303 – Ears

Season Intro and Episode Overview 0:00

Hi, welcome to season three of the baby manual podcast, the holistic mama's handbook. This season will go through alternative and supportive care to help you take care of your little one when they're sick, but too young to take most medicines. I'm your host, a pediatrician and mom, and the author of The Baby Manual and The Holistic Mama's Handbook, Dr. Carol Keim. Hello and welcome to this week's episode of the Baby Manual podcast, Holistic Mama's Handbook. Today we're going to be talking all about ears and I'm really excited because I am going tell you about the two most common ear things that I see in the office.

One is regular ear infections and the other one is parents asking about earwax. I think the treatments are going to surprise you a little bit, so I'm excited to get going on this. Now also in the Holistic Mama's Handbook, I talk about Swimmer's Ear. I am not going talk it today on the podcast, but if you want to head over to Amazon, you can pre-order it at a discount before November 15th, and you'll get it delivered to your Kindle as soon as it becomes available on 15. or if it's after November 15th of 2023, you can just go ahead and order that over there.

I'll remind you again at the end. All right, so ear infections, also called otitis media, is an infection of the middle part of ear. So there are three parts of an ear, there's the outer ear which is the canal, which gets infected with swimmer's ear there is a middle ear where we get these ear infection in children and then there the inner ear responsible for hearing So things like hearing loss or ringing in the ears happen on the inner ear,

What Ear Infections Are and How to Spot Them 1:29

and those are more like adult conditions or older children. So for ear infections, the symptoms that we see are ear pain. You might notice children tugging at one of their ears. And remember, tugging on the ears is actually not very specific for ear infections. A lot of times, especially with younger children, like less than age three, if they're rubbing or pulling on one of their ears, it can just be that they have some congestion or some fluid in there, or it could even be from teething, because children when they you'll see them kind of reaching in that area to be like, ow, something hurts over here.

And then they find their ear and kind to play with it. But if you do see your child tugging on their air, and if that ear seems really painful to them, but if they've got fever, that's a little bit more suggestive of an ear infection. Some ways that you can check at home. You can actually push and pull on three different places on both of the ears. And if the ear is more painful on one side than the other, it's more likely to be an ear infection. So the first thing you could do is pull up on the top part of your ear.

It's called the pinna. That rounded part if you just pull upwards on it and tug it. Then you do that on those sides and it bothers them a lot more on that side. That might be a sign of an ear infection. The other place you can press is the tragus, which is that little button at the front of the ear. Pressing on that moves the air canal and would be painful in an air infection, and the third spot is pressing on the hair canal itself, underneath the ears. So if you reach under your baby's ear, like under the earlobe kind of behind it into that soft indentation and lightly press there.

And I would press both sides at the same time and see if they wince and then do like one side at a time, and try to figure out if it seems to really be bothering them. If both sites are bothering then when you do that, that's more suggestive of a viral infection or of teething or just being congested, which sometimes happens with allergies too. So pain on one site would make you think that they might have a bacterial ear infection. Things that can cause ear infections, babies who lie down with bottles, the middle ear drains from the eustachian tube and the station tube connects from ear to the back of the throat.

So when a baby lies down, with a bottle of milk, that the milk has sugar in it and that it can grow bacteria. and it can get into the bottom part of that ear canal. And then the infection can just kind of climb up that eustachian tube and get in to that middle ear and then get trapped in there. They get pain because that's behind the eardrum and the pressure just builds up behind that air drum. It's a pretty small space, so a little bit of pressure can cause quite a bit pain in that area. Babies who are formula fed are more likely to get ear infections than those who were breastfed.

And that's also because of the sugar in the formula and they don't have the antibodies along with it to help fight infections that you would get with breast milk. If an ear infection goes untreated, it can sometimes cause some complications. Sometimes the eardrum will rupture, which sounds a lot worse than it is, but the ruptured eerdrum heals up within a few days. But sometimes that pressure builds up so high that the ear drum pops. And actually once the air drum ruptions, It feels better because the pressure is relieved.

but it's something that we'd like to avoid because it cause scarring on that eirdrum and over time can cause hearing loss or just decreased hearing. Sometimes if an ear infection's untreated, it can get into the bone that's under there. So you have that soft indent that you're feeling for the ear canal. The bone, that right behind that, sticks out, is called the mastoid process. And the mastoid has a lot of air pockets in it. If the infection gets in there, It can grow pretty quickly and can cause an osteomyelitis, which is an infection of the bones itself, called mastoideitis.

And with mastoiditis, that's a pretty serious infection. They typically need surgery to clean it out and then some IV antibiotics. So it's pretty big deal. And very rarely, ear infections can get into the space around the brain and cause meningitis. Meningitis is another very serious infections that would require your baby to be hospitalized and need IV antibiotic.

Causes, Risks, and Complications of Ear Infections 5:44

Now, a lot of ear infections will go away on their own, but these are just possible complications of bacterial ear infection, which is why we typically will treat them in children. And sometimes ear infections are caused by group A strep, and group a streps is the one that causes your typical streped throat. But if it's causing that ear inflection and it doesn't get treated, even if gets cleared on its own it can cause rheumatic fever in kids who are under age six. And rheumatic fever is a pretty serious condition as well that needs some IV antibiotics, and that's where the strep kind of hides out in the body and then it comes back into the bloodstream.

It infects the heart, it can get into brain, It can cause these sort of weird neurologic symptoms and writhing movements and things. And it's a very serious conditions in children. So we treat ear infections to avoid that and to then avoid these other complications. Oh, the other thing is after an ear infection, sometimes the fluid will hang out there for a while. So your doctor may want to have you come back in the office to take another look in their ears to make sure the flow it has drained out of there.

If the flu doesn't drain, it sounds like to your child like there's just water in there ear all the time. And so hearing can be affected and they can actually have speech delay for children who get a bunch of ear infections. Some of these other alternative treatments can help to avoid that as well. So from a Western standpoint, the first treatment for ear infections is actually ibuprofen for 48 hours. Remember, children need to be over six months old to take ibiprofin. Under six month, you can give them Tylenol for the pain.

But pain management is the main thing for your infections. They hurt quite a lot. And then if it's a bacterial ear infection, we would give some antibiotics. We typically start with amoxicillin, but your doctor should know other options if your child's allergic to amaxicilin. You have to do a high dose of antibiotics because that ear space doesn't have a lot of great blood flow. And it takes quite a concentration of antibiotic to get enough into that your fluid to sterilize that fluid. Remember the antibiotics are only sterilizing the fluid, they're not actually doing anything for the pain.

So it'll help a little bit with the inflammation because when there's less bacteria, you have less white cells coming into there to try to fight the infection. It's a bit less swelling. But for the most part, antibiotics are not pain treatments. They really just sterilize that fluid and then the ibuprofen on top of it will really help with that pain. When a child has multiple ear infections, from a Western standpoint, we often will put ear tubes in. We'll send them to an ENT specialist or ear, nose and throat specialist for that.

And what the eartubes do is they're like a little tiny straw. They put it through the eardrum and it just makes a hole in that eerdrum that stays there with that little rubber straw in place so that anytime fluid tries to build up, it's just drains out. So children who have ear-tubs can still get ear infection and they do still ear infections. But what happens is rather than having all that pain and pressure build up, the fluid and the pus and sometimes blood just drains out of it. So if you notice, if your child has ear tubes and you see discharge coming out their ear that's red or has pus in it, then that could be a sign of an ear infection as well.

And sometimes they don't get a fever with that because the infection is kind of draining. Just that copious discharge can lead you towards thinking that they've got an air infection. One thing I recommend from a supportive care standpoint for ear infections is decongestants. Because any congestion that's in the nose and throat area can cause swelling at the bottom of that eustachian tube where it drains and it makes that fluid build up. So actually being congested can predispose to ear infection, but also decONGESTANTS will not only help prevent them but can help treat them because they help that to drain out.

Now remember that children under six can't take medicine decongestants, but what you can do is you give them ginger, which works as a decongestant. So ginger tea is great for babies less than a year. I would make it pretty watery, at least twice as much water for a ginger tea bag or you can even use a small chunk of ginger and just boil that in water

Conventional Treatment and Ear Tubes 9:56

and let it cool down. Ginger is a natural decongestant and that can help a bit with that. And then steam, breathing in steam can helps. So having either a humidifier or using hot water in the sink and put their head over the thing with like a towel over it. They can breathe in a steam that comes off of that or running the shower. You can also run the shower with some of those decongestant oils like peppermint oil or eucalyptus oil, and I often recommend that too. Or even just running the show and having your baby in the bathroom while the showers running and breathing that steam in.

What it does is it thins out the mucus that's in back of the nose and helps that drain out and then also helps the congestion go along with it. You can use saline nose sprays, nose drops, and nose gels. What salines does is also decongest the baby. It also thins out that mucus. The hypertonic salin will make them release more fluid into that space and naturally clear out their mucous. And regular saling just like flushes it out. So either regular or hyper tonic will work. And spicy foods are also a natural decongestant.

Most young children don't like spicy food, but if your child does, if you've ever had wasabi at a restaurant, you know how it just kind of clears your sinuses. You just feel it open everything up. That's a process called gustatory rhinitis. I love that name. It just means that when you have something spicy, it makes your nose run and makes like watery mucus in that area. So spicy. Foods can help as well. Something like hot and sour soup is really great for kids who are decONGESTED or who were congested.

if they're able to eat that kind of thing. Also, you want to push fluids, lots of water. You could do watered down juice, but remember that the sugar in juice will feed infections as well. So if you can just get them to drink water, that's the very best. you could also do tea or broth, like chicken broth or veggie broth. Those are really good also because the more liquid is in their body, the liquidier their mucus will be and the easier it'll drain back there. And of course, rest is always part of getting better.

From a chiropractic standpoint, I've actually seen really, really good results in my patients who get regular chiropractic treatments from a pediatric chirapractor. What they do is they very gently adjust the neck. Remember, no twisting or popping. They're just using pinkies and very light, maybe craniosacral therapy or just very a light touch.

Supportive and Alternative Care for Ear Infections 12:24

and a little bit of fascial manipulation or massage technique to help that fluid to drain out. This can help active infections and it can also help prevent future infections. So when your child has multiple ear infections or even with their first one, you can take them into a pediatric chiropractor. But for those that are saying, like the patients that have told me that their child needs to get ear tubes, I tell them try going to the chiropractor a handful of times first to see if that can help.

Also, if they've got persistent fluid in their ears, that that fluid's just not draining enough and they have that buildup and the potential speech delay, chiriopractic can prevent that as well. From an acupuncture standpoint, both acupuncture and or Chinese herbs can help with ear infections, and they can with the acute infection primarily. And that works both for viral infections and bacterial infections. So any kind of ear infection and ear fluid, acu-puncture will help. A reminder that acuppunture in children doesn't involve needles.

They're just doing something called shonishin, which is lightly tapping on points. Sometimes they'll use moxibustion as well. From a nutrition and supplement standpoint, you want to try to avoid sugar and dairy because these can feed the bacterial infections and sometimes dairy can cause more mucus and more congestion in that area. Make sure that they're doing lots of good, healthy foods. Things like fruits and vegetables are great. The sugar that's in fruits is not as bad as the sugar in what I call the C words, like candy, chocolate, cupcakes, all that stuff.

You don't want to necessarily do ice cream for those. Those are all things that will feed the infection a bit more. But naturally, curing sugars are okay. Just don't do juice because that does have quite a lot of sugar in it. And if you are giving your child juice, you want to water it down at least three quarters water and one quarter juice. You can also use immune boosting vitamins like vitamin C, vitamin D, zinc, echinacea, and elderberry. And those especially help with viral infections. Elderberry and ekinacean zinc are all antiviral and vitamins C and D and also echnaceae are immune-boosting where they just trigger more of an immune response and can help any kind of infection to clear faster.

From a naturopathic standpoint, you can make onion earmuffs, which is kind of a cute name. What you do is you take an onion or slices of onion and warm it up either by pouring hot water over the onion, or microwaving it for a few seconds, but then touch it to make sure that it's not hot because onions get really hot really fast. So you want it just be warm and not hard enough to burn your child. And then you put that onion on or around your children's ear. and that should help with the ear infection.

I actually did this for my own daughter when we were traveling one time and it helped. It was, I was really amazed by it. But so from a personal standpoint I can say I've definitely tried that. And garlic oil is another thing that is sometimes recommended and you can do garlic ear drops into your child's ear. Then there's something called N-acetylcysteine, which is a supplement that can thin secretions and mucinex or goifanazine. is another, is actually a medicine that you can buy that children are able to take and that thins out mucus as well.

Remember that mucinex though, I don't love how it's marketed because in the U.S. we market it as a cough medicine and actually what it does is it thynes mucous out and then it makes you cough it out more. So if your child also has cough with this ear infection, they're going to cough more with mcnex and they might appear to be getting worse. I wouldn't recommend it in that case. You can also, from naturopathy standpoint, they'll do eustachian tube massages, which is where they're rubbing on the side of the neck under that ear canal, or fascial manipulation, like a light massage.

And then they recommend wet socks. The wet or magic socks are where you take a cotton sock in cold water, put it on your child's feet, and then put a wool sock over it or wrap their feet in a towel if they're just laying there. And as that sock dries and their heat, their, feet warm it up, the heat kind of goes down towards the feet and that can help to clear fever and can to help clear ear infections as well. From a homeopathic standpoint, allium sepa is something that is made from things in the garlic and onion family.

And so that supplement can help. Pulsatilla is sometimes recommended. Belladonna and calceria carbonica. These are all homeopathy remedies that you might try for ear infections. Keep in mind that homeopathy is not fully supported by Western medicine and Western science. And if it's not helping within a day or so, then you should try some other treatments than that. These homeopathic remedies are all taken by mouth. They're available as sugar pellets and for children who are less than a year or less You can dissolve one sugar pellet into a teaspoon of water and then just give them a few drops or up to a spoonful of a water at a time with that remedy in it to see if that can help.

From an essential oil standpoint, there's a lot that could be done as well. So you can make a pain mix for ear infections by mixing half an ounce of vegetable oil ten drops of lavender oil, five drops German chamomile, six drops palmarosa, and three drops cardamom. You mix it all together and you put one or two drops into the affected ear and that can help with pain. From an infection, an ear infection mix, for oils, what you can do is do a half ounce of vegetable oil with three drops of thyme, three drop of lavender, 10 drops Roman chamomile, and three of calmarosa.

You'll mix those together and put one or two drops into the affected ear. Now, the ear infection, that the otitis media is behind the eardrum, as I've said. So, when you put drops into the air, they don't necessarily get behind eerdrum. They just kind of get onto it. But skin is also lipophilic, which means that, The oils can actually go through skin and can go though the airdrum a little bit. A little of it might get into that inner ear and it can help. If a child has a ruptured eirdum or even if they have a lot of pressure on the eardrum, putting any kind of drops in that ear can actually cause more pain.

So if you ever put drops into your child's ear and they cry or they say that it hurts, you should stop because that means it's not helping. Now with these essential oil blends, what you can do is you can wet a washcloth with warm water and put about half a teaspoon of that mix onto the wash cloth and then use that as a warm compress outside the ear. And sometimes even just warm, compresses with water will help. But yeah, these essential oils might also be able to help a little bit more with that.

So I hope this helps with ear infections. I've seen so many and they can be so painful in children's, I think trying a lot of different things can really be helpful for your child. Now for earwax. Earwacks usually doesn't cause a lot of symptoms, but sometimes when the ear wax builds up, it can be uncomfortable and you'll see your child rubbing at their ear or putting their finger in there, or it could even cause hearing loss and some verbal delays because the sound just isn't going through as well from the canal.

And sometimes you'll see wax leaking out of your child's ear. So earwax starts off yellow and it's sort of light and flaky, but over time as it builds up or as is melts and stays in there, it turns brown or even like a rust color. Sometimes when the wax is darker brown like that and then it gets a little melty and comes out, It can look like blood, But it is not actually blood. It's just the dark wax coming out. So from Western standpoint, q-tips are really controversial. It seems like about half a doctor's love and half hate them.

So I'm a fan of the cotton swabs or the q tips for yellow wax. When the wax is still really light, you're able to just go in there very gently and grab it with a q tip. They make safety q tips for babies that look like a pretty wide bulb with the narrower one at the end of it. And that's so that you can't accidentally shove it in too far. But the providers who don't like Q-tips are the ones that tell me that, you know, putting anything in the ear can actually push that wax further in. And that's true too.

So if you're not really getting good return on it, I would say for yellow wax, the best time to clean your child's ears is after a bath or a shower if they've got a little bit of water in their ears. You know the warm water can help soften it even more. and can help you get a little bit more out. If there's any wax that you can actually see, you could do that. You can also dip that Q-tip or cotton swab in a bit of either olive oil or baby oil, just enough to moisten it, and oil will stick to earwax.

So you just moist it a litle bit and then use that to clean your baby's ear out and that can When your child has brown wax in there, we recommend an over-the-counter medicine called Debrox, which is a peroxide mix. You can also use hydrogen perooxide one-to-one with water.

Earwax: Symptoms and Western Treatments 21:38

Debrex is oilier and greasier, and it doesn't come out as quickly, so it'll stay in a little bit easier. Or if you do hydrogen Peroxide, you just put a couple of drops of half hydrogen, half water, into that ear, wait two to three minutes, and then either wash it out in the bath or use a Q-tip to try to remove it. In the office, we'll sometimes irrigate the ear with warm water and dish soap, or sometimes peroxide in that water as well. And there are special devices that we use for that. They kind of look like spray bottles, but we put that up against your child's ears, spray that in, and it goes in at kind a high flow but should not be painful.

That can help to flush that out. Or sometimes we will use a little tiny spoon called a curette. In a Curette we can just go in and scoop out the Earwax that were able to see. You can also put baby oil into your child's ear to try to get that to thin it out, or you can use Colace, which is a medicine that is an anti-gas medicine. It's kind of interesting, but if you find Colase gel caps over the counter, Colasemethicone, you just pop the end of it with a thumbtack and then put a few drops of that into the child ear and that can really help to break up the wax and help it to come out.

So a lot of different options from a Western standpoint. From an acupuncture standpoint, there's not actually acupunture for earwax, but there are Chinese herbal drops that they use. And they also do something called ear candling in a lots of places in Asia where they put like a wick into the ear and they can light it with a flame and that just like candle, the wicks sucks up the wax and gets it out of the year. This is something we don't typically do in Western culture. And so if you are thinking of doing this, you want to go to somebody that actually has experience with that because there is a chance that, I mean, hair is very flammable and your child's skin could get burned if it's not done properly.

So it needs to be done by someone who has experienced with. There's no really anything from chiropractic standpoint for earwax. From a nutrition and supplement standpoint, you can put garlic, mullin oil, or olive oil drops into the ears, and that can help break up the wax and make it flush out more easily. Or you could do fish oil by mouth. Fish oil just helps kind of lubricate everything in the body, can make that wax come out a little bit thinner. If you're breastfeeding and your baby has a lot of ear wax, the mom can take extra fish and oil that comes out in breast milk and can get into your From a homeopathic standpoint, there's not really anything that they would do for earwax specifically.

It would have to be part of a constellation of symptoms. And then from an aromatherapy standpoint we don't really use essential oils in the ear for break-up wax will kind of absorb into it and dissolve it a little bit and help it wash out. But typically from an oil standpoint, we would just say olive oil, garlic, mullin oil. Those can help a bit. Remember, if you're using any essential oils near the ears, you do want them to be diluted. And you can try those, the ear pain mix and the air infection mix that I mentioned earlier, and those might help as well.

And then just like hot water in the ears. So if your, you know, hotwater melts earwax, and this just sort of goes like across the board, this isn't any specific modality, but yeah, ear wax tends to come out in shower, in bath, a little bit of shampoo in there, some kind of soap can help to stick to that wax and help pull it out. So I hope that this helps. If you want more information and also like these recipes for the ear oils, you can check out the Holistic Mama's Handbook.

Alternative Earwax Remedies and Closing Remarks 25:18

And I also talk about swimmer's ear in there, which is an infection of the Ear Canal itself. It's the skin in the Air Canal that gets infected and then gets really inflamed. and can be very painful as well, and it can look like an ear infection. And swimmer's ear can happen in young babies even from baths and from water being in the ear, which is partly why I am pro cotton swabs in-the-ear after bath time, just to get that water out and dry it out at least, because you can prevent swimmers ear that way.

All right well I hope that you loved this episode. Make sure you click that subscribe button because next week we're going to be talking all about teething and I'm so excited for that one as well. You can pre-order the Holistic Mama's Handbook on Amazon at a discount before November 15th of 2023 or if you're listening to this episodes later you can get it just for sale on amazon. It's also available on Kindle. And a reminder that the Baby Manual is the other book that I've written for babies, ideally in the first year of life, that can help you get through all those scary things that babies go through in that first-year.

I have stuff in there about how to tell if it's teething or air infections, and a little bit about cleaning babies' ears in this book as well. The baby manual is on Amazon and Kindle all throughout the world. And then if you look at the show notes, there's links to these and there is also a link to get vitamins and supplements at 10% off. I do get commission if click on that link and buy supplements through it. But there are no specific brands. There are many, many brands that are available there and I don't have any ties to any specific companies for vitamins or supplements.

So I just recommend things like vitamin C, vitamin D in general. All the brands on the link that you can see, are all really good, trusted brands, and so I would recommend any one of those. I hope this was helpful. Have a wonderful day. Thank you for listening to the Baby Manual Podcast. Please hit that subscribe button below so you don't miss the new episodes as they come out.