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The question

My child has chronic ear infections. What is causing this? Is there anything I can do?

The answer

Chronic ear infections are more prevalent in children who:

  • have allergies
  • were not breastfed
  • have a family history of chronic ear infections
  • attend day care

In November, 2010, an article published in the Journal of The American Medical Association looked at close to 100 studies done on children with acute ear infections. The bottom line was that 80 per cent of children with middle ear (which refers to the space just behind the ear drum where fluid can build and cause pain) infections get better with no antibiotic treatment.

However, in a child who is prone to numerous middle ear infections, the story may be a bit different. These children suffer if left alone - fluid that builds up in the middle ear space gets sticky, causing a "glue ear," which makes it harder for antibiotics to penetrate into the middle ear space.

The child may suffer hearing loss if the fluid is not drained. This significantly increases the risk for speech delays.

A few decades ago it was not uncommon for pediatricians to put these children on a chronic low dose of an antibiotic. These long-term antibiotics have the potential to wipe out some of the good bacteria found in a child's intestinal tract. But if probiotics are added, they may counteract some of the damage caused by antibiotics. Probiotics are good bacteria found in fermented dairy products. See www.healthykids.ca for more information on probiotics.

Currently, the long-term use of antibiotics has become much less common.

When a child with chronic ear infections sees a specialist, these experts will drain the fluid from the middle ear space and insert a ventilation tube in the ear drum. These tubes serve the same way as an open window to a stuffy room - they allow for some ventilation and reduce the risk of future ear infections.

Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Peter Nieman.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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