Many children with recurrent ear infections have their own characteristic symptom patterns parents learn to recognize early in the illness. Unusual irritability, emotional sensitivity, or clinginess may accompany ear infection, and sometimes a child’s mood changes are the only evidence of the problem. There may be a high fever, but ear infections often occur without any fever at all. Sometimes the child vomits or has diarrhea because of an ear infection, with no sign that something is wrong with the ears. In most cases, if nothing else is responsible, these digestive symptoms clear up rapidly.

The diagnosis of an ear infection depends on accurate visual examination of the eardrum performed with an otoscope, a magnifying lens and light that illuminates the drum and external canal through a small speculum that fits into the canal. A normal eardrum has a pearly gray, slightly shiny appearance and looks delicate and translucent. During an infection the most characteristic change is outward bulging of the eardrum due to buildup of pus inside. The eardrum becomes thickened and more opaque and often looks quite red. Redness of the drum, however, may be caused by fever, crying, or cold, and a diagnosis of otitis media should never be made on the basis of a red eardrum alone.

Traditionally, physicians have held that antibiotics effectively treat ear infections and prevent complications. However, many scientific studies over the past 25 years contradict such beliefs. In one large study of children with acute otitis media, those treated with antibiotics actually recovered at a slightly lower rate than those who were not. (Froom, et al, 1990). Another found that children with chronic otitis maintained on prophylactic (preventative) antibiotics were two to six times more likely to have recurrent acute infections than those on placebos (Catankin, et al, 1991). Recently, John Bailar, M.D., a Harvard professor and editorial board member at the New England Journal of Medicine, comprehensively reviewed the scientific literature on the treatment of otitis with antibiotics. He concluded that the available research, "... seems to demolish the conclusion that antibiotics improve the outcome [in otitis media]" (Bailar, 1995).

In any case, be watchful if otitis media is diagnosed. Serious acute complications of middle-ear infection are rare but do occur. These include mastoiditis, infection of the bony area just behind the ear. Be alert for any redness, tenderness, pain, or swelling in this area and report these symptoms immediately to your health practitioner. Mastoiditis can become a chronic problem and result in hearing loss and erosion of the bone.

Meningitis and other infections of the central nervous system may result from acute otitis media if the infection spreads through the blood stream to bony structures. Symptoms of these problems include severe or persistent headache, stiff neck, persistent vomiting, and marked change in mood or alertness.

The most common complications of middle-ear infections are the chronic ear problems that often follow. Serous otitis media, accumulation of a translucent noninfectious fluid in the middle ear, interferes with normal motion of the eardrum and the tiny middle ear bones so that hearing is reduced.

Homeopathic constitutional treatment is often effective with chronic serous otitis. Antihistamines and decongestants are worthless, though they are often prescribed. Conventional treatment for persistent hearing loss due to serous otitis involves surgical insertion of polyethylene tubes into the eardrum to allow drainage of middle-ear fluid. These tubes seem to improve treated ears'hearing for a few months, and this may be very important to the child who is at a crucial stage of language development. Research has shown, however, that there is no long-term improvement in hearing when tubes are inserted, and eardrums in which tubes have been placed tend to become scarred. We believe that the tubes should be inserted for serous otitis only when there is a significant, documented hearing problem, when the risks of the surgery are clearly understood, and when the goal of treatment is improved hearing within a short period.