Also indexed as: Glue Ear, Otitis Media
Ears prone to infections can lead to symptoms such as fever,
irritability, and sleeplessness. According to research or other evidence, the following steps
may help keep your family’s ears clear:
- Try xylitol
- Control mouth bacteria that cause ear infections by chewing gum or
eating candy sweetened with xylitol, a natural sugar found in fruit
- Steer clear of smoke
- Stop smoking and avoid all sources of passive cigarette smoke
exposure to reduce ear infection recurrences
- Pass up pacifiers
- Reduce ear infection risk in babies by weaning them off
- Uncover food allergies
- Work with a knowledgeable health professional to find out if food
allergies are causing infections
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full recurrent ear infections
article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and
dietary and lifestyle changes that may be helpful.
About recurrent ear infections
Many children suffer recurrent infections of the middle ear, a condition also known as
otitis media (OM).
Product ratings for
recurrent ear infections
What are the symptoms?
Ear infections can cause irritability, difficulty sleeping, runny nose, fever, fluid
draining from the ear, loss of balance, mild to severe ear pain, and hearing difficulty.
Untreated infections can cause permanent hearing impairment and can also spread to other parts
of the head, including the brain. Frequent or persistent ear infections in children can reduce
their hearing when normal hearing is critical for speech and language development.
Over-the-counter analgesics, such as
acetaminophen (Tylenol®), naproxen
(Aleve), and ibuprofen (Motrin IB®), may
help relieve pain associated with acute ear
Prescription drug treatment for acute ear infections usually consists of antibiotics, such as amoxicillin/clavulanate
(Zithromax®), and cephalexin
(Keflex®). Serous otitis, which results from the accumulation of fluid in the tubes that
drain the middle ear, may eventually lead to an acute ear infection. Though antibiotics are
frequently used for serous otitis, the benefit is often small and side effects or drug
resistance may result. 1 2
Chronic infections or persistent fluid in the ear many require myringotomy, an operation in
which small “tympanostomy tubes” are inserted in the affected eardrums. The
procedure equalizes ear pressure and allows drainage of fluid from the middle ear. Enlarged or
infected adenoids may be removed (adenoidectomy) during the myringotomy procedure. Though
frequently performed, myringotomy has not consistently demonstrated long-term efficacy for
preventing recurrent ear infections. 3
Dietary changes that may be helpful
The incidence of allergy among children
with recurrent ear infections is much higher than among the general public.4 In one
study, more than half of all children with recurrent ear infections were found to be allergic
to foods. Removing those foods led to significant improvement in 86% of the allergic children
tested.5 Other reports show similar results.6 7 In one
preliminary study, children who were allergic to cow’s milk were almost twice as likely to have recurrent ear
infections as were children without the allergy.8 People with recurrent ear
infections should discuss allergy diagnosis and elimination with a doctor.
Although sugar intake has not been studied in relation to recurrent ear infections, eating
sugar is known to impair immune
function.9 10 Therefore, some doctors recommend that children with
recurrent ear infections reduce or eliminate sugar from their diets.
Lifestyle changes that may be helpful
When parents smoke, their children are more likely to have recurrent ear
infections.11 It is important that children are not exposed to passive smoke.
Humidifiers are sometimes used to help children with recurrent ear infections, and animal
research has supported this approach.12 Nonetheless, human research studying the
effect of humidity on recurrent ear infections has yet to conclusively show that use of
humidifiers is of significant benefit.
Use of pacifiers in infants increases the risk of ear infections.13
Vitamins that may be helpful
Xylitol, a natural sugar found in some
fruits, interferes with the growth of some bacteria that may cause ear
infections.16 17 18 In double-blind research, children who
regularly chewed gum sweetened with xylitol had a reduced risk of ear infections.19
20 However, when they only chewed the gum while experiencing respiratory
infections, no effect on preventing ear infections was found.21
Vitamin C supplementation has been reported
to stimulate immune function.22
23 As a result, some doctors recommend between 500 mg and 1,000 mg of vitamin C per
day for people with ear infections. Nonetheless, vitamin C supplementation has not been
studied by itself in people with ear infections.
Zinc supplements have also been reported to
increase immune function.24 25 As a result, some doctors recommend zinc
supplements for people with recurrent ear infections, suggesting 25 mg per day for adults and
lower amounts for children. For example, a 30-pound child might be given 5 mg of zinc per day
while suffering from OM. Nonetheless, zinc supplementation has not been studied in people with
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Echinacea has been reported to support
healthy short-term immune response. As a
result, it has been suggested that some children with recurrent ear infections may benefit
from 26 1–2 ml (depending on age) of echinacea tincture taken three times per
day or more.27 Doctors who use echinacea suggest that supplementation be started as
soon as symptoms start to appear and continued until a few days after they are gone.
Nonetheless, research has not been done to determine whether echinacea supplementation either
reduces symptoms or prevents recurrence of ear infections.
Ear drops with mullein, St. John’s wort, and garlic in an oil or glycerin base are traditional
remedies used to alleviate symptoms, particularly pain, during acute ear infections. No
clinical trials have investigated the effects of these herbs in people with ear infections.
Moreover, oil preparations may obscure a physician’s view of the ear drum and should
only be used with a healthcare professional’s directions.
An unpublished clinical trial of children with colds found that linden tea, aspirin, and bed rest were more effective than antibiotics at speeding recovery and reducing
complications such as ear infection.28 (Aspirin is no longer given to children due
to the threat of Reye’s syndrome.) However, no research has yet confirmed the use of
linden for preventing ear infections.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
1. Del Mar C, Glasziou P, Hayem M. Are antibiotics indicated as initial
treatment for children with acute otitis media? A meta-analysis. BMJ
2. Kozyrskyj AL, Hildes-Ripstein GE, Longstaffe SE, et al. Treatment of
acute otitis media with a shortened course of antibiotics: a meta-analysis. JAMA
3. Le CT, Freeman DW, Fireman BH. Evaluation of ventilating tubes and
myringotomy in the treatment of recurrent or persistent otitis media. Pediatr Infect Dis
4. McMahan JT, Calenoff E, Croft J, et al. Chronic otitis media with
effusion and allergy: modified RAST analysis of 119 cases. Otolaryngol Head Neck Surg
5. Nsouli TM, Nsouli SM, Linde RE, et al. Role of food allergy in serous
otitis media. Ann Allerg 1994;73:215–9.
6. McGovern JP, Haywood TH, Fernandez AA. Allergy and secretory otitis
media. JAMA 1967;200:134–8.
7. Roukonen J, Pagnaus A, Lehti H. Elimination diets in the treatment of
secretory otitis media. Internat J Pediatr Otorhinolaryngol 1982;4:39–46.
8. Juntti H, Tikkanen S, Kokkonen J, et al. Cow’s milk allergy is
associated with recurrent otitis media during childhood. Acta Otolaryngol
9. Sanchez A, Reeser JL, Lau HS, et al. Role of sugars in human
neutrophilic phagocytosis. Am J Clin Nutr 1973;26:1180–4.
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recurrent acute otitis media in children in daycare centers. Pediatrics
16. Tapiainen T, Kontiokari T, Sammalkivi L, et al. Effect of xylitol on
growth of Streptococcus pneumoniae in the presence of fructose and sorbitol. Antimicrob
Agents Chemother 2001;45:166–9.
17. Kontiokari T, Uhari M, Koskela M. Antiadhesive effects of xylitol on
otopathogenic bacteria. J Antimicrob Chemother 1998;41:563–5.
18. Kontiokari T, Uhari M, Koskela M. Effect of xylitol on growth of
nasopharyngeal bacteria in vitro. Antimicrob Agents Chemother
19. Uhari M, Kontiokari T, Koskela M, Niemela M. Xylitol chewing gum in
prevention of acute otitis media: double blind randomised trial. BMJ
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preventing acute otitis media. Pediatrics 1998;102:879–84.
21. Tapiainen T, Luotonen L, Kontiokari T, et al. Xylitol administered
only during respiratory infections failed to prevent acute otitis media. Pediatrics
22. Leibovitz B, Siegel BV. Ascorbic acid, neutrophil function, and the
immune response. Int J Vitam Nutr Res 1978;48:159–64.
23. Vojdani A, Ghoneum M. In vivo effect of ascorbic acid on enhancement
of human natural killer cell activity. Nutr Res 1993;13:753–64.
24. Duchateau J, Delespesse G, Vereecke P. Influence of oral zinc
supplementation on the lymphocyte response to mitogens of normal subjects. Am J Clin
25. Fraker PJ, Gershwin ME, Good RA, Prasad A. Interrelationships between
zinc and immune function. Fed Proc 1986;45:1474–9.
26. Brown DJ. Herbal Prescriptions for Better Health. Rocklin,
CA: Prima Publishing, 1996, 213–4 [review].
27. Schilcher H. Phytotherapy in Paediatrics: Handbook for Physicians
and Pharmacists. Stuttgart: Medpharm Scientific Publishers, 1997, 43–5.
28. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum
and Beaconsfield, UK: Beaconsfield Publishers, 1985, 227–8.