Q: My 1 1/2-year-old daughter has chronic ear infections. She has been on every type of antibiotic and now her doctors are suggesting tubes. Are there any other options?

A: Millions of children, like your daughter, suffer from ear infections. In the U.S., at least 5 million children are diagnosed with otitis media, the medical name for this infection, and another 12 to 24 million are given antibiotics for a possible ear infection.

Common symptoms include pain, irritability, fever, nausea, vomiting, and dizziness. Recurrent ear infections may also lead to hearing loss or delayed speech development.

Antibiotics are the standard initial treatment for otitis media. However, given that so many millions of children with both definite and presumed ear infections are prescribed antibiotics, overuse and misuse of antibiotics occurs as well as subsequent development of drug-resistant organisms causing ear infections. This may occur when a child does not take the entire cycle of antibiotics, or if antibiotics are prescribed unnecessarily, such as the case of a non-bacterial infection.

Prevention
Given the problems created by frequent antibiotic use, health professionals stress prevention, while searching for other treatment options. The following measures may help prevent the development or recurrence of ear infections:

Breastfeed for the first year of a child's life. Breast milk contains antibodies that help fight infection. In addition, a recent study suggests that nursing, as opposed to bottle feeding, does not create pressure in the ear canals that may precipitate infection.
Use a fully ventilated feeding bottle rather than a non-ventilated or under-ventilated bottle. Non-ventilated and under-ventilated bottles create pressure in the ear canals, while fully ventilated bottles more closely resemble the mechanics of breastfeeding.
Avoid pacifiers if possible.
Keep your child away from second-hand smoke.
Prevent colds as much as possible, with frequent hand washing, and eating plenty of fruits and vegetables rich in vitamin C and carotenoids when the child is old enough. Some studies suggest that affection and relaxation also reduce the likelihood of developing a cold.
Check with your pediatrician about using vaccines (influenza and pneumococcal) to prevent recurrent infections. A vaccine for an organism called Haemophilus, a common cause of ear infections is presently being developed.
In the case of recurrent infections, investigate the possibility of allergies or sensitivities to food or environmental factors that make a child more susceptible to infection. A doctor who specializes in either allergy or environmental medicine can help identify and eliminate these triggers.

Alternative treatments:
Some alternative approaches to treat an ear infection include:

• Head and neck adjustments. Select a chiropractor or an osteopath who is accustomed to working with children. Experience and early scientific studies suggest value in these methods, and now cranial manipulation by osteopaths is undergoing rigorous study for prevention and treatment of ear infections at the University of Arizona in Tucson. (echinacea for prevention of ear infections is also being studied at this same academic center.)
• Garlic oil extract (Allium sativum), in ear drop form
• Mullein flower (Verbascum densiflorum) ear drops
• Homeopathy. Bring your child to a homeopathic specialist who will individualize a treatment regimen. Remedies commonly used for ear infections include Apis mellifica, Pulsatilla, or Chamomilla.

As each infection is unique, it is important to be in constant communication with your physician. Often placement of tubes cannot be avoided. If this is the case, try not to get discouraged. Even if tubes must be placed, it is still worthwhile to consider the preventive measures outlined above to avoid additional problems. In addition, a child's quality of life often improves dramatically once tubes are placed they're likely to experience decreased emotional difficulties, improved hearing and speech, and a lot fewer limitations in activity.