Torn about abx use for Ear Infection

[AmandaT]

Background: my DD is almost 8 months old, unvaxed and EBF. She had a 72 hour course of abx when she was born because she aspirated meconium. She had a fever last Sunday, and has been cycling through 98-101F since yesterday. I took her to the pediatrician today and she has an ear infection. She was prescribed a 10 day abx routine. 

I'm very torn about whether to give her the abx or not. I would rather use breast milk/ ear oil to try and treat than give her abx, but am leery because she isn't talking and I worry I won't know when she's feeling better. Most of the time she is her normal happy self, with a few sleep issues and the fever. DH had many ear infections as a child and thinks we should just give her the abx. My pediatrician gave me hell for not giving her Tylenol immediately so I didn't want to bring up alternative treatments (time to find a new practice!).

I'm concerned about her getting a yeast infection, or thrush, or just using abx in general so any suggestions or comments would be greatly appreciated! Thanks!

[heatherdeg]

Wow!!!  Giving you hell about not giving her Tylenol?  Yeah--new practice.  What area of NJ are you in?  Perhaps I can steer you to a good one.

Thing is, they're not even supposed to prescribe abx for this anymore unless you're past day 3.  That's the APA (or whatever it is) own guideline change as of a couple of years ago.

I'm thinking you notice when something's wrong.  I mean, she's not talking, but you know if she's happy, eating, putting out the same number of diapers, sleeping more or less, tugging at her ear or sensitive, etc.

And honestly, I'm so NOT in the know about these things, but a 10-day course of abx sounds like a lot for an ear infection?  Anyone else know?

If you do give her the abx, just be sure to bump up the probiotics to help her out.  Primal Defense Kids comes in powder form, so you can put some in a little bit of applesauce or something.  I would do it a few times/day.  It will certainly help.

Hugs, mama.

[AmandaT]

Thanks for all the info!

I agree about it seeming like so much abx, I actually just read an article that only about 1/3 of ear infections are even helped by abx anyway: http://www.cnn.com/2010/HEALTH/11/16/antibiotics.ear.infections/index.html of course it mentions the guidelines are for children ages 2 and up 

 Because she is EBF and its summer, it is probably "swimmer's ear" so the abx may help. I actually hopped in the shower with her a few days ago and do remember the water getting into that ear... I just hate the idea of giving her abx, and so many!

I'm in Southern NJ and plan on making some phone calls starting Monday for a more natural minded practice. She is on Medicaid (Horizon) so we are a bit limited by network. Its so hard dealing with doctors, especially as a younger parent I get NO respect and don't want to be accused of failure to medicate or any such nonsense.  

Do you know of any liquid probiotics? She's still EBF and I don't want to introduce a new food on top of everything else.

On a good note, I put a few drops of breast milk in her ear twice today and she's been fever-free since 3pm. If she's fever free through tomorrow morning maybe we can skip it.

Edited by AmandaT - 10/14/12 at 7:04pm

[TCMoulton]

Originally Posted by heatherdeg 

Wow!!!  Giving you hell about not giving her Tylenol?  Yeah--new practice.  What area of NJ are you in?  Perhaps I can steer you to a good one.

Thing is, they're not even supposed to prescribe abx for this anymore unless you're past day 3.  That's the APA (or whatever it is) own guideline change as of a couple of years ago.

Since the OP said that her daughter has been sick since last Sunday that puts this ear infection at possibly 6 days at which point antibiotics seems reasonable.

[AmandaT]

She had a slight fever on Sunday, and then was fine again (fever-free and acting like her normal happy self) until Thursday. Her gums are a bit swollen on the bottom so I think a tooth may finally be coming in and confounding everything that's been going on.

But now she's been fever-free since 3pm yesterday! Last night she slept on the side with the infection (which she was not doing two nights ago) and seems perfectly happy and healthy. I have been putting a bit of breastmilk in her ear since yesterday and hopefully she beat this infection on her own! I made an appt to go back to the dr's on Tuesday morning and am hoping to hear her ear looks fine. As heatherdeg said the AAP's most recent recommendation is to wait three days to see if the infection heals itself and if not give abx- it appears as if she was fine by the middle of day two. 

I've decided if the fever does return (or her ear still looks infected on Tues) to start the abx but hopefully it won't come to that. 

[sbgrace]

Yes, there is a wait and see recommendation for antibiotic use for ear infections. I think, though, that's for kids older. I would want to wait and see myself but realize there is risk there. My son was one of the ones who ended up with a bad outcome from wait and see. But it's rare and I would still use wait and see for another child of mine. I'm glad she's doing better. That initial fever could have been the virus that later turned into the ear infection. I would count days from that high fever more recently. You might look at Klaire Labs to see if they have a liquid. There stuff is high quality and allergen free. I'd consider it for her. You could put the powder in or on breastmilk, on a spoon, or even on your breasts perhaps. You can dose yourself too.

[AmandaT]

Originally Posted by sbgrace 

 My son was one of the ones who ended up with a bad outcome from wait and see. But it's rare and I would still use wait and see for another child of mine.

If you don't mind my asking more about this: did he seem better before his bad outcome, or did he just continue to stay sick/get sicker?

[sbgrace]

Originally Posted by AmandaT 

If you don't mind my asking more about this: did he seem better before his bad outcome, or did he just continue to stay sick/get sicker?

I knew it was bad...you would know so don't worry.

It was a Sunday afternoon when my son first complained of ear pain and started a fever. We did wait and see per his pediatrician and I did what we had learned in the past for ear infections (supplements, massage, diet, etc.). At this point it was very much like ear infections he had had before. I hated we were there again but not concerned. He seemed to improve on Monday. I don't remember (this was 5 years ago) for sure but I think the fever was actually gone by the end of the day on Monday. I know on Tuesday the fever was gone. He was playing, etc. and doing great. Then in the late afternoon/evening he suddenly spiked a really high fever and clearly felt extremely sick. I took him the chiropractor. He was in pain and the adjustment was hard because of that. She wasn't too worried but i was. Mommy instinct was telling me this wasn't normal/something was very wrong. The pediatrician had told me it was normal for fevers to come back in the afternoons/evenings. Still I was concerned. I slept with him that night and we just never did that. He woke up at various points in the night crying and I was glad I was there. He seemed comforted to know i was with him. On Wed when he woke up to get up I picked him up and noticed his ears were folded forward toward his face. I was, well, alarmed. I googled and was more alarmed when I read about mastoiditis. I called the pediatrician. She had never seen mastoiditis before my son (so this is rare, very rare). She examined him and then sent us to the children's hospital (about 1.5 hours away) and we were admitted. My son was on IV antibiotics for two weeks, had surgery, and then went home on a month more of antibiotics.

This is a known risk of wait and see. There will be a percent of infections that might have been killed with prompt antibiotic usage that go into these more serious complications. When a child presents with an ear infection there is no way to know if their bacteria (if it is bacteria and not a virus for which antibiotics wouldn't do any good anyway!) is the sort that really needs treatment. This is rare. It can happen with even prompt treatment though these complications do increase with wait and see. The drawbacks to antibiotics when not necessary, though, outweigh the small risk of serious complications. On my son's floor there was another mastoiditis and I think two sinus infections that had spread too if I remember. So it happens. But it happens rarely. Rarely enough that I would and have done a "wait and see" with another child of mine without fear.

You would know if there was something bad happening. You would see a quick severe downturn, high fever, lots of pain. Be aware but don't worry.

[heatherdeg]

I don't any doctors that far south.  Sorry.  

You can get HLC Neonate probiotics for infants and they are administered by having the baby suckle it off of your finger--no new foods needed.

[Mandomami]

I'm in a similar situation. Been treating my 8 month old ear infection with mullein garlic oil. She seemed better but last night had an all out crying session pumping on her ears and hair. Did a lot of research and read about most ear infections being viral. Decided to try the natural approach but after last night I think I'm giving in to abx :-(.

She was crying and in so much pain. Feel so torn.EBF and dealt with thrush with my first so scared to go through that again. Gonna pick up the baby probiotics later today.