By Megan Boyle, Editorial Director

Fever, headache, tugging at the ear, crying more than usual and trouble sleeping – most parents recognize that these dreaded symptoms mean an ear infection.

More than 80 percent of children will get at least one ear infection by age three, the National Institute on Deafness and Other Communication Disorders estimates. That makes them the most common reason parents take young kids to see a doctor.

These days, however, pediatricians are intervening less in the healing process and prescribing far fewer antibiotics. Globally, taking antibiotics when they aren’t strictly necessary is contributing to the buildup of antibiotic-resistant bacteria, a problem that threatens the health of both children and adults.

If your child has an ear infection, pediatricians may suggest medicated eardrops, nasal spray or over-the-counter pain relievers to ease your child’s discomfort. Tylenol and Motrin are often recommended for fever pain.

Consult a health care professional first if you suspect your child has an ear infection or if your child experiences new or escalating symptoms, especially a rising fever or fluid seeping from the ear. For more natural steps you can take, here are some options to consider. Note that these approaches have varying degrees of effectiveness.

Things that work

Time

In most cases, time is the best cure. Symptoms often clear within 72 hours. Warm compresses and steam inhalation may alleviate pain as you wait it out.

Prevention

These steps can lower the odds that your child will develop an ear infection in the first place:

Vaccinations are also protective. Studies show that kids who are up to date with their shots – especially for pneumonia, meningitis and flu – get fewer ear infections.

Things that might work

Researchers have explored a variety of alternative measures to prevent ear infections. Although clinical data shows mixed results, these are generally safe to try.

Vitamin D

Studies suggest that children with recurrent ear infections are more likely to have low vitamin D levels. When researchers gave vitamin D supplements to kids with recurrent infections in two separate studies (here’s one), they got fewer new infections during the study period.

Researchers still lack evidence to show cause and effect, but many kids are low in vitamin D, so a supplement will likely offer other health benefits. Babies need 400 IU (10 mcg) per day, and daily supplements are especially important for breastfed babies. Everyone else needs 600 IU (15 mcg) per day, which generally requires taking a daily supplement during the winter months.

Probiotics

Researchers have also studied oral probiotics and nasal sprays for preventing ear infections. More research is necessary to determine which strains of bacteria might be most helpful, whether it’s best to administer them as a spray versus oral supplements, and the best dose. But probiotics are generally low-risk and offer other health benefits, such as aiding digestion.

Vitamins and Nutrients

Some studies suggest that common vitamins and nutrients such as zinc, vitamin A and omega-3 fish oils may help kids stay healthy and prevent ear infections, but the evidence is mixed. Be sure to read bottle labels carefully for the appropriate dose for children.

Xylitol

Surprisingly, several studies have shown that this natural fruit sugar, common in sugar-free foods, can also help prevent ear infections. Xylitol inhibits bacterial growth, which is one reason why toothpastes and gums made with xylitol are good for teeth.

Several studies found that giving kids xylitol – as gum, syrup or nasal spray – prevented recurrent ear infections, but mainstream doctors caution that they need more data before they’ll routinely recommend it.

To produce a preventive benefit, most of the studies to date have found that it is necessary to give xylitol to kids five times a day (approximately 10 grams per day total). At this dose, kids generally had a 30 percent decrease in recurrent ear infections. Gum and lozenges appear to be more effective than syrup, although syrup may be the only realistic option for young children.

Physicians and parents know that such frequent treatments can be a challenge for busy families, and lower doses may not be helpful. A recent study that gave kids xylitol three times a day (15 grams total) did not show any preventive benefit.

Be aware that some kids may develop digestive problems when given xylitol, particularly in higher doses. 

Not enough evidence

Other herbs and alternative treatments

Most herbal supplements have not been rigorously tested for preventing or treating ear infections. The NIH Center for Complementary and Integrative Health offers these tips for parents considering herbal supplements for children.

Osteopathy, chiropractic and traditional Chinese and Japanese medicine all suggest alternative approaches for ear infections. These options have been little studied and may vary from one provider to the next. High cost or low availability may make them impractical for some families.

Don’t go there

You may see resources that recommend trying ear candling or herbal preparations that include mercury, goldenseal or colloidal silver to prevent ear infection. These are not safe for children. Don’t try them.