“I keep treating my child, but their ear infections continue to reoccur.”
The number one question that I believe gets missed too frequently and is critical to stopping chronic ear infections is: Why?
Your provider does a great job of identifying the ‘What’ –type and severity of ear illness. This article provides resources to tackle ‘How’ to treat, but figuring out the ‘Why’ is going to require detective work on your part.
Chronic ear infections are caused by two things:
•structural abnormalities (i.e. babies with Down Syndrome or other genetic disorders have small ear structures that may be inverted and poorly move fluid out)
•environmental triggers that create inflammation resulting in increased fluid
I am going to discuss environmental triggers. An Audiologist and/or ENT would be the professional to diagnose structural abnormalities as a potential cause of recurrent ear infections.
But how can a food allergy cause an ear infection?
Eating an offending food will create inflammation in the body. One way inflammation is expressed is an increase of fluid and congestion. This can look like recurrent ear infections, puffy eyes, frequent runny nose, allergic shiners under eyes, excess phlegm, etc.
“The middle and inner ear are immunologically responsive and this includes responsiveness to food hypersensitivities. Both chronic otitis media with effusion and Meniere’s disease can improve with treatment of food allergies.” ¹ Other common signs of inflammation include eczema, rashes, and asthma. Symptoms sounding familiar?
In a study that looked at the association between recurrent otitis media with effusion and its association to food allergies, “the most common food found to be associated was milk, egg, beans, citrus, and tomato.”² They removed the food(s) for a few weeks; symptoms resolved. They added the suspected offending foods back in; symptoms returned. This practice is commonly referred to as an Elimination Diet.
So Milk and Eggs are top causes of recurrent ear infections in this study. They are also on the Top 8 Food Allergens list for the world.
Allergy to milk is THE most common food allergen in the entire world! This is not rare. So, why aren’t parents being advised to eliminate milk for 30 days as a Least Invasive, evidence-based approach to chronic otitis media?
This is how I observe it usually play out…
Ear infections begin around age 1. Round(s) of antibiotics resolves. Next month, new ear infection occurs. Repeat same antibiotics treatment. Following month, same thing again. Professional assures you that if it happens again your child is a candidate for PE Tubes (Do they expect us to start cheering?). Next month, guess what? Yep, ear infection again. PE Tube surgery is scheduled and completed under general anesthesia. You are relieved that this is over… Unless you have one of the thousands of children that go on to have continued drainage issues sometimes resulting in the surgically-placed tube falling out. No problem. They will surgically put the tube right back in under general anesthesia. Repeat the cycle of most invasive, symptom-focused treatment…
This story is far too common. As an early interventionist and a Hearing Specialist I can tell you that this same story is told to me monthly. Every time I ask the parent, “What did the professional say is CAUSING the ear infections?” ***crickets***
“They never talked about a cause…”
So I begin asking basic, non-medical questions.
Me: You said ear infections began monthly around age 1. What else changed around age 1?
Parent: I can’t think of anything. She wasn’t in daycare yet, no illnesses.
Me: What did she eat or drink around that time?
Parent: We switched her over from Breastmilk/formula to cow’s milk after her 12 month checkup. **ding ding ding**
Me: Does anyone in the family have food reactions?
Parent: Well I am lactose intolerant, but she hasn’t showed any negative reactions to dairy thankfully.
And this is the problem. Intelligent, well-intentioned, loving parents have ZERO clue that the #1 Allergen in the whole wide world can CAUSE ear infections. And they are led on a journey of pharmaceutical and surgical interventions, many times without any discussion of there being a cheap, easy, and less invasive solution for the vast majority. And all the literature that clearly demonstrates the association is never discussed even with high risk families such as parents with a history of food intolerances.
Here is what I wish would occur…
12 month check up:
Pediatrician: Many kids start cow’s milk at age 1. Do you or anyone in your immediate family have a history of food allergies/intolerances, eczema, allergies, or asthma?
Parent: Yes, I am lactose intolerant, have asthma and allergies. My other child has eczema and allergies.
Ped: Well, dairy is the #1 Allergen and with your family history you may want to either wait to introduce dairy or observe for the following signs that a reaction is occurring…
Ear Infection Appointment:
Pediatrician: Here is a list of Ear Infection treatment options. If there are no signs of other infections in the body, let’s pursue a Least Invasive to Most Invasive approach. This means we will save antibiotics as a last resort.
Recurrent Ear Infection Appointment:
Pediatrician: What new foods or environmental triggers has your child been exposed to?
Let’s try 6 weeks of an Elimination Diet of the Top Allergens to see if food is a factor. Let’s also review the treatment options so we can pursue a Least Invasive to Most Invasive treatment path. Read my other article, Treatment Options for Ear Infections: A Least Invasive to Most Invasive Approach.
I used examples citing cow’s milk as the culprit because it is the most common. However, any food can cause an inflammatory response. We are all individuals with individual responses. There are a variety of ways to identify food culprits. To read about Why and How to do an Elimination Diet to identify food triggers read Dr. Axe’s article.
Remember to assess your child’s environment for other environmental triggers as well. The Top 6 Environmental Allergies list.
Check products that you put on your child by using an app like Skin Deep to see the Environmental Working Group’s toxicity rating on skin products, foods, cleaning products, and more.
The most important focus of this article is empowering parents to ask Why questions and Cause questions. These are the questions that will Heal Our Little Ones.
- The role of food allergy in otolaryngology disorders. Ramakrishnan, JB. Curr Opin Otolaryngol Head Neck Surg. 2010 Jun;18(3):195-9. http://www.ncbi.nlm.nih.gov/pubmed/20168232?log$=activity
- Recurrent otitis media with effusion and food allergy in pediatric patients. Arroyave CM. Rev Alerg Mex. 2001 Sep-Oct;48(5):141-4. http://www.ncbi.nlm.nih.gov/pubmed/11759256