Ear Infections in Children

It can be heartbreaking when your child is suffering from an ear infection. Let’s explore ear infections and what you can do if your child suffers from ear aches.

Ear infections can last for weeks or months 2

Otitis Media

We usually call an ear infection that comes on quickly ‘ear ache’, and doctors call it acute otitis media.2 Infections like this are most frequent in children under two and are one of the most common reasons parents take their child to a doctor.

Antibiotics

It wasn’t that long ago that doctors routinely prescribed antibiotics to kids with an ear infections.3 More recently, though, experts have warned against routine antibiotic use because it doesn’t usually help very much, and the side effects of antibiotic medication often outweigh the benefits.4

Video Transcript

It can be heartbreaking when your child is suffering from an ear infection. Crying, distressed with the pain, pulling on their ears, and unable to settle or sleep, as a parent you may be left feeling helpless not knowing what to do to comfort your child.1 2 Let’s explore what ear infections are and what you can do if your child is suffering from earache.

Ear infections can come on quickly and last for just a few days, or they can be chronic and last for weeks or months.2 We usually call an ear infection that comes on quickly ‘ear ache’, and doctors call it acute otitis media.2 Infections like this are most frequent in children under 2 and they’re one of the most common reasons for parents to take their child to see a doctor. Ear infections that last for a long time are more common in kids who are a little older and these infections are often called glue ear or otitis media with effusion.2 Earache and glue ear are usually caused by a viral or bacterial infection deep in the ear.2

It wasn’t that long ago that doctors routinely prescribed antibiotics to kids with an ear infection.3 More recently though, experts have warned against routine antibiotic use because it doesn’t usually help very much and the side effects of antibiotic medication often outweigh the benefits.4 These days the most common medical approach to otitis media is to provide pain relief and then to ‘wait and see’ how well the child’s own immune system deals with the infection.2 This is because about 80% of children with earaches get better on their own within a few days.5 If it doesn’t get better on its own, there are a number of medical treatments that may be used, but scientists still question whether they are very effective or not.6

One of the traditional common treatments for ear infections that won’t go away by themselves is to insert grommets or ventilation tubes in the ear.6 Unfortunately, current research tells us that in many cases of chronic ear ache, grommets don’t work all that well.6 This brings many parents back to having to follow a watch and wait approach. This can be very frustrating when your child is in pain, and with some children with glue ear suffering from temporary hearing loss, which can affect their education and development,2 many parents look for alternative options to help their child with their ear infections.

One place parents may look is to manual therapists, like chiropractors, because many people believe that it may help at least some children with ear infections.7 But what does the research tell us about this?

Researchers have looked into whether chiropractic or osteopathic care may help children with otitis media because they think that it may help with their immune response, or it may help to drain the tubes that are blocked or infected by changing the way their cranial bones move or the muscles that impact on the blocked tubes.7  

One researcher reviewed almost 50 different research articles that looked at chiropractic care or osteopathy and ear infections.7 What they found was that many of the studies came from a single patient or a small number of patients with ear ache who got better, but there was no control groups in the studies, so it was impossible to tell if the children would have improved by themselves even if they didn’t see the chiropractor or osteopath. In the review the researcher did find some higher quality randomised controlled trials, which had some promising, but mixed results.

One of the studies involved osteopathic care and it didn’t show any real benefits in preventing ear ache in children who were prone to getting it.8 Another osteopathy study was more positive and found that the osteopathy treatment was beneficial for the kids with recurrent acute otitis media.9 In this study they included 57 kids, aged 6 months to 6 years, who suffered from recurrent ear ache. One group received usual medical care from a paediatrician, and the other group received the same usual medical care as well as care from an osteopath. They followed the kids for 6 months and found that the group receiving osteopathic care had fewer episodes of earache throughout the study period than the other group that didn’t see an osteopath. They also had fewer antibiotic prescriptions and fewer grommet surgeries. So, there were some really good results in this trial for the children suffering with recurring bouts of earache.

However, researchers always want to have a number of good-quality studies that report consistent results before they’re convinced that an intervention works. This means that when they look at all of the research that’s available about chiropractic and osteopathy and earache, researchers say that although it may help, they can’t tell for sure until more good quality studies are done.10

So, what does this mean for you if your child suffers from ear infections? You should know that for some kids with recurrent earache or glue ear, they may really benefit from having their spine checked by a chiropractor or other manual therapist. But a lot more research needs to be done to really understand how well chiropractic care may help these kids. However, we do know that research studies have found that chiropractic care for children and infants is very safe.11-13 So, if you aren’t happy with taking a wait and see approach, or are looking for a safe, natural intervention when it comes to your child’s health and wellbeing, take them to see your family chiropractor and make sure their spine and nervous system are in tip-top shape and give them the best possible start in life.

References
  1. Suzuki HG, Dewez JE, Nijman RG, et al. Clinical practice guidelines for acute otitis media in children: a systematic review and appraisal of European national guidelines. BMJ open 2020;10(5):e035343. doi: 10.1136/bmjopen-2019-035343 [published Online First: 2020/05/07]
  2. Qureishi A, Lee Y, Belfield K, et al. Update on otitis media – prevention and treatment. Infect Drug Resist 2014;7:15-24. doi: 10.2147/IDR.S39637
  3. Bluestone CD. Otitis media in children: to treat or not to treat? N Engl J Med 1982;306(23):1399-404. doi: 10.1056/nejm198206103062305 [published Online First: 1982/06/10]
  4. Venekamp RP, Sanders SL, Glasziou PP, et al. Antibiotics for acute otitis media in children. The Cochrane database of systematic reviews 2015;2015(6):CD000219-CD19. doi: 10.1002/14651858.CD000219.pub4
  5. van Zon A, van der Heijden GJ, van Dongen TM, et al. Antibiotics for otitis media with effusion in children. Cochrane Database Syst Rev 2012(9):Cd009163. doi: 10.1002/14651858.CD009163.pub2 [published Online First: 2012/09/14]
  6. Schilder AG, Chonmaitree T, Cripps AW, et al. Otitis media. Nat Rev Dis Primers 2016;2(1):16063. doi: 10.1038/nrdp.2016.63 [published Online First: 2016/09/09]
  7. Pohlman KA, Holton-Brown MS. Otitis media and spinal manipulative therapy: a literature review. Journal of chiropractic medicine 2012;11(3):160-69. doi: 10.1016/j.jcm.2012.05.006

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