Ear infections: Wait and See or DO SOMETHING ELSE!
By Jerry Bozeman L.P.C., R.P.T.-S.
[Licensed Professional Counsellor and Registered Play Therapist – Supervisor.]
I was devastated when my infant son battled ear infections when he was less than a year old. The doctors told me that nursing helped prevent them. I NURSED! They said smoking caused them. MY HUSBAND STOPPED SMOKING! They said exposing him to germs by taking him out caused them. I STAYED HOME!
As he grew older, the infections got better, but I was a teacher, and I knew that he was missing things. He didn’t seem to hear things well, and we later found out the ear infections had caused a persistent ringing, called tinnitus, which interferes with hearing. He didn’t learn to read until he was in the fourth grade, and only then because I worked extra hard finding a way to help him learn. The teachers thought he was just slow and pretty much gave up. He’s now a licensed professional engineer, and he’s not slow.
He had a set of problems that often go along with ear infections. They are problems that doctors don’t look at because they only see the medical aspects of ear infections. But every time a child gets an ear infection some fluid from the inflammation gets into the middle ear. This is the place where all of the small bones are that transmit sound from the ear drum to the brain. When fluid is there, sound is not transmitted well, hearing and speech are compromised, and these children often wind up in remedial reading classes or special education.
The early experience of Helen Keller shows how critically important this connection is in early childhood development. Helen herself, as well as those caring for her, described her as an animal prior to her understanding of the symbol for water that was repeatedly written on her hand in between shoving it under an open tap. That simple connection, which most of us take for granted, made it possible for Helen to think in symbolic terms. It opened her brain and allowed for her to change from an “animal” to the humanitarian leader that she became. While Helen’s case was extreme, it clearly shows the understated importance of a solid foundation of symbols in the foundation of thought. Most of us use the symbolic words in our languages as this foundation, and we don’t even think about it. Persistent fluid in the middle ear of a child decreases his or her ability to discriminate sounds and is a significant roadblock on the path to this understanding.
In the United States, we call the collection of fluid in the middle ear serious Otitis Media. In England it’s called glue ear, a more descriptive label. In both countries, it’s treated by putting grommets into the ear drums so that the ear drums can move and children hear better. But by then it is often too late.
There is a window of opportunity for learning sounds and the associated languages. It’s a developmental window, which means that it’s related to the growth and development of the brain. If a child is not exposed to the material during the window, then the task becomes much harder later. This was the situation with my son – and with many others too. When I returned to teaching, I worked in special education. When I would ask my students how many of them had grommets put into their ears when they were young, they all raised their hands.
This connection is becoming clearer and more people are recognizing it. Thirty years ago when I spoke with other educators and administrators about the problem, the acknowledgement of the connection was marginal to bad.
It is only a little better today, and the problem remains in both the educational and the medical communities where neither sees it clearly. Doctors see ear infections primarily as the greatest reason for giving antibiotics to infants and children; which makes it also one of the greatest reasons for the problem of antibiotic resistant bacteria. This is a problem that doctors do see, especially the ones who are trying to figure out how to cope with these resistant germs. Preventing antibiotic resistance, they find, is best done by not using so many antibiotics.
Several doctors working in the Emergency Room at Yale studied a “wait-and-see” approach to ear infections, comparing it with the usual antibiotic treatment. They found that the children given an antibiotic did not do any better medically than those not given an antibiotic. Their study was reported in the Journal of the American Medical Association on September 13, 2006. That is all well and good as far as medical reasoning goes, but until medicine learns of the link between this problem and delays in language, they only see half the problem.
This was where we were when my son’s infant daughter began having recurrent ear infections. By this time, I had become a school counsellor, and I really liked to use principles of reality therapy that point out how we continue using methods that don’t work because we don’t know any better. When my granddaughter had her fourth ear infection in as many months, I told my physician husband, “What you’re doing is not working! DO SOMETHING ELSE!”
The next day, while looking for that something else, he read about a study using xylitol sweetened chewing gum, and how chewing two sticks four times a day cut ear infections by more than 40%. Unfortunately, my granddaughter was too young to chew gum. Since xylitol works on the bacteria that cause the infection and these bacteria live in the nose, my husband decided to put it into a nasal spray.
My granddaughter’s ear infections went away when her parents used the Xlear xylitol nasal spray before every diaper change. Ten other children in my husband’s practice, which used the Xlear nasal spray in the same way, had their doctor visits for ear aches reduced by more than 90%. In a clinical trial done in the Czech Republic, using the xylitol nasal spray three times a day reduced visits by 80%.
Ear aches are a problem for parents who have to comfort their babies and toddlers suffering from a very painful condition. They are also a problem for doctors who want to prevent antibiotic resistance. It needs to be better understood that ear aches are also a problem for teachers trying to do their jobs with a child whose ability and potential has been needlessly compromised.
If we can reduce chronic ear infections by 90% simply by keeping a baby’s nose clean, reduce ear-ache-related visits to the doctor and reduce prescriptions for antibiotics that lead to resistance, then what my husband is doing is working and…
we need to do more of it!