil to ensure it is not too hot before applying to the ear).
- The old onion remedy! Take a large white onion, chop it up finely and warp it in a piece of cotton cloth. Put it into the oven an warm it up to fairly hot but tolerable to touch. Put it on your child’s ear and securely cover with a a warm hat. Keep it on until its starts cooling down. Warm it up again and repeat the application. This procedure is relaxing for the child and very good to do at bedtime. Its a bit messy and makes your child smell of onion but it works amazingly!!!
All these measures should be applied as early as possible. If after 2-3 days the pain and fever are not getting any better you have have to resort to antibiotics. However in majority of cases these natural treatments work very well and the child recovers without medical help. In the meantime it it is a good idea to start the long term intervention (diet and probiotics) as soon as possible. to prevent any further infections.