Middle Ear Infections: A Discussion of Some Issues
Stephen M. Edelson, Ph.D.
Center for the Study of Autism
Recurrent middle ear infections are quite common in children, estimated to be around 12%; and there is increasing evidence that these infections may be even more common in children with developmental disabilities. Several large-scale surveys have shown that ear infections are more frequent in children with developmental delays, autism, and fetal alcohol syndrome. In fact, there is concern that chronic ear infections and/or the treatment of these infections may actually lead to developmental delays. For example, research has shown that those who have had frequent ear infections often suffer a loss of about 13 decibels. Additionally, researchers have found that children with persistent ear infections often have speech and language problems in later years.
Possible causes associated with ear infections include:
- consuming cow’s milk
- drinking a bottle in bed/crib
- genetic susceptibility
- breathing second-hand smoke
- experiencing injury during delivery
- having respiratory problem
There is mounting evidence that many ear infections, possibly the majority, are primarily a reaction to an allergen. These allergens may be airborne (e.g., pollen, mold, second-hand smoke, dust, animal dander) and/or certain food items. The common food items are: dairy products, wheat, eggs, chocolate, nuts, and sugar. In the past, most of the evidence supporting the allergy/ear infection relationship stems from survey reports and manipulation of the person’s diet, such as using the rotation diet. However, a recent study by Robert F. Labadie, M.D. of University School of Medicine in San Antonio, Texas and several researchers at the University of North Carolina have demonstrated a direct relationship between middle ear infections and an allergic reaction. These researchers inserted a strain of bacteria, which is known to induce an allergic reaction, into the middle ear of laboratory rats. This led to a swelling and then closure of the Eustachian tube, resulting in a build-up of fluid in the middle ear.
The most common treatment for ear infections is antibiotic drugs. However, research shows that the antibiotics prescribed for ear infections are neither effective in the short-term nor in the long term. Research by Erdem Cantekin and his colleagues at the Otitis Media Research Center in Pittsburgh has shown that those treated with the antibiotic, amoxicillin, were more likely to have a recurrence of an ear infection within four weeks after treatment compared to those in the placebo group.
There is also evidence that some antibiotics cause hearing loss, ringing or ear noises, and/or other auditory problems. Parents should consult with their physician, pharmacist, or the Physicians Desk Reference to find out if the antibiotic prescribed to their child can cause hearing damage.
Antibiotics may also lead to a yeast overgrowth, often termed ‘Candida albicans,’ in the intestinal tract. Candida albicans can release toxic substances into the body which may alter brain functioning. There is evidence that the toxins released by this yeast overgrowth can cause autism and other related disorders.
Another form of treatment for ear infections is to surgically implant patchless eustachian (P.E.) tubes to drain the fluid from the middle ear. There is evidence that P.E. tubes may lead to permanent hearing loss.
Due to the growing concern of the dangers and ineffectiveness of antibiotics and P.E. tubes, many families are starting to rely on safer and healthier treatments, such as dietary interventions (e.g., removal of certain foods from the child’s diet) and strengthening their child’s immune system. Some homeopathic therapies have also been successful in treating ear infections, such as Belladonna and Chamomilla. Interestingly, there is evidence that chewing gum sweetened with xylitol may decrease the frequency of ear infections. Xylitol inhibits Streptococcus pneumoniae, which often causes ear infections.
Many parents and physicians are not aware of the various causes of ear infections as well as the negative side-effects of commonly prescribed treatments. Through better public awareness and, because of the increasingly prevalent ineffectiveness of antibiotics due to resistance from over-prescription, we must acknowledge more effective and safer interventions.
Two quarterly newsletters often feature articles on ear infections and various treatments: New Developments, published by the Developmental Delay Registry, (Developmental Delay Registry, 6701 Fairfax Road, Chevy Chase, MD 20815, USA); and the Autism Research Review International, published by the Autism Research Institute (Autism Research Institute, 4182 Adams Ave., San Diego, CA 92116, USA).
Dr. Michael A. Schmidt has also written two excellent books: Childhood Ear Infections and Beyond Antibiotics, written with Drs. Lendon H. Smith and Keith W. Sehnert (both books are published by North Atlantic Books, P.O. Box 12327; Berkeley, CA 94701, USA)
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