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Standard treatment for ear infections is a dose of antibiotics, but there are several important things parents should know when it comes to helping their child get better:

When should antibiotics be used to treat a child’s ear infections?

Before you go to the doctor, parents should know that the thing a doctor is most likely to do (prescribe antibiotics) may not be necessary, and in fact can actually be more harmful than helpful. Ear infections are the #1 reason kids are prescribed antibiotics, yet a study in the November 17, 2010 Journal of the American Medical Association found that in 80% of cases, a child’s ear infections will get better all on their own in about 3 days. Antibiotics increase this cure rate only slightly, to 92%. In other words, for every 10 kids with an ear infection, 8 will get better on their own. Giving all 10 kids antibiotics means 9 will get better, or one more child per 10, MEANING THAT ANTIBIOTICS ARE UNHELPFUL FOR TREATING EAR INFECTIONS AROUND 88% OF THE TIME.

Antibiotics also come with side effects. Three in ten children will develop a medication-related rash as a side effect to antibiotics, and depending on what type of antibiotic is used, anywhere from 5 to 10 more will get diarrhea.

Yet the most worrisome aspect is that by exposing a child to antibiotics unnecessarily it can potentially make future ear infections worse and harder to treat. Some studies have even suggested that children who receive antibiotics might be more prone to recurrent infections. Dr. Alan Greene, M.D., advises parents that “the most up-to-date guidelines recognize that skipping or delaying antibiotics is more effective for most (not all!) ear infections.” (Greene, 2012) The wait-and-see approach seems to work best when it comes to dealing with a child’s ear infections.

Guidelines on when to get an antibiotic prescription to treat a child’s ear infection

The most common antibiotic prescribed for a child’s ear infection is amoxicillin, generally prescribed in a 10-day regimen. Here are some general rules for when antibiotics should be used:

Doctors recommend antibiotic use if …

  • A child of any age appears seriously ill, with symptoms that could include moderate to severe pain and/or a fever of 102F or higher.
  • If a child’s eardrums are oozing puss.
  • If a child has an infection in both ears.
  • If a child is young. Many doctors prescribe antibiotics for infants less than 6 months, just because such an infection is more risky for this age group. Other pediatricians recommend antibiotics for any child two or younger.

You should wait and see if …

  • The child has only mild symptoms and is otherwise healthy.
  • There is a follow up plan in place that can be taken if the condition lingers or worsens.
  • You can ask your doctor about anesthetic drops, which may help with the pain, though many doctors consider this unnecessary.

Sometimes doctors will prescribe an antibiotic that parents can fill if the child has a high fever or worsens after 48 hours. That way you can try to let it run its course, but you still have something to fall back on without having to schedule another doctor’s visit should things get worse.

Soothing pain and discomfort caused by a child’s ear infection

A)    If your child is complaining of pain or discomfort, the best relief for ear infections is a bedtime dose of over-the-counter ibuprofen or acetaminophen, which will help relieve pain and reduce inflammation.  These are often more effective at soothing a child than antibiotics.

B)    Parents can also try pressing a warm washcloth against the ear to soothe discomfort. It’s a home remedy that isn’t proven to be effective, but it also doesn’t seem to cause any harm.

Alternative Treatments you shouldn’t use

Should you treat a child’s ear infection with breast milk?

Some parents attempt to treat a child’s ear infection by placing a few drops of breastmilk into their ear, a folk-tale medicine technique often advised by breastfeeding advocates. This is absurd, for several reasons.

First, the benefits of breast milk occur when a child ingests its antibodies, and it has no medicinal value as a topical solution. Second, as discussed in our earlier section on the anatomy of an ear infection, the barrier between the outer ear and the inner ear makes it impossible for the breastmilk to get to the inner ear, where common ear infections occur. Third, breast milk contains sugars. So dropping this into your child’s ear is a great way to give them an outer-ear infection to go along with their inner one. The reason you don’t leave breast milk sitting out on the counter is to prevent bacteria growth. Allowing breast milk to sit out and spoil inside your child’s ear isn’t such a good idea, either. (Carroll & Vreeman, 2009)

Using an ear candle to treat a child’s ear infection

“For ear pain, some parents will insert a hollow cone or ear candle into their child’s ear and light it,” says Dr. Shaili Singh, MD, a pediatrician with the National Center for Complimentary and Alternative Medicine. DON’T DO THIS. “First of all, it doesn’t work,” says Dr. Singh. “If the child has an ear infection, it can rupture his eardrum. You can also burn his ear or his skin. I’m in favor of alternative medicine, but this is one thing that’s outrageous.” (Landau, 2011)

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