Ear infections are a common childhood illness, with about 46 percent of infants affected before their first birthday, but new statistics show the infections have declined significantly in recent years. A new study suggests this improvement can be attributed to improved vaccination rates and encouragement of breastfeeding.
The study comes from researchers at the University of Texas Medical Branch (UTMB) in Galveston, Texas, and was published Monday in the journal Pediatrics. The researchers tracked 367 newborns, born between October 2008 and March 2014, until their first birthday. Along with taking regular mucus samples from each infant’s nose and throat, the researchers examined medical records and family histories. The parents were instructed to notify the researchers when their child had either an ear infection, also called acute otitis media, or an upper respiratory infection.
Throughout the study, 143 infants had a total of 180 ear infections, and a total of 305 babies had respiratory infections that can lead to ear infections. The researchers found that by the age of three months, six percent of the children had an ear infection. By the age of six months, 9 percent of the children had an infection, and by their first birthday, 46 percent of the children had an ear infection. When the researchers compared this to earlier studies in the 1990s, they saw that in the past, 18 percent of children had an ear infection by the time they were three months old, 23 percent by six months old, and 62 percent by their first birthday. This seems to indicate that the rate of ear infections in infants has dropped significantly since the 1990s.
Not only did the researchers identify a drop in ear infections, they also pinpointed some possible causes. Major risk factors for an ear infection are frequent upper respiratory infections, such as cold, flu, and pneumonia, along with bacteria in the nose. The researchers speculate that as the increasing use of pneumonia and flu vaccines in recent decades has helped to reduce the incidence of these infections, ear infections have also declined. They also believe that decreasing smoking rates over the years, especially around children, likely helped reduce upper respiratory irritation which would then lead to a reduction in ear infections.
Another risk factor for an ear infection, according to the researchers, is lack of breastfeeding. They found that babies who were breastfed were less likely to have an ear infection than their bottle-fed peers. This is likely because breastfeeding helps improve immunity, and the encouragement of breastfeeding in recent years could be helping to improve immunity from ear infections.
According to the American Academy of Pediatrics (AAP), between 1995 and 2006, doctor’s office visits for ear infections dropped 30 percent. The AAP attributed this improvement to increased vaccination rates with the influenza vaccine and the 7-valent pneumococcal conjugate vaccine. This particular vaccine helps protect against various strains of the bacteria Streptococcus pneumoniae, which commonly cause ear infections.
Earlier research also supports the role of breastfeeding in infant health. Breastfeeding can help improve immunity, helping babies fend off ear infections, respiratory infections, and allergies, along with reducing the chance of sudden infant death syndrome, obesity, and diabetes.
Most ear infections are mild, requiring only treatment with over-the-counter painkillers. However, more serious or chronic cases can lead to complications such as hearing loss. Although many doctors prescribe antibiotics to babies with an ear infection, these drugs may only help slightly, along with the risk of complications. The AAP updated its guidelines for treating ear infections in 2013, suggesting that pediatricians avoid prescribing antibiotics initially. However, they recommend monitoring the children and prescribing antibiotics if their condition worsens or does not improve in the next two or three days.
For parents to reduce the chance that their infant acquires an ear infection, pediatricians recommend breastfeeding the child until the age of at least six months. Parents should also ensure their child gets the pneumococcal vaccine at the age of two months, followed by a series of booster shots. For ear infections and other health reasons, parents should also avoid smoking around their children.