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Chronic or Recurrent Ear Infections

little girl an earache on white background

Once a rare occurrence, frequent or chronic inflammation of the middle ear has come to be seen as a “normal” aspect of childhood in the United States. Generally, ear infections are treated with antibiotic drugs. Often, ear tubes are implanted. Some doctors recommend the removal of tonsils and adenoids. Other doctors (especially in countries outside the U.S.) are beginning to advise “watchful waiting” for the less severe ear infection to see if it will resolve itself without the use of antibiotics.

The Studies

The studies listed below are organized by date, with the most recent date first.  Some of the full texts will need a password because they are kept in a locked file to protect their copyright.  For educational purposes only, we are allowed to share the password with you if you write to us.

If you are trying to find a particular author, see the Index below which lists all the primary authors alphabetically with their publication dates.

Author Index
  1. Angarano 1988
  2. Duncan 1993
  3. Hagerman 1987
  4. Hagerman 1987
  5. Heiner 1984
  6. Hurst 1990
  7. Manning 1992
  8. Nsouli 1994
  9. Wasowka-Krolikowska 1998
  10. Wilson 1983
Wasowka-Krolikowska 1998: Ear infection rate down 75% when babies' diet better

The way of nutrition and frequency of otitis media in hospitalized infants and 3-year-old children, Wasowka-Krolikowska K, Dynowski J, Godzisz J, Pol Merkuriusz Lek, 1998 Dec;5(30):333-4

The frequency of hospitilization of infants and children for otitis media at the Clinic of Childrens Diseases of the Medical University of Lodz decreased from 22.6% in 1975 to 4.2% hospitalized in 1995. “It was caused mainly by the change of a way of nutrition from artificial to natural and easy accessibility diets. It shows an allergic process as a probable source of otitis media in children.”
MedLine (article in Polish)

Nsouli 1994: Food allergy and earache

Role of Food Allergy in Serous Otitis Media, Nsouli TM, Nsouli SM, Linde RE, O’Mara F, Scanlon RT, Bellanti JA. Annals of Allergy 1994 Sep;73(3):215-9

There was a significant association between food allergy and repeated earaches (recurrent serous otitis media) in 81/104 patients (78%). “The elimination diet led to a significant amelioration of serous otitis media in 70/81 (86%) patients as assessed by clinical evaluation and tympanometry. The challenge diet with the suspected offending food(s) provoked a recurrence of serous otitis media in 66/70 patients (94%). CONCLUSIONS. The possibility of food allergy should be considered in all pediatric patients with recurrent serous otitis media and a diligent search for the putative food allergen made for proper diagnostic and therapeutic intervention.”


Duncan 1993: Study on 1,013 babies show breast feeding protects against earache

Exclusive breast-feeding for at least 4 months protects against otitis media, Duncan B et al., Pediatrics 1993 May;91(5):867-72

1013 infants were followed for their entire first year. “Infants exclusively breast-fed for 4 or more months had half the mean number of acute otitis media episodes as did those not breastfed at all and 40% less than those infants whose diets were supplemented with other foods prior to 4 months. . . . This protection was independent of the risk factors considered. CONCLUSION. These findings suggest that exclusive breast-feeding of 4 or more months protected infants from single and recurrent episodes of otitis media.”
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Manning 1992: Animal model of ear infection with vitamin A deficiency

Incidence of otitis media in vitamin A-deficient guinea pigs. Manning SC, Wright CG, Otolaryngol Head Neck Surg 1992 Nov;107(5):701-6

“After observing an association between vitamin A deficiency and otitis media among children in Micronesia, we sought to develop an animal model for vitamin A-deficiency-induced otitis media. … None of the 15 controls demonstrated middle ear abnormalities. In the experimental group, 77% of temporal bones showed middle ear pathology consisting of either of subepithelial edema (27%) or frank otitis media (50%). …”

Hurst 1990: Refractory ear infections cured by allergy or diet treatments

Allergy management of refractory serous otitis media, Hurst DS, Otolaryngology –  Head and Neck Surgury, 1990 Jun;102(6):664-9

“20 patients classified as having otitis media with effusion (OME) refractory to all previous medical and surgical therapy were entered into a prospective study to see if classic allergy techniques could diagnose and treat otherwise unresolved effusion and persistent hearing loss … Among those choosing allergy immunotherapy, 65% maintained normal hearing, normal tympanograms, and the elimination of recurrent infections for three years. The remaining 35% resolved on appropriate food elimination diets. None of the control’s symptoms resolved. ”

Angarano 1988: External ear infection can be from inhalant or food sensitivity

Diseases of the pinna. Angarano DW, Veterinary Clinics of North America, Small Animal Practice, 1988 Jul;18(4):869-84

“… A variety of diagnostic tests, including hematology, serum biochemical profiles, urinalysis, serology, intradermal skin testing, hypoallergenic diet trials, histopathology, and direct immunofluorescence, may be necessary in some cases before a definitive diagnosis is reached. … All too frequently, the chronic otitis externa is the result of a hypersensitivity (either inhalant or food) that has been overlooked in the attempt to treat the subsequent infectious otitis. Thus, in animals with recurrent otitis externa, every attempt should be made to identify and treat the underlying etiology.”

Note – okay, this is an animal study … but people are animals, too.

Hagerman 1987: Children with more ear infections more likely to get ADHD

An association between recurrent otitis media in infancy and later hyperactivity. Hagerman RJ, Falkenstein AR, Clinical Pediatrics (Phila) 1987 May;26(5):253-7

“An association between the frequency of otitis media in early childhood and later hyperactivity is reported in this study. … Ninety-four percent of children medicated for hyperactivity had three or more otitis infections, and 69 percent had greater than 10 infections…”
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Hagerman 1987: Recurrent earaches make behavior problems worse in fragile X

Recurrent otitis media in the fragile X syndrome. Hagerman RJ, Altshul-Stark D, McBogg P, American Journal of Diseases of Children, 1987 Feb;141(2):184-7

“…Males with fra(X) [fragile X syndrome, a genetic disorder] are at high risk for recurrent ear disease, which may exacerbate the cognitive, language, and behavior problems that exist in this syndrome. ”

Heiner 1984: Recurrent earache, rhinitis, large tonsils related to food allergy

Respiratory diseases and food allergy.  Heiner DC, Annals of Allergy 1984 Dec;53(6 Pt 2):657-64

“Both upper and lower respiratory tracts can be affected by food allergy. Manifestations in either may be exclusively due to food allergy (common in infants) or may result from the combined effects of food allergy plus another defect … or a concomitant inhalant allergy. Chronic rhinitis is the most common respiratory tract manifestation of food allergy… Recurrent serous otitis media may be solely or partially due to food allergy. Large tonsillar and adenoid tissues, sometimes with upper airway obstruction, may be caused, or aggravated by, food allergies. Lower respiratory tract disease manifested by chronic coughing, wheezing, pulmonary infiltrates, or alveolar bleeding may also occur. … Food allergy should be considered when there is a history of prior intolerance to a food in childhood or of symptoms beginning soon after a particular food was introduced into the diet. It is an important consideration in patients who have chronic respiratory tract disease which does not respond adequately to the usual therapeutic measures and is otherwise unexplained.”

Wilson 1983: Allergy and earache in babies

Recurrent acute otitis media in infants–role of immune complexes acquired in utero, Wilson WH, Laryngoscope 1983 Apr;93(4):418-21

“Ten infants experiencing recurring episodes of acute otitis media with associated otitis media with effusion while on human breast milk afford a study of the role of possible immune complexes acquired in utero through the mother’s allergic diathesis. … Challenge feeding tests determined the mothers’ hypersensitivities. Those infants breast fed by mothers exhibiting positive challenges to specific foods, manifest allergic responses themselves following the first breast feeding after the mothers’ challenge. A cessation of episodes … occurred in five … as foods proven to be offenders were eliminated from the mother’s and child’s diet…”


The Diet Connection

Based on feedback from families using the Feingold Program, children with behavior and learning problems appear to be very susceptible to ear infections. According to these families, removing the synthetic additives not only enabled their children to calm down and focus, but it also brought an end to chronic ear infections.

When children eat foods with synthetic chemicals, some of them experience a sensitivity reaction that includes tissue swelling. If the cells in the Eustachian tubes swell, they can close up and prevent fluid from draining out of the inner ear. This means that any liquid in there will be trapped in a warm, dark environment; bacteria in the fluid will increase and this can lead to an infection. Some doctors now believe that the medicine typically given to children with ear infections actually brings on the next episode. Of course, most of these medicines contain artificial colors and flavors!

There have been quite a few scientific studies connecting a change in diet with improvement of ear health.

History of antibiotics for ear Infections

Despite the concern of a growing number of doctors, antibiotics are still prescribed for millions of children.

In the mid 1980s, researchers at the University of Pittsburgh carried out a five-year study to compare the effectiveness of using a drug (amoxicillin) to treat otitis media versus no medicine. Half way through the trial, the team ran out of the $17.4 million in grants they had received from the National Institutes of Health. At the request of the lead researcher, Dr. Charles Bluestone, drug companies gave another $3.4 million. Then he changed the study’s original design, based upon the assumption that the drugs were proven to be effective. Later, Dr. Bluestone personally received $262,000 from the companies whose drugs he was testing. After this, the use of antibiotic prescriptions increased to become the routine treatment for otitis media.


Foul play?

The co-investigator in the studies was a bio-medical engineer named Erdem Cantekin, who says that Bluestone manipulated the results of the study to favor the antibiotics. “It was a fraudulent study,” Cantekin believes, “This isn’t a question of scientific interpretation. They made certain changes to make the drugs look better.”

He believes that this research bears much of the blame for the overuse of antibiotics, which, in turn, has created “superbugs” that have made the original antibiotics less effective.

Biological Treatments for Autism and PDD - by William Shaw, PhDOther scientists believe the use of antibiotics for children has played an important part in the increase of autism, PDD (pervasive developmental disorders) and ADHD. In his book, Biological Treatments for Autism and PDD, Dr. William Shaw explains how antibiotics wipe out beneficial bacteria, leadng to yeast overgrowth in the intestinal tract. The yeast produce abnormal by-products which are absorbed into the bloodstream and travel to the brain, altering behavior.


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