ear infection, prevention

Parents frustrated by their child's frequent ear infections often wonder what they are "doing wrong," or what they can do to prevent ear infections. First, there are two types of ear infections. By far the most common in the fall, winter, and spring is otitis media, the classic middle ear infection¹. External ear infection, otitis externa or swimmers ear, is common in the summer. Here are some things that will (and will not) help.

Prevention of otitis media

Breast feed if possible. Breast feeding is known to be protective against otitis media.
Do not allow your child to lie in bed or sleep with a bottle or sippie cup. Not only does this create ideal conditions for ear infections, but it is a cause of nursing bottle tooth decay.
Don't smoke. Not just, "Don't smoke around the kids," but just don't smoke period. Children of smokers have significantly more ear infections than non-smokers, period. Smoke on your clothes is all that it takes. And, honestly speaking, I don't believe it a bit when parents claim they "don't smoke in the house." After all, winter comes, and it rains ...
Bathing or swimming has absolutely nothing to do with middle ear infections if the child has intact eardrums, meaning no tubes in the ears or known ruptured or draining ear. Hair washing or even play in the tub when the child puts his head under water will not cause a middle ear infection².
Avoid day care if possible. In general, the fewer children to whom your child is exposed, the fewer colds and subsequent ear infections he will get.
Since nasal/head congestion causes middle ear infections, logic would suggest that efforts to dry up that congestion would help prevent ear infections. Unfortunately, that has been shown in many studies to be false. Decongestants and antihistamines do not reduce the incidence of ear infections.

Swimmers ear prevention

Swimmers ear (otitis externa) is caused by infection of the skin of the ear canal, usually by a bacterial germ known as Pseudomonas. The chief symptom of bacterial swimmers ear is intense pain in the ear canal, with redness and swelling. The auricle is very tender to touch - if you pull on the outer ear and your swimming-age child screams, that's a swimmers ear. It may also be caused by fungal infection; I have found that to be more rare. Both conditions are prevented in the same way.

The mainstay of prevention is to thoroughly dry the the ear after swimming, and restore the normal pH of the ear canal skin. The cheap and simple way to do this is to flush the ears with a half and half mixture of isopropyl (rubbing) alcohol and ordinary household vinegar when the child is through swimming for the day and changes into street clothes. The idea is to more or less fill the ear canal, not just a drop or two (as the commercial swimmers ear drops advise³.
Ear plugs would seem to help prevent swimmers ear, and are worth trying for the child who gets the infection repeatedly. I personally don't use them very much, because just relying on plugs does not seem to be as effective as ear canal flushes.

1. The inner ear is never infected.

2. But he could produce a swimmers ear if he did this quite a lot.

3. They advise this because the commercial drops are expensive - another good argument for making them yourself.

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