Disease Proof

Last Friday we learned that ear infections are over-treated. In case you missed it. Here’s a quote from Dr. Fuhrman that helps explain why:

Studies show that the majority of ear infections are of viral etiology. For example, 75 percent of pediatric ear infections were caused by common respiratory viruses in a microbiological survey.1 Generally speaking, the use of antibiotics should be reserved for serious or life-threatening infections, not conditions that the body is well-equipped to resolve on its own.

Now, here’s more reason to hold the antibiotics. New research has determined that antibiotics do little for inner eat infections. Steven Reinberg of HealthDay News reports:

Dutch researchers did a meta-analysis of several previously published studies and found the results don't support the use of antibiotics for the fluid buildup that can accompany inner ear infections.

"Due to the marginal effect and the known negative effects of prescribing antibiotics, such as the development of antibiotic resistance and side effects, we do not recommend prescribing antibiotics to prevent middle ear effusion," said lead researcher Maroeska M. Rovers, from the Julius Center for Health Sciences and Primary Care at the University Medical Center Utrecht in The Netherlands.

Ear infections are very common among infants and children. They can lead to fluid buildup in the ear, which is known as otitis media with effusion. This buildup can result in hearing loss, which can affect language development, cognitive development, behavior and quality of life, according to the researchers.

Hey parents, do me a favor. In the comments tell me what you do when your young children get ear infections—I imagine its tough to resist just taking them to the doctor.

“Whether bacterial or not, our children get a routine prescription for an antibiotic at every minor illness,” explains Dr. Fuhrman. And when it comes to ear infections kids are REALLY getting hit with the antibiotic stick. More from Dr. Fuhrman:

In some European countries, antibiotics are used for ear infections only when there is a persistent drainage or persistent pain because these infections resolve on their own more than 85 percent of the time without treatment.1 Studies show that the majority of ear infections are of viral etiology. For example, 75 percent of pediatric ear infections were caused by common respiratory viruses in a microbiological survey.2 Generally speaking, the use of antibiotics should be reserved for serious or life-threatening infections, not conditions that the body is well-equipped to resolve on its own.

Adding fuel to the fire, Laurie Tarkan of The New York Times wants to know, are ear infections too often misdiagnosed and then over-treated? Let’s find out:

One reason why ear infections are so often overdiagnosed is that they can be hard to identify in young children, especially ones in screaming pain. “You’re dealing with a tiny subject, the baby or toddler, where the ear canal is narrow and tends to be occluded with wax, which you must remove to see the eardrum, and doing that can be a harrowing experience,” said Dr. Jack Paradise, professor emeritus of pediatrics at the University of Pittsburgh School of Medicine. Doctors then have to interpret what can be subtle differences between an ear inflamed by crying or fever and a true ear infection. “Many if not most practitioners have difficulty in this area,” Dr. Paradise said…

…In 80 to 90 percent of ear infections, the bacterial infection will clear up on its own. Though these bacteria are not typically harmful in and of themselves, clearing up the infection sooner with antibiotics can hasten pain relief. A trade-off is drug side effects like nausea, upset stomach, diarrhea and even rare, life-threatening allergic reactions. “For every case of ear infection that goes away faster, we may cause between three and seven cases of diarrhea,” Dr. Powers said. “We’ve moved the problem from up North to down South.” The use of antibiotics can also increase a child’s susceptibility to new ear infections.

This easy way out of ear infections does carry serious risks. Dr. Fuhrman talks about how antibiotics can actually lead to more—not fewer—ear infections. Have a look:

The vicious cycle of poor nutrition and the overuse of antibiotics works to place a tremendous disease burden on the future health of our children. We bring our young (improperly fed) children to physicians with their first ear infection. At this point the majority of these infections are viral, not bacterial. Nevertheless whether it's viral, bacterial, fungal, or some mixture, a healthy child has no problem recovering from an ear infection without antibiotics. In the United States almost all these children are routinely given antibiotics. Taking the antibiotic kills off the beneficial bacteria and promotes the colonization of more disease-causing strains, and now the next ear infection has a greater chance of being bacterial, not viral. Viral, bacterial, or a mixed infection, it matters not, because at the next visit your kid gets another antibiotic anyway, starting the cycle of infection after infection, antibiotic dependency, and impaired immune function.

I guess the lesson to be learned here is, don’t mortgage the future for the present—quick-fixes are not without their price tag.

It seems that a certain strain of ear infection has become quite the advisory. Serena Gordon of HealthDay News explains:

An emerging "superbug" that causes ear infections in children and is resistant to multiple antibiotics can only be treated with an adult medication, researchers report.

Two Rochester, N.Y., pediatricians report finding a multiple antibiotic-resistant strain of Streptococcus pneumoniae that caused ear infections in nine children in their practice over three years. The only antibiotic that was effective in treating these infections was levofloxacin, which isn't approved by the U.S. Food and Drug Administration for use in children.

"We found a superbug causing ear infections in Rochester -- the Legacy strain -- that's resistant to all antibiotics approved by the FDA for use in children," said the study's lead author, Dr. Michael Pichichero, a professor of microbiology, immunology and pediatrics at the University of Rochester Medical Center, and a private practice pediatrician with the Legacy Pediatric Group.

The resistant infections accounted for only 1.5 percent of the ear infections in their practice, Pichichero noted.

Could the problem be the overuse of antibiotics? More from Dr. Fuhrman:

Most doctors want to please their patients and they want to do it quickly and move to the next patient as soon as they can. Patients often expect them for common respiratory illnesses and many doctors comply with their wishes. Antibiotics as a solution work great; they enable the doctor to maintain their important role in the eyes of the patients, reinforce the value of doctor visits, and allow the patient to think their care was indispensable. The only problem is that most prescriptions are either not needed, or not in the best long-term interest of the patients.

Why do kids get ear infections? Well, I’m no doctor. So I can’t say for sure, but, according to Dr. Fuhrman improper nutrition is a major contributing factor. A reason that most likely goes overlooked, because after all, it’s easier just to write a prescription for antibiotics.

In a previous post Dr. Fuhrman shares the story of one little girl who kicked her persistent ear infections not with antibiotics, but with nutritional excellence. Take a look:

When Stephanie Rogers, a typical seven-year-old girl, became my patient, her parents handed me a printout from the local pharmacy documenting the filling of 67 rounds of antibiotics at the cost of $1,643.80 by the ripe age of seven. Once the pediatric group started prescribing the antibiotics for minor complaints of fever and cough, it escalated to ear infections, sinus infections, and finally visits to the ear specialist by the age of four. She received 15 separate prescriptions of antibiotics when she was five years old. The first year she was my patient, the entire family changed its diet style. Stephanie went along for the ride and did fine. I did use an antibiotic once for her that next winter, when she had a persistent high fever and a red painful eardrum; however, that was the last time an antibiotic prescription was necessary. Luckily, Stephanie has been free of antibiotics ever since.

And here’s a little more proof that nutrition has something to do with ear infections. New research claims there is a link between body fat and a certain type of ear infections, meaning overweight children might be at a heightened risk of ear infections. Randy Dotinga of HealthDay News is on it:

Scientists in South Korea have uncovered a possible connection between body fat in children and a certain kind of ear infection, but several specialists in the United States are expressing doubts about the research.

If the link does exist, however, it could provide doctors with yet another indication of how extra fat is bad for kids just as it is for adults. "We have to pay close attention to decrease childhood obesity," said study co-author Dr. Seung Geun Yeo, a researcher at Kyung Hee University in Seoul.

Ear infections in children remain very common, affecting as many as eight or nine of every 10 kids. Doctors blame the middle ear, which often cannot fully drain fluid as it is developing.

It sure seems like so many things come back to nutrition. And yet, we don’t pay it enough attention. It’s a shame that we evolved these big brains, because so many of us don’t use them. Here are a few more posts about ear infections:

• Report: Ear Tubes Hit or Miss
• Inappropriate Use of Antibiotics
• Ear Infections and Antibiotics

Now I had ear tubes, I don’t really know why? I was little at the time and don’t remember much about it. According to my mother I used to get a lot of ear infections and my doctor at the time thought it was the best course of action. And back then it didn’t seem that usual because almost all my classmates were getting them. It was kind of like a first grade rite of passage.

Of course I’m older now and regularly exposed to alternative points of view; most notably Dr. Fuhrman’s. So to say the least, I wish my parents hadn’t fed me milk—especially since I later found out that I’m very lactose intolerant. Maybe if they skipped the milk I might have avoided some of those ear infections that led to my tubing. Disease-Proof Your Child has more on this:

Ear infection, or otitis media is the most common medical problem for children in the United States, and it is the most common reason for prescribing antibiotics for infants and children. Not only do nine out of ten children develop at least one ear infection each year, but almost one-third of these children develop chronic congestion with fluid in the middle ear that can lead to hearing loss and make the child a candidate for myringotomy, or tube placement by a specialist.

Babies who drink from a bottle while lying on their backs may get milk and juice into their eustachian tubes, which increases the occurrence of ear infections. Children who are breast-fed for at least a year have been shown to have much fewer infections than those weaned earlier.1

So as you can imagine, this next report compelled me. According to Reuters a new study found that children who didn’t receive tubes suffered no additional developmental difficulties than children who underwent the tubing procedure. Gene Emery reports:

But a new long-term study challenges that practice, saying it does nothing to help most youngsters with fluid-filled ears develop normally.

In a study to be published in the New England Journal of Medicine on Thursday, researchers from several institutions studied hundreds of otherwise-healthy children up to 11 years old in the Pittsburgh area. They tested the benefits of a procedure that once was the second-most common surgery in the United States and found none.

Even when it doesn't cause pain, an ear infection can cause fluid to build in the middle ear, muffling hearing. Because hearing is essential to speech development, doctors and parents worried that persistent middle ear infections could cause developmental problems.

Now, since I’ve grown up to become the kind of person who doesn’t like going to the doctor, popping pills, or undergoing medical procedures, news reports like this make me curious. Was there a better way? Did I really need tubes? Maybe if my parents paid better attention to my nutrition I could have avoided the whole thing. Just makes me wonder, you know what I mean?

For more on tubing and ear infections, check out these previous posts:

• Nutrition as Medicine
• Ear Infections: To Tube Or Not To Tube
• Childhood Ear Infections: A Multibillion-Dollar Industry

A recurring topic here on DiseaseProof is the misuse and overuse of antibiotics. According to Dr. Fuhrman antibiotics are too often prescribed for conditions that when treated with proper nutrition will resolve naturally, without medication—ear infections are a big one. More from a previous post entitled Childhood Ear Infections: A Multibillion-Dollar Industry:

Studies also point to the fact that most ear infections early in life are viral, not bacterial.1 The vast majority of ear infections resolve nicely on their own, whether bacterial or viral, without an antibiotic. It is a common practice in this country to treat all ear infections with an antibiotic. Whether bacterial or not, our children get a routine prescription for an antibiotic at every minor illness. This cycle often is repeated many times, which may beget other medical problems in adulthood…

…Another international study following over 3,000 children treated by general practitioners in nine countries showed that antibiotics did not improve the rate of recovery from ear infections. Nearly 98 percent of U.S. physicians in the survey prescribed antimicrobials routinely, the highest percentage of all countries surveyed.2 The variable showing the strongest relationship with protection from ear infections was breast-feeding.3

So after considering all this, I wasn’t exactly surprised by the contents of this report from the American Academy of Family Physicians (AAFP). Apparently a lot of patients associate antibiotics with pain-management, which doesn’t appear to be a good thing. Read on:

"Our study suggests that the patient's desire for an antibiotic may be based on the mistaken view that this treatment is best for pain relief," say Mieke van Driel, M.D., M.Sc., of the department of general practice and primary health care at Ghent University, Belgium, and the other authors. They call for a clinical trial "to find out whether exploring patients' expectations about treatment for pain and offering adequate analgesic treatment can assist physicians in the management of sore throats more often without prescribing antibiotics."

Now, I’m sure most people can relate to this. When you’re hurting, priority one is stopping the pain, and in a distant second is determining the source or cause of your discomfort. So with this being said, I decided to get a professional opinion on the AAFP’s report. And here’s what Dr. Fuhrman had to say:

Everyone knows antibiotics are overused by physicians and that they are dangerous drugs. So called “Lyme Disease” specialists and some of the labs that support them are some of the worst offenders, repeatedly falsely diagnosing patients with chronic Lyme, and giving antibiotics because they can relieve pain and make patients feel better from a host of potential causes. All physicians should work aggressively to curtail unnecessary antibiotic use.

Most doctors want to please their patients and they want to do it quickly and move to the next patient as soon as they can. Patients often expect them for common respiratory illnesses and many doctors comply with their wishes. Antibiotics as a solution work great; they enable the doctor to maintain their important role in the eyes of the patients, reinforce the value of doctor visits, and allow the patient to think their care was indispensable. The only problem is that most prescriptions are either not needed, or not in the best long-term interest of the patients.

Nutritional excellence practically negates the need for most prescriptions such as those prescribed for headaches, cholesterol lowering, high blood pressure and diabetes. Antibiotics are more dangerous, than most physicians and their patients consider. I believe much more care should be taken to restrict antibiotic use to only the most severe infections and documented bacterial conditions.

• Antibiotics, are they the be-all-end-all? Dr. Fuhrman believes they’re over-prescribed, especially when it comes to ear infections. And according to The New England Journal of Medicine they might not be needed for treating bronchitis either. January W. Payne of The Washington Post reports:

Doctors can't help patients recover more quickly by prescribing antibiotics, said Richard P. Wenzel, chairman of the Department of Internal Medicine at Virginia Commonwealth University. “There is probably some sense of a placebo effect, but that's short-lived,” he said.

• Here’s a heartfelt piece written for The New York Times by Dr. Kent Sepkowitz, the director of infection control at Memorial Sloan-Kettering Cancer Center. Have hospitals grown so cold that doctors can’t shed a tear with patients during a time of grief? Read on:

Given the intensity and high-voltage anxiety of serious illness, public crying in hospitals — by patients or family or staff — is less common than one might expect. Sure, it goes on more frequently than, say, at a department store or a restaurant. But more often, people remain buttoned up, dry-eyed, determined to maintain composure.

• Africa, too, is facing an obesity problem.  Clare Nullis from the Associated Press has more:

Africa, a continent usually synonymous with hunger, is falling prey to obesity. It's a trend driven by new lifestyles and old beliefs that big is beautiful. Ask Nodo Njobo, a plump hairdressing assistant. She is coy about her weight, but like many African women, proud of her "big bum." She says she'd like to be slimmer, but worries how her friends would react.

• According to Dr. Fuhrman there are lots of good reasons to maintain healthy body weight, such as disease prevention and increased longevity. But, as Will Dunham of Reuters reports, keeping a healthy body weight is even more important for cancer survivors:

Staying slim and fit is especially important for cancer survivors, because obesity raises the risk of cancer coming back, the American Cancer Society said in new guidelines issued on Wednesday.

• Guess what? More bad news for smoking—don’t act so shocked, this happens all the time. Robert Preidt of HealthDay News reports pregnant mothers who smoke might actually be priming their kids to pick up the habit:

Children whose mothers smoked during pregnancy were nearly three times more likely to start smoking regularly at, or before, age 14 and about twice as like to start smoking after age 14 compared to children born to nonsmoking mothers.

• Okay, how many of you belong to a gym? I do. Have you ever really looked at some of the trainers? A lot of them could use a personal trainer themselves—they’re pumped up, but a little doughy. So this begs the question, how qualified are they? Rick Callahan of the Associated Press investigates:

Virtually anyone can become a certified trainer because there are no national educational standards for the field. Numerous Web sites offer personal trainer certification after just a few hours of online training -- and a few hundred dollars.

• Apparently leafy greens, like broccoli rabe and escarole, are gaining popularity in the United States—sounds good to me! Beth Fortune of The Los Angeles Times talks about this growing trend:

And at this time of year, bitter greens are calling from nearly every other stall or stand at the farmers market or the grocery store; they're a boon of winter. Until fairly recently, bitter greens have been popular in this country only in the South, but more of them have become more widely available, though their names still can be confusing. Greens in the chicory and endive family include Belgian endive (also called French endive and witloof), curly endive (sometimes called chicory or frisée), escarole and several varieties of radicchio. Then there are dandelion greens, mustard greens and turnip greens (yes, keep the tops of your turnips).

• There shouldn’t be any real surprise here—more negative press for smoking. According to Reuters tobacco-related illnesses will kill 50 percent more than AIDS by 2015. I wonder how obesity stacks up against these figures. More from the report:

The study by World Health Organization researchers projects global figures for mortality and the burden of 10 major disease groups in both 2015 and 2030.

"According to our baseline projection, smoking will kill 50 percent more people in 2015 than HIV/AIDS and will be responsible for 10 percent of all deaths globally," said their study in the Public Library of Science Medicine.

In Disease-Proof Your Child Dr. Fuhrman’s position on treating childhood ear infections certainly deviates from common medical practice. How so? I’ll let him explain:

Studies also point to the fact that most ear infections early in life are viral, not bacterial.1 The vast majority of ear infections resolve nicely on their own, whether bacterial or viral, without an antibiotic. It is a common practice in this country to treat all ear infections with an antibiotic. Whether bacterial or not, our children get a routine prescription for an antibiotic at every minor illness. This cycle often is repeated many times, which may beget other medical problems in adulthood.

What, no antibiotics? For some this is hard to believe. Hey, it shocked me too. As a kid I got tons of ear infections, and each time my doctor prescribed antibiotics. Now, Dr. Fuhrman believes antibiotics should only be administered if the condition lingers or worsens. Not a bad idea considering all the news about the emergence of antibiotic-resistant bacteria and viruses.

Julie’s Health Club shares this concern. Today she’s taking a look at a recent study published in Journal of the American Medical Association advocating a wait-and-see approach for treating ear infections. Here’s a quote from the study that sounds awfully familiar:

"In this country, 96 to 98 percent of physicians treat ear infections immediately with antibiotics, even though most cases will resolve on their own without treatment," lead researcher David Spiro told Web MD, an on-line source of health information.

Julie points out that approximately 15 million prescriptions for antibiotics to treat childhood ear infections are written each year.

For more on ear infections and antibiotics, check out this previous post: Childhood Ear Infections: A Multibillion-Dollar Industry

Jane E. Brody of The New York Times takes a look at the conventional medical practice of surgically implanting tubes in the ears of children with persistent ear infections. This old standby seems to be coming under new scrutiny:

The tubes were intended to remain in the ear for up to 14 months. By then, many children outgrow the problem. After age 3 or 4, Dr. Robert Stenstrom of St. Paul’s Hospital in Vancouver explained, the eustachian tube lengthens and changes position, reducing the risk of middle ear infections and fluid buildup.

Still, after the tubes are removed or fall out on their own, many children need to have them replaced at least once. Each operation involves general anesthesia and the risks it entails.

According to a new long-term study by Dr. Stenstrom and colleagues, when young children were randomly assigned to receive ear tubes or to be treated daily with antibiotics, those with ear tubes suffered greater damage to their eardrums and had, on average, poorer hearing 6 to 10 years after the tubes were removed.

Although the tube design has changed and daily antibiotics are no longer recommended, this controlled clinical trial calls into question whether the benefits of ear tubes outweigh the risks.

In Disease-Proof Your Child Dr. Fuhrman explains feeding children a healthy diet and avoiding dairy products (especially in infancy) is crucial for preventing ear infections:

Babies who drink from a bottle while lying on their backs may get milk and juice into their eustachian tubes, which increases the occurrence of ear infections. Children who are breast-fed for at least a year have been shown to have much fewer infections than those weaned earlier.1

Dr. Fuhrman also condemns continually using antibiotics to remedy ear infections:

Studies also point to the fact that most ear infections early in life are viral, not bacterial.2 The vast majority of ear infections resolve nicely on their own, whether bacterial or viral, without an antibiotic. It is a common practice in this country to treat all ear infections with an antibiotic. Whether bacterial or not, our children get a routine prescription for an antibiotic at every minor illness. This cycle often is repeated many times, which may beget other medical problems in adulthood.

For more on this topic check out an earlier post: Childhood Ear Infections: A Multibillion-Dollar Industry

Ear infection, or otitis media is the most common medical problem for children in the United States, and it is the most common reason for prescribing antibiotics for infants and children. Not only do nine out of ten children develop at least one ear infection each year, but almost one-third of these children develop chronic congestion with fluid in the middle ear that can lead to hearing loss and make the child a candidate for myringotomy, or tube placement by a specialist.

Babies who drink from a bottle while lying on their backs may get milk and juice into their eustachian tubes, which increases the occurrence of ear infections. Children who are breast-fed for at least a year have been shown to have much fewer infections than those weaned earlier.1

Studies also point to the fact that most ear infections early in life are viral, not bacterial.2 The vast majority of ear infections resolve nicely on their own, whether bacterial or viral, without an antibiotic. It is a common practice in this country to treat all ear infections with an antibiotic. Whether bacterial or not, our children get a routine prescription for an antibiotic at every minor illness. This cycle often is repeated many times, which may beget other medical problems in adulthood.

One of Dr. Fuhrman's patients sent in the following story a few years ago. It appeared previously in his Dr. Fuhrman's Healthy Times newsletter.:

As a graduate student in the mid-1980s, I suffered from asthma, headaches, and allergies. I took the oral medication theophylline, plus two inhaled medications for my asthma, Tylenol for my headaches, and Sudafed for my allergies. I developed bronchitis at least once each year, for which I took antibiotics and sometimes codeine. After a while, I developed recurring migraine headaches, for which I tried the standard medication.

My diet had always been fairly mainstream. I had experienced many food allergies throughout my life, and found that raw fruits and vegetables made my tongue, throat, and the inside of my mouth itchy and uncomfortable. As a result, I ate all of my vegetables cooked, except for lettuce, cucumbers, and tomatoes. I avoided fruit altogether, hoping to prevent allergic reactions. As years went by, I became more aware of the importance of healthful eating and improved my diet somewhat. But it wasn't until after my first child was born that I found out about a truly healthful approach to eating.

My son was born in 1994. By the time he was 18 months old, he was on antibiotics and suffering with his fourth ear infection. Fortunately, I was referred to Joel Fuhrman, M.D. After one consultation with Dr. Fuhrman, I changed my son's diet. He has never suffered another ear infection.

After reading a few articles and information sheets about nutrition by Dr. Fuhrman, and attending one of his lectures, I began to make small changes in my diet. For one thing, I began to eat a large salad with my lunch every day, without fail. I felt a little bit healthier, but I still wasn't committed to following all of Dr. Fuhrman's nutritional advice. The real turning point for me came when Dr. Fuhrman helped me through a severe sinus infection. Only then did I realize I had found an expert on whom I could confidently rely for tangible benefits.

I often got a cold early in the winter. My sinuses would clog up, and I would feel uncomfortable for months. Dr Fuhrman gave me a menu plan of nothing but raw fruits and vegetables, and stated that my sinuses likely would clear in three days. I pointed out that this condition had already lasted almost two months, to which he replied it might take as long as ten days. I followed his instructions exactly, and one week later my sinuses were clear. I was hooked; I use this method whenever I catch a cold and have not had bronchitis or sinusitis since. No more antibiotics for me!

There were more benefits to come. I had my second child in 1999, and during the pregnancy I developed psoriasis. I consulted with a dermatologist who put me on a strong steroidal ointment. When I told Dr. Fuhrman about it, he increased my intake of omega-3 by adding a tablespoon of ground flaxseed and a handful of walnuts each day, increased the amount of vegetables, and had me totally eliminate milk products. The outbreaks came less frequently, which was good, but they didn't go away completely. By the time 2002 rolled around, I was totally fed up with the psoriasis (and using steroid creams). So I went back to Dr. Fuhrman again and asked how I could really fix it. He put me on what I call my "green diet," which is essentially the same as the diet he recommends in his book Eat To Live.

These days, I eat a pound of raw veggies (mostly leafy greens) and a pound of cooked green veggies each day, with unlimited fruits and beans, and eat only a small amount of starchy vegetables and grains. I consume no extracted oils, about one half an avocado, and only a small amount of raw, unsalted nuts and seeds in addition to my flaxseed and walnuts. I include eggs and fish in my diet about once each week.

On this plan, my psoriasis has mostly disappeared, reoccurring only when I deviate from my diet and include too many starches. Even then, it is much milder. I can use the ointment for a few days and the psoriasis won't reappear for months. I feel good. Headaches, asthma, bronchitis, and severe allergies are in the past. I take no medications and breathe easily. Although I did not switch all at once to Dr. Fuhrman's recommended diet, each step I took was permanent. I have made steady improvements in my health over the course of sixteen years. This step-by-step approach has worked wonders for me.

Ear infection, or otitis media, is the most common medical problem for children in the United States, and is the most common reason for prescribing antibiotics for infants and children. The typical doctor does not take care to avoid the overuse of these potentially dangerous drugs, and he does not champion nutritional excellence to prevent future infections.

When Stephanie Rogers, a typical seven-year-old girl, became my patient, her parents handed me a printout from the local pharmacy documenting the filling of 67 rounds of antibiotics at the cost of $1,643.80 by the ripe age of seven. Once the pediatric group started prescribing the antibiotics for minor complaints of fever and cough, it escalated to ear infections, sinus infections, and finally visits to the ear specialist by the age of four. She received 15 separate prescriptions of antibiotics when she was five years old. The first year she was my patient, the entire family changed its diet style. Stephanie went along for the ride and did fine. I did use an antibiotic once for her that next winter, when she had a persistent high fever and a red painful eardrum; however, that was the last time an antibiotic prescription was necessary. Luckily, Stephanie has been free of antibiotics ever since.

An international study following more than 3,000 children treated by general practitioners in nine countries showed that antibiotics did not improve the rate of recovery from ear infections. But nearly 98 percent of U.S. physicians in the survey prescribed antimicrobials routinely, the biggest percentage of all countries surveyed.

As a result of accumulating evidence documenting the dangers of antibiotics and their overuse, new guidelines for treating ear infections in children were just released from a joint effort of the American Academy of Family Physicians and the American Academy of Pediatrics. These guidelines represent a major shift in policy and thinking by physician leadership. The guidelines encourage doctors to initially manage the pain and not prescribe antibiotics for children with ear infections and to defer antibiotic use for the sicker children who are not improving two or three days later. I hope doctors will heed this message.

The story of Stephanie Rogers (not her real name) is from the book Disease-Proof Your Child.

One group of people I thought about frequently as I wrote Disease-Proof Your Child are those families who suffer from the vicious cycle of recurrent ear infections. What we have learned from the best available research is that getting antibiotics from our doctor for typical childhood infections may not be so wise. Plenty of medical authorities agree that antibiotics are overused, and are of no value against viral infections.

Now we are also discovering that antibiotic use may predispose our children to more frequent and more serious infections.

The American Academy of Family Physicians and the American Academy of Pediatrics recently released joint guidelines for doctors advising doctors not to prescribe antibiotics for ear infections unless they are severely ill or not improving on their own in three days. These guidelines represent a major shift in policy and thinking by physician leadership.

Disease-Proof Your Child takes these guidelines a step further.

My new book instructs parents how to feed their children to increase their natural resistance to infection, and to prevent those allergies, runny noses, and frequent illnesses. I believe food is the most effective medicine to keep your child away from the doctor's office. In Disease-Proof Your Child I discuss hundreds of medical studies that document that what you feed your children in the first 10 years of life can have far-reaching effects of their health for the rest of their life.

If you are a parent or parent-to-be and want scientific guidelines to keep your child from getting sick frequently, Disease-Proof Your Child is a book for you.

In my practice, it is common for me to see a parent whose child only eates macaroni and cheese, french fries, chicken nuggets, pizza, and cold cereal with milk. Parents routinely tell me, "Johnny won't eat any fruits and vegetables!" Incredible as it seems, high-calorie, trans-fat-filled french fries are the most common vegetable eaten by young children today. Twenty-five percent of children eat fast food french fries daily.

The Petersons brought their three-year-old son, Joshua, to see me because his prior physician had prescribed twelve seperate antibiotic prescriptions for recurrent ear infections in less than nine months. Most often, within a few weeks of stopping the antibiotic, he was sick again with another illness. The latest advice from their pediatrician was to put Joshua on a low dose of antibiotics continuously to help reduce the incidence of these infections. I explained to them that for Joshua to stay well and not require antibiotics, he had to adopt a dietry program of superior nutrition. They laughed.

The Petersons didn't need me to tell them that Joshua's diet was inadequate. They clearly knew it. They did not think it was possible to get Joshua to eat healthy food. They were wrong. The followed my advice for reforming their picky eater and when they returned to my office one month later, they proudly reported to me that he was eating a diet of all healthy food. Importantly, they accomplished this without difficulty. We stopped his antibiotics, and he proceeded through that winter without any further ear infections.

When a family first brings their chronically ill child in to see me, I insist that the entire family come--both parents and all siblings--so that we can devise a new eating plan for the entire family. The focus is never solely on the ill child. For the ill child to recover, the crucial first step is for the entire family to make a recovery from their less than optimal diet style.

When the Petersons insisted, "Josh won't eat fruits or vegetables," I explained to them that all children would eat healthfully if ship-wrecked. True hunger is difficult to deny. If faced with limited options, they will gleefully eat whatever food is available, without intellectual gymnastics to get them to.

It is not necessary to coax them to eat or to eat healthfully. In fact, battling about food with your child is counterproductive. The trick here is to adhere to this one most important rule: only permit healthy food in your home. Children will eat whatever is available. They will not starve themselves to death; they will adapt easily and learn relatively quickly to like the food that is offered.

The story of Josh Peterson (not his real name) is from Disease-Proof Your Child by Joel Fuhrman M.D. To learn more about this new book, or to buy a copy of Disease-Proof Your Child, click here.