Prevention of Ear Infections

Since it's a common problem, a source of great frustration and something parents want to prevent, here's a list of ways to help keep ear infections away.

Please notice that "keeping water out of your ears" or "stop swimming lessons" is not on this list.  That's because middle ear infections start from the nose and go up.  They don't start from the external ear and go in-- that's swimmers ear.


If you haven't gotten the idea yet, I'm a big breastfeeding advocate -- and for good reason.  The single biggest risk factor for getting ear infections is formula feeding. Formula feeding is an even bigger risk factor for ear infections than cigarette smoke or day care.

Stop Smoking

Having more than 2 people in the house who smoke increases the risk of the child getting an ear infection by 85%!  If just mom smokes, the risk is 70%.  These are not small numbers --- it's hard for me to help your child get better when there is a smoker in the house.  And it doesn't matter where you smoke- in the bedroom, outside, just in your car, whatever-- smoke, is smoke, is smoke.

Here's the problem:  the lining of the tube that leads from the middle ear space to the nose has cells that have little tiny hairs on them.  Those hairs protect the middle ear space from viruses and bacteria.  Smoke make the hair cells stupid so there is essentially no protection against germs in the child's ear.

A suggestion until you can quit:  Invest in a HEPA filter.  It's a free-standing filter that you can put in the room where the child is, to at least make a commitment to having the air around the child semi-smoke free.  I get no money from Target for this, but this prod imageis what I'm talking about.

Wash Your Hands

It's the best way to prevent the viral and bacterial upper respiratory infections that can lead to ear infections.

Pneumococcal Vaccine

Strep pneumoniae is the leading bacterial cause of ear infections.  We are routinely immunizing kids for it now at 2, 4, 6 and 12 months, but can immunize any child with recurrent ear problems under the age of 5.  Click here for more info.

Influenza Vaccine

A good idea even for healthy kids.  Click here for more info.

Smaller (or no) Day Care

If you can, exposure to less children reduces the amount of viruses the kids can get.  But you do what you can.  As I sit here at my job :) I fully realize people have to work.

Get rid of the pacifier

Mounting evidence suggests that pacifiers are a risk factor for ear infections, especially in older children.

Xylitol Gum or syrup

Xylitol is a type of sugar that apparently makes it harder for bacteria to attach and cause disease.  It's a remedy for older kids, since the younger ones might just swallow the gum, and you have to chew it pretty much all day long, but it has been shown to decrease the number of ear infections kids get.  More info here.


This is a good bacteria that is found in yogurt.  The data isn't as good for lactobacillus as a preventative measure for ear infections as it is for diarrhea, but it has been shown to reduce the number of annual ear infections kids get.  And I figure, its yogurt-- what's the harm?  If you're going to try this, make sure the yogurt contains "active cultures."  It should be on the label somewhere.