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You may not be able to prevent ear infections entirely however, there are things you can do in your daily life and in caring for your children that may reduce the risk.

To reduce your children’s risk of ear infections:

Avoid Exposure to Cigarette Smoke or Smoke From Wood-burning Stoves

Cigarette smoke and smoke from wood-burning stoves irritate the mucous membranes and can make it easier for respiratory infections to travel to the middle ear. Try to quit smoking, but if you are unsuccessful, be sure that your children are not in the same room or car as a smoking adult. Try to avoid using a wood stove to heat your home. If you must use this form of heat, try to keep children away from the smoke.

Consider Breastfeeding Your Baby for at Least the First Six Months

Breast milk contains substances that are beneficial for your baby’s immune system and may help your child resist ear infections. In addition, breast milk is less likely than formula to trigger an allergic reaction that could increase the risk of ear infection.

If You Bottlefeed Your Baby, Keep Your Baby’s Head as Upright as Possible

Never lie your baby down flat in bed with a bottle. In this position, fluid is more likely to fill the eustachian tubes. Try to hold your baby in an upright position or use one of the newer angled bottles.

Reduce Exposure to Environmental Factors That Trigger Allergic Reactions

The mucous membranes of children with allergies or asthma are more likely to become swollen, which reduces fluid drainage from the eustachian tubes. In some children, allergies are associated with prolonged or recurrent ear infections. In these children, exposure to environmental allergens, such as pet dander, increases mucus production and may lead to ear infections. If your child is allergic to a pet, try to find the animal a new home. If other environmental allergies are confirmed by your child's doctor, use foam pillows instead of feather or down, and try to wash bedding frequently in hot water. Avoid carpets in the bedroom if possible, and get rid of stuffed animals or keep them in a closet.

Use of Long-Term Antibiotics

If your child has recurrent problems with fluid and infection in the ears, the doctor may recommend long-term antibiotics to prevent an infection. Long-term antibiotics are usually prescribed for a period longer than six weeks.

Surgery

If your child has a history of ear infections, talk to the doctor about a surgical procedure called a myringotomy. During a myringotomy, tympanostomy tubes can be inserted into the middle ear to help prevent the accumulation of fluid.

Try to Avoid Using a Pacifier or Use One Only When Your Child Goes to Sleep

Children who use pacifiers continuously are more likely to develop ear infections than those who use them only when going to sleep. Avoid using a pacifier or try to wean your child from the pacifier by the time they are one year old. If you are unsuccessful, set rules for when the pacifier can be used. Wash the pacifier and/or replace it frequently, especially after a cold, sore throat, or other respiratory infection.

Make Sure That Your Child Receives All Recommended Immunizations

Keeping your child up-to-date on immunizations can reduce his risk of illness. For example, the pneumococcal vaccine is effective in preventing some types of middle ear infections caused by pneumococcal infection. Evidence is still unclear about whether it can reduce the overall number of middle ear infections.

Your child should also receive a yearly flu shot, especially if he has asthma or other chronic health conditions or if he attends daycare.

Use Good Hand Washing Techniques and Other Practices to Avoid Spreading Germs

Wash your hands frequently, and teach your children to do the same, especially after blowing their noses. If your child chews on toys or puts them in his mouth, keep those toys separate and wash them thoroughly before they are played with again. Teach your children to cover their mouths with a disposable tissue when they cough or sneeze and to throw the tissue away immediately.

If Your Child Snores, Ask the Doctor to Check for Enlarged Adenoids

The adenoids are tonsil-like structures located in the back of the nose, invisible to normal methods of examination of either the nose or throat. When adenoids are large, children tend to mouth-breathe, and they may snore at night. Many children with enlarged adenoids have a “nasal” sounding voice because of obstruction. The eustachian tubes open into the nose very close to the adenoids, and their opening may be blocked when adenoids are enlarged. Blocked eustachian tubes are among the causes of chronic middle ear infection. In some cases, the doctor may recommend that your child has his adenoids removed. While this surgery has not been shown to stop middle ear infections from occurring, it can help to get rid of fluid build-up in the ear.

What Should You Do About Daycare?

For most families today, there are few, if any, alternatives to group care. Daycare has some health risks, but it may also have significant and lasting health benefits. Children who go to daycare in the first year or two of life are more likely to develop ear infections because they catch more frequent viral infections from other kids. However, daycare may have health benefits, as well. Children in daycare may be less likely to eventually develop asthma and other allergic conditions—especially if their mothers do not have asthma.

Find Out About Xylitol

Xylitol is a natural sugar that is used to sweeten a number of different products, like gum and candy. Researchers have found that children who eat foods with xylitol on a regular basis have fewer cases of middle ear infections. This sugar may work by inhibiting the growth of bacteria strains that can lead to ear infections.

References:

Acute otitis media. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated June 3, 2013. Accessed September 3, 2013.

Ear infections. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/. Accessed February 27, 2013. Updated September 3, 2013.

Ear infections in children. National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/health/hearing/pages/earinfections.aspx. Updated February 2013. Accessed September 3, 2013.

Middle ear infections. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Middle-Ear-Infections.aspx. Updated May 11, 2013. Accessed September 3, 2013.

7/21/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Pavia M, Bianco A, Nobile CG, Marinelli P, Angelillo IF. Efficacy of pneumococcal vaccination in children younger than 24 months: a meta-analysis. Pediatrics. 2009;123:e1103-1110.

3/26/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Van Den Aardweg M, Schilder A, Herkert E, Boonacker C, Rovers M. Adenoidectomy for otitis media in children. Cochrane Database Syst Rev. 2010;(1):CD007810.

12/16/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Azarpazhooh A, Limeback H, Lawrence HP, Shah PS. Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database Syst Rev. 2011;11:CD007095.

Last reviewed September 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.