Ear Infections: To Tube Or Not To Tube

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

1. Ramakrishna T. Vitamins and brain development. Physiol Res1999;48(3):175-187. Brown JL, Sherman LP. Policy implications of new scientific knowledge. J Nutr 1995;125(8S):2281S-2284S. Schoenthaler SJ, Bier ID, Young K, et al. The effect of vitamin-mineral supplementation on the intelligence of American schoolchildren: a randomized double-blind placebo-controlled trial. J Altern Complement Med 2000;6(1):19-29.

2. Leiva PB, Inzunza BN, Perez TH, et al. The impact of malnutrition on brain development, intelligence and school work performance. Arch Latinoam Nutr 2001;1(1):64-71.
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