Toddler TEOTWAWKI--Ear Infections in a Collapsed Society

The RSV epidemic, the secondary ear infection that it may cause in young children and infants, and the shortage of antibiotics to treat this infection are all in the news right now with parents panicking when unable to source the prescribed amoxicillin.  Most are under the impression that consequences of not being able to administer the antibiotic will be dire.  While the child will be in pain, that pain will eventually pass without any lasting consequences.  Fortunately, a middle ear infection, otitis media, is rarely a true emergency for children or adults.  But the pain can be intense, on par even with kidney stones or labor pains.  Knowing your little child can be in this kind of pain is torture.

Otitis media is the classic, typical ear infection of infants and toddlers.  An otoscope, the tool for looking into an ear, is not at all difficult to use (we got to practice in our off-grid medicine class), and identifying whether an ear is infected is as easy as can be.  (Grayish--not infected.  Red--infected.)  I'm sorry I can't comment on which one to get--there are too many choices and a huge range in prices.  I'd probably suggest one in the $60-90 range.

If you do happen to get an otoscope and are checking for a potential ear infection, first check the normal ear.  (Doing the normal ear first prevents transferring any bacteria from the infected ear.) The eardrum should be a light gray color.  Then check the ear that is causing pain.  If it's infected, it should be pink or red, and the eardrum may even be bulging out.  If it's not pink or red, then is there debris, a foreign object, or ear wax?

Without an otoscope, how are you going to determine whether your child has an ear infection?  Symptoms include:

• pain, which may worsen when lying down
• difficulty sleeping
• crying
• irritability
• fever
• loss of appetite
• holding or pulling the affected ear 

Otitis media infections can occur alone, but they most often occur as a result of a cold causing congestion and blockage of the nose and Eustachian tube.  Bacteria get blocked and fluid and pus accumulate.  And then your child is in pain.

For the past half-century or so, antibiotics have been the standard treatment, but before that most every doctor knew how to lance an eardrum.  Current beliefs are that neither antibiotics nor lancing are necessary for most infections.  And you really don't want to dip into your antibiotic supply if you don't have to.

But you know your child is in pain, extreme pain.  S/he is not sleeping, so neither are you.  Pain relief is the goal.  Acetaminophen or ibuprofen or both should reduce the pain.  Herbal remedies can reduce the pain and kill the infection.  Warm compresses should reduce the pain.  If they do not, and if the patient gets worse, look for a professional.

In most cases, even when an eardrum ruptures, whether in adults or children, antibiotics are not necessary.  Do not irrigate the ruptured ear.  This will force water and potential contaminants, including bacteria, past the ruptured eardrum, and that may cause a worse infection.

The most common antibiotic choices are cephalexin, azithromycin, amoxicillin, penicillin, and erythromycin.  Ciprofloxacin is another option in adults.  Augmentin, doxycycline, penicillin, and tetracycline are other possibilities.

Physicians often prescribe the following antibiotic dosages for otitis media infections:

• amoxicillin, 25-90 mg/kg per day in divided doses taken every 8 hours for 7-10 days for children; 500 mg 3x/day/5-7 days for adults  (there's a pretty wide range among doctors in what they recommend for children)
• azithromycin, 5-12 mg/kg per day, once per day
• penicillin, 80-100 mg/kg per day, in divided doses taken every 8 hours, for ten days or until two days after the fever has passed in children.
• cephalexin, 500 mg every 12 hours for 7-14 days
• erythromycin, 250-500 mg every 6 hours for 7-14 days

Dr. Alton, author of The Survival Medicine Handbook, suggests the following remedies using olive oil and essential oils.

• Mix 1/4 teaspoon rubbing alcohol and 1/4 teaspoon vinegar or hydrogen peroxide together.
• With the patient lying on his side with the afflicted ear up, put 3-4 drops of the mixture in the affected ear.
• Have the patient remain in this position for 5 minutes, and then tilt the head and drain out the solution.
• Next, use plain warm olive oil, or add one drop of any one of the following essential oils to 2 ounces of olive oil:  
• tea tree
• eucalyptus
• peppermint
• thyme
• lavender
• garlic
• mullein
• Put 2-3 drops of warmed oil mixture in the ear canal.
• This does not need to be drained or removed.
• Repeat 3-4 times per day.

Other herbal remedies including using tinctures of mullein, Oregon grape or Japanese barberry, Usnea, or Echinacea on unruptured eardrums.  These may also be taken internally.

In order to reduce the incidence of ear infections, do not feed infants or toddlers while they are lying flat.  No nursing to sleep, no bottles to sleep.  This will also help prevent rotting teeth, which is another problem best avoided.

Links to related posts:
Echinacea
Lavender
Japanese Barberry
Usnea
Peppermint
Thyme

For further reading:
The Survival Medicine Handbook, pp 436-439.
The Herbal Medic, p 60.
Alton's Antibiotics and Infection Disease

 9.22.19