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Ear Infections - When and How to Treat

Ann McCarthy | 13 June, 2021

            Ear Infections - When and How to Treat

As a pediatrician and as a mom who cares deeply about the microbiome, giving antibiotics to my baby is HARD, so HARD. But when you need ‘em, you need ‘em and thank goodness we have them! 

I break it all down by Conventional Medicine, Integrative Medicine and Hippie Medicine. 

🩺 Conventional Medicine 

Here’s WHY and WHEN to treat middle ear infections:


If untreated, there is an increased risk of tympanic membrane perforation, 7th nerve palsy, abscess or infection of the mastoid bone, and even meningitis.


 - Bilateral (both ears are infected) - treat with antibiotics
 - Unilateral (one ear) - depends
      ➡️  Temp >39C (102.2F) - treat 
with antibiotics

      ➡️  Symptoms for more than 48-72 hours - treat with antibiotics

Some conventional facts:

- Peak incidence of ear infections occur between 6-12 months of age.
- The most common reason antibiotics are given to children is for an ear infection.

🌿 Integrative + Functional Medicine

Avoiding unnecessary antibiotics and relieving pain is the goal and then focusing on what may be causing recurrent ear infections. 

Alternative treatments:

- Get rid of the mucus blocking up the Eustachian tube. Use saline nose spray and a nose aspirator. Avoid dairy as it can cause excess mucus.

- Supplements: Vitamin C, Zinc, Elderberry, Cod Liver Oil

- Garlic/Mullein/Calendula oil ear drops (2-3 drops every 4 hours) inhibit viral and bacterial growth and decrease inflammation. Also reduces pain. Warm up the drops by running the bottle under warm water. 

- Treat pain with warm onion compress and elevate the head when lying down.

- Onion compress: Onions make us cry and help remove fluid. The idea is to loosen up mucus and open the blockage. You can bake an onion at 450 degrees fro 15 minutes. When it cools, you can wrap a quarter of the onion in cheese cloth and hold in over the ear. 

- Probiotics are likely a good idea. It is possible your child's microbiome is not as robust as it should be which could have helped paved the way for the ear infection in the first place. 

- Note: do not put anything in the ear if the ear drum is perforated, ruptured or you have ear tubes and please talk with your doctor. And if symptoms do not improve in 2-3 days it's likely time for antibiotics.

Check out "Ear Infections - My Medicine Cabinet" for brands I like.

Some integrative facts:

- 66% percent of ear infections resolve on their own in 24 hours and 80% resolve in 7 days (even bacterial infections).

- Just one course of antibiotics can increase your risk of depression. I think this suggests the microbiome in our gut is intimately related to how our brain functions. 

- There is a link between those who received multiple rounds of antibiotics and those who then develop asthma, allergies, eczema, Crohn's, ulcerative colitis, and even cancer. 

- Repeated use of antibiotics can set the stage for recurrent infections. The antibiotic kills both harmful and helpful bacteria. Without the good bacteria we are more susceptible to future infections. The more antibiotics given makes it more likely to have future bacterial infections. 

💫 Hippie Medicine

In this section, I share some crazy stuff from a wide range of sources and places. If any of it resonates with you, great. If not, ignore it and throw it out.

What Are We Hearing Around Us?

Ears are to hear. Why are we blocking up our ears? Too much anger or turmoil coming from sounds around us? Or are we trying to hear better?

German New Medicine suggests that children are proliferating the cells in the Eustachian tube for two possible reasons. (1) the child is desiring to hear their parent's voice, or praise, approval or even "I love you." (2) the child is trying to work out and expel unpleasant sounds such as insults, criticisms, nagging voices, annoying sounds (loud noise machines), angry voices or arguments.

Then once things settle down or improve, bacteria move in to help reduce the cellular buildup within the Eustachian tube. Thus the ear infection. 

A good affirmation: "I hear with love and release all else."


Children who receive multiple rounds of antibiotics for ear infections are associated with more highly educated parents. What does that mean? More access to medical care? More accepting of medical authority and/or quick fixes? A better-safe-than-sorry attitude? 

I have no idea, but I think this is interesting. I would love to do a study on the children of pediatricians and see if they have lower/higher use of antibiotics and do they have lower/higher rates of illness or chronic conditions? 

Some references:

American Academy of Pediatrics.

Lurie I, Yang YX, Haynes K, Mamtani R, Boursi B. Antibiotic exposure and the risk for depression, anxiety, or psychosis: a nested case-control study. The Journal of clinical psychiatry. 2015 Nov 25;76(11):1552-28.

Frosh, Adam, et al. "Effect of a dairy diet on nasopharyngeal mucus secretion." The Laryngoscope 129.1 (2019): 13-17.

Ibrahim RN, Alsalmani MS, Zedan TH. STUDY THE ANTIBACTERIAL ACTIVITY OF AQUEOUS EXTRACTION OF ONION (Allium cepaL) AGAINST Staphylococcus aureus ISOLATED. The Iraqi Journal of Agricultural Science. 2019;50(3):1186-92.

Venekamp RP, Sanders SL, Glasziou PP, Del Mar CB, Rovers MM. Antibiotics for acute otitis media in children. Cochrane database of systematic reviews. 2015(6).

Foliaki, S., Pearce, N., Björkstén, B., Mallol, J., Montefort, S., Von Mutius, E., of Asthma, I.S. and Allergies in Childhood Phase III Study Group, 2009. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. Journal of Allergy and Clinical Immunology124(5), pp.982-989.

Shaw, Souradet Y., James F. Blanchard, and Charles N. Bernstein. "Association between the use of antibiotics and new diagnoses of Crohn's disease and ulcerative colitis." American Journal of Gastroenterology 106.12 (2011): 2133-2142.
Song, Mingyang, et al. "Antibiotic Use Associated with Risk of Colorectal Polyps in a Nationwide Study." Clinical Gastroenterology and Hepatology (2020).
Velicer CM, Heckbert SR, Lampe JW, Potter JD, Robertson CA, Taplin SH. Antibiotic use in relation to the risk of breast cancer. Jama. 2004 Feb 18;291(7):827-35.
Eldeirawi, Kamal, and Victoria W. Persky. "History of ear infections and prevalence of asthma in a national sample of children aged 2 to 11 years: the Third National Health and Nutrition Examination Survey, 1988 to 1994." Chest 125, no. 5 (2004): 1685-1692.