“An ounce of prevention is worth a pound of cure.” I am not sure who originally made this quote, but it is certainly true when it comes to ear infections. It is estimated that ear infections cost American families somewhere in the ball park of $5 Billion every year. This is not to mention the subjective expense of having to deal with a sick baby. Thus it makes good sense to implement any reasonable measure you can to prevent this pesky and rather common childhood infirmity.
Risk Factor #1
Most parents are aware that taking their children to daycare and exposing them to lots of other sick kids is not a good idea. Although, for many families, leaving one parent at home to care for the kids is not an option. The interesting thing about daycare is that the risk is directly proportional to the number of kids in the daycare. Thus if your child is in a large daycare setting (10+ kids) they are about 2.5 times more likely to get an ear infection. If you move them to a smaller home-based daycare (5 or less kids), this risk drops substantially to about 1.5 times more likely versus taking care of your kid at home.
When possible, care for your kids at home. If you need to send them to daycare, look for a smaller home-based daycare. The fewer the number of kids, the better.
Risk Factor #2
This is probably not surprising to most informed parents. Just about any way you look at it, kids who are breastfed are less sick than those who are not. The interesting thing about breastfeeding is that any breastfeeding is protective and lasts for several months even after you stop breastfeeding. For the most part, the first six months are the most beneficial. Kids who breastfeed during the first six months virtually never get ear infections during this time. As you move from six months to 3 years the benefit decreases, but is still substantial. The simple fact is this…
On average, kids who do not breastfeed get ear infections at an earlier age and have more overall ear infections.
Risk Factor #3
Feeding while supine
This means letting your baby feed while they are laying on their back. It matters little whether your baby is breastfeeding or formula feeding in this respect. When babies are supine, it is harder from them to swallow the milk. Thus the milk has a tendency to run from the back of their throat, through the Eustachian tube, into the ears. This is a set up for infection.
When possible, let your baby feed upright.
Risk Factor #4
This is a hotly debated topic, but the data shows that pacifier use is associated with an increased risk of ear infection. The controversy here rests on the potential benefits of a pacifier – namely soothing and SIDS prevention. The current suggestions by most experts are that pacifier use may have a favorable risk:benefit profile in the first 6 months, but this declines after 6 months when SIDS becomes way less common. Kids who use a pacifier are only about 1.2 times more likely to get ear infections. On the other hand, it is estimated that for about every 2000 babies that use a pacifier, 1 case of SIDS may be avoided.
Personally, I would not worry about it much about pacifiers from the standpoint of ear infection.
Risk Factor #5
Just as breastfeeding is good for you no matter how you look at it, smoking is bad for you no matter how you look at it. Turns out, though, it is hard to prove that it statistically linked to ear infections in kids. Use some common sense. Parents who smoke have kids that smoke. There is probably no other single thing, which you control, that is as bad for your health as cigarette smoke. My simple advice…
Don’t smoke around your children and keep them away from those who do.
Review the Treatment Guidelines I use in the ER.