Sunday, 2 February 2014

Ear Infections in Children - Otitis Media(OM).



OM is extremely common in pediatric patients; in fact, it is the most common reason for pediatric (up to 15 years of age) primary care visits. This is largely due to the anatomy of the pediatric eustachian tube. Studies have found no bacterial etiology in aproximately 60% of OM cases. However, the remaining of OM patients exhibit bacterial pathogens (haemophilus influenza, Streptococcus pneumonia, and Brahnamella catarrhalis)
If Bacterial OM--monitor closely for signs of complication. Please note these are very rare!! T.M. rupture, meningitis, cranial nerve palsies, abscess, lateral sinus thrombosis.

1. Dietary measures
*diet high in bioflavonoids helps decrease allergic and inflammatory responses (like mucous buildup and subsequent plugging of normal anatomic drainage).
allergy rotation or elimination diets are important in managing chronic OM presentations. The most common food allergies include wheat, cow's milk, soy, corn, and strawberries.
*recommended diet: high in fresh vegetables, beans, lean meats, and fish. Avoid mucous forming sources, such as wheat, dairy, and orange juice.
*Probiotics modulate immune function and decrease allergic response. Probiotics given within the first year of life are preventive and can significantly decrease the number of ear infections during childhood.

2. Lifestyle changes
*parental or caregiver smoking is strongly associated with increased risk of upper respiratory conditions and OM in children
*pacifier use and thumb sucking is associated with increased risk of upper respiratory tract infections and OM

3. Botanical medicine 
*Matricaria chamomila/recutita: a safe and effective antiviral, anti-inflammatory, and vulnerary that is used extensively in the treatment of OM. Strong infusions are considered excellent first-line approaches for acute or chronic OM. Chamomile is contraindicated for patients who are allergic to asters and chrysanthemums.
*Echinacea angustifolia/purpurea: well-studied botanical remedies for the prevention and treatment of colds and flue. Also safe and effective in the treatment of both acute and serous OM. Glycerinates are available for infants. Echinacea is contraindicated for patients with autimmune disease.
*Zingiber officinalis: also indicated in OM accompanying a cold with clear and watery mucous. Ginger is best combined with other botanicals in tea or syrup


4.Homeopathy
The following homeopathic remedies are most commonly chosen for acute otitis media:
*Ferrum Phosphoricum: the most commonly used remedy for early OM. Indication include gradual onset of symptoms, flushed face, dislike of noise or stimulation, and desire to lie still.
*Belladona: recommended in right ear OM, flushed face, fever, restlessness, scant thirst, and sensitivity to noise or light.
*Chamomilia: indicated for Om in irritable and cranky children who cannot be appeased for a long time; one cheek is red while other is pale; and aggravation by heat
*Kali muriaticum: recommended when patients experience fullness and congestion in the ear, impaired hearing, and popping or crackiling sounds on swallowing. This remedy is commonly used to clear the eustachian tubes when serous fluid persists after acute OM.
*Pulsatilla: usually used for earaches that are accompanied with white nasal discharge, thirstlessness, and throbbing pain in the ear that is aggravated by heat. Also indicated in the treatment of OM when the child exhibits changing moods (clingy, weepy, fidgety) with a need to be consoled.

5. Applied Kinesiology to treat birth injuries and Chiropractic for very gentle re-alignment of the upper cervicals.

6. Pain Relief
*Ear oil is a traditional and effective method of providing comfort for the pediatric OM patient (and their parents) and in many cases will be enough of an intervention to alleviate the condition altogether. Seek traditional or proprietary ear oil brands contaiing Olive oil with Mullenin (Verbascum thapsus), St. John's Wort (Hypericum perforatum), Calendula (Calendula officinalis), Garlic (Allium sativa) extracts. Hyperosmotic glycerol "glycerine USP" ear drops, will draw fluid through the semi-permeable tympanic membrane (ear drum) and provide almost instant pain relief. 

7. Clinical Nutrition
  • Omega 3-6-9, selenium, Vitamin C complex, Echinacea, Zinc

As always,it is very important to remember that your child is unique and I will treat him/her as a whole being and the therapies are taylor made for him.
In the past I’ve had excellent results in treating these children, especially if the ear infection is chronic and does not clear up with antibiotics.

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