ear infections

My phone rang around 11 pm. I was on call covering our clinic so the late night call wasn’t surprising. “Hello,” I said kindly, in spite of rolling out of bed, trying to catch a little sleep in case I had to admit a patient to the hospital over night. I anticipated it might be a worried patient on the other end of the line and a kind voice can go a long way toward reassurance.
Sure enough, an anxious mom responded “Hello, Dr. Romm?” I could hear a toddler’s slight coughing in the background.
“Dr. Romm, I’m so sorry to bother you at night… My daughter Janie is almost 2. She’s had a temperature of a max of about 100.2 since this afternoon, and she’s been fussy and pulling on her right ear since just after dinner. Before that she was playing with her older brother, but by dinner she was cranky and didn’t eat much. She’s clingy. She’s taking juice and water which I’ve been giving her to keep her hydrated, and I gave her a Tylenol about an hour ago just to see if it would help her sleep. Her fever has been down to 99.6 since then and she’s settled down some. My son has had ear infections before, and both kids have had a cold for a few days. I’m a bit worried and don’t know if I should bring her to the emergency department or whether she needs an antibiotic right away. My son has gotten antibiotics every time he’s had an ear infection, so I just didn’t know what to do…


I know it’s super confusing to figure when your little one actually does – or doesn’t – need an antibiotic for an ear infection. I’m here to help you sort that out. In this article I’ve laid out the basics of ear infections, exactly when using antibiotics is appropriate, and my go-to natural treatments. Here’s how it really rolls in my own practice…

Ear Infection Basics

Acute otitis media (AOM) refers to those typical painful ear infections kids get with fevers and upper respiratory infections – and that’s what we’ll be focusing on in this article. 


AOM is generally mildly to severely painful, making most babies and children fussy and irritable. Typically your child will start out with a cold, especially a runny nose, but occasionally the earache seems to come out of nowhere. There is often a fever. Younger children may pull on their ears or may scream or cry suddenly and unexpectedly; older children will generally tell you that they have ear pain. Ear infections are super common in kids under 12, and especially before grade school. Viruses generally cause them.

As I discussed in Part 1, antibiotics are highly over prescribed for kids with ear infections, and can lead to

  • Serious resistant infections in your child, for example, pneumonia
  • Can cause antibiotic reactions, and
  • May cause long-term consequences including asthma, allergies, and inflammatory bowel disease

Antibiotic overuse also contributes to the global problem of antibiotic resistant infections.

But when it’s your kid that’s sick all you want to do is the right thing to keep him healthy and safe. So what should you do?

When to See Your Doctor

Any time you are seriously worried about your child, it is absolutely appropriate to call or make an appointment to see his doctor. Like most docs who take care of kids, I never mind getting a late night call or an office visit from a worried parent.

When I received the call mentioned earlier, I reassured Janie’s mom that since Janie had a cold, was able to be settled easily with only one age-appropriate dose of Tylenol, and had what I would consider a low fever at its highest (did you know that below 100.2 is not medically considered a fever?), this was likely a mild case of an ear infection and that waiting and watching overnight would be totally safe and appropriate.

I asked her to please call me back if Janie got worse. But if by morning she was better or even about the same, she could continue to wait and watch – but that at this point, and in most cases of acute otitis media, no antibiotics were needed. We discussed the safe use of Tylenol and ibuprofen, since she didn’t have any herbal remedies for pain relief at home (stocking a home herbal medicine chest is a great idea and will be discussed in a future blog and is covered extensively in my course Healthy All Year.

Here’s when I absolutely ask my patients to bring their little one in for a look-see:

  • Your child is under 6 months old
  • There is pain that won’t resolve
  • There is high fever (> 39 C or 102.2 F) and persistent ear pain
  • There is drainage from the ear
  • There is neck pain or stiffness

Janie, whose momma called me, met none of these criteria. Watching and waiting at home was safe – and actually best – for her baby.

When Are Antibiotics Needed?

The latest guidelines from the Academy of Medicine have come around to recommending what natural practitioners have known for a long time – that prevention and a watch-and-wait attitude are the best approaches for most kids with ear infections, most of the time. The new guidelines encourage doctors not to overuse antibiotics.

Antibiotics are recommended for:

  • Babies under 6 months old, or babies 6-23 months old with ear infection of both ears

And any children with severe infection defined as:

  • Rapid onset of symptoms
  • Moderate or severe ear pain
  • Ear pain lasting 48 hours, and
  • Signs of an ear infection on exam
  • Temperature > 39°C [102.2°F])

The American Academy of Pediatrics and Centers for Disease Control and Prevention (CDC) agree: Both recommend a watch and waiting period of 48-72 hours to see if mild ear infections in babies over 6 months resolve on their own before using an antibiotic.

When there is ear pain, treatment to reduce pain – not antibiotics – should be recommended unless there is a severe ear infection. Antibiotics should never be prescribed preventatively to reduce the frequency of AOM episodes in children with recurrent AOM. Keep in mind that just because antibiotics are recommended, it does not always mean they are necessary. Use good common sense and talk with your child’s doctor if your child meets these criteria but you’d like to try natural approaches before the antibiotics.

Here’s What I Tell My Patients

Most ear infections are self-limiting – that means they go away with time, patience, and supportive therapies.

kid_restingAmazingly, approximately 80% of kids with acute otitis media get better without antibiotics in 2-7 days! Not only that, they have no increased risk of hearing problems, ear infections in the other ear, or need for more invasive medical intervention. Also, they do not have any of the adverse outcomes that kids who received antibiotics experienced – including the development of antibiotic resistant pneumonia. Those who went on to need antibiotics did just as well as kids who had received them from the onset of infection.

So a watch and wait attitude with some comfort measures is often all that’s needed. But if your child doesn’t recover in 48 or so hours, or worsens, an antibiotic can still be prescribed. Let’s check in in 24 hours and see how things are going. You can speak with my nurse, and if she feels things aren’t improving, she’ll put you through to talk with me and we’ll figure out the next steps together.

In the meanwhile, you might want to consider natural therapies and comforting treatments. I’ve used natural remedies for kids’ ear infections for 3 decades and have not been disappointed! Herbal treatment can work quite well to relieve earache symptoms and infection. These are the first-line treatments I suggest to my own friends and family – in addition to my patients.

What can you expect? With a combination of the following approaches, ear pain and associated symptoms usually start to improve within a few hours, and are almost or completely resolved by 48 hours. Again, I always tell my patients to come see me if symptoms get worse or don’t improve noticeably within 48-72 hours.

For reducing pain:
  • Use a hot water bottle wrapped in a towel (to avoid burning your child) can bring a lot of comfort to a painful ear. Let your child sleep on a slightly filled hot water bottle – if it is overly full it will be too firm to rest on comfortably. (Do NOT use a heating pad.)
  • Give firm but gentle massage all around the jaw and head in the area adjacent to the ear. Massage in a downward direction behind the ear on the neck and apply gentle inward pressure in front of the ear toward the cheek (about where sideburns would be). This will facilitate drainage of ear fluids and stimulate pressure points in the area. It may be uncomfortable to your child so do it a few times a day for short periods.
  • Give Children’s Herbal Compound (Herb Pharm) every 1-4 hours depending on the pain severity. Their formula contains chamomile, lemon balm, catnip, and fennel. It is very soothing and also helps with fever symptoms. For babies the dose is ¼ teaspoon, for children 2-6 ½ tsp., and for older children even up to 1 tsp. each time. It can be diluted in water, and is quite tasty. You can get it on Amazon. Of course, you can also make your own tincture or tea using these same ingredients if you prefer.
  • You can always give children’s doses of Tylenol or ibuprofen if needed. The herbs, which I prefer, are gentler and safer, but don’t necessarily work as quickly. I try to avoid things that reduce the fever much, because fever is an important natural process for fighting infection.
For infection:

In addition to the above, I like a combination of Garlic Mullein Oil in the affected ear, and a combination of Elderberry Syrup- Echinacea- and Anise Seed Blend to boost the immune system and break up upper respiratory congestion.

Garlic-Mullein Earache Oil

10 july mullein flowerThe classic herbal remedy for ear infections is garlic-mullein oil. Garlic is a natural antimicrobial, addressing infections of both a bacterial and viral nature. Mullein is an analgesic, relieving the pain associated with earaches. It’s very easy to make at home or can be purchased.

To prepare garlic mullein oil, place one whole bulb of finely chopped fresh garlic and 1 oz. of mullein flowers in a pint-sized jar. Add olive oil until the jar is full. Stir with a chopstick or the handle of a wooden spoon to release air bubbles. Cover the jar and place in the sunlight for 3 weeks (2 weeks in warm weather). Strain into a clean jar (discard plant material) and store in the refrigerator. This will keep for up to two years.

To use place 3-7 drops of the oil into the affected ear while the child lays on his side with the affected ear upward. The oil should be at room temperature or slightly warm. To warm it, put the drops in a spoon or a glass eyedropper and briefly hold a lit match close to it. Test the oil against the underside of your wrist to make sure it is not too hot. Have the child rest with the affected ear up for 5-10 minutes, keeping a warm hot water bottle on the ear. After this time let the child roll over and rest on the hot water bottle for as long as this brings comfort. Repeat on the other ear if necessary. This treatment can be repeated 2-3 times a day but may only be necessary once or twice as it is very effective.


Echinacea -Elderberry Syrup-Anise Seed Blend

Echinacea_purpureaYou will need to purchase each of these products separately, and then mix them in equal parts (1/3 each) into a clean glass bottle. A medicine bottle with a dropper is ideal. This blend can be given preventatively starting during the season your child is most apt to ear infections, or at the start of an upper respiratory or ear infection. For prevention I give 1-2 teaspoons daily for children 2 and over (1/2 of that dose for babies), and or an acute infection, I give ¼-1 teaspoon 3-4 times daily, depending on severity. Continue at the preventative dose several times a week after all symptoms have cleared to prevent relapse. This product will stay good for a couple of years if stored in a cool, dark area. For babies under 1, make sure the Elderberry syrup is made without honey.

If your little one isn’t improving, or is getting worse, you can always start conventional treatment! But you might be delighted to find that you don’t need to!

In general:
  • Keep your child well hydrated, preferably with water and non-caffeinated herbal teas. 

Here’s when an antibiotic is appropriate:

  • If your child’s eardrum looks angry, red, and bulging. Because there is enormous variability in skill amongst doctors when it comes recognizing a true ear infection – even with a proper otoscope exam, they are likely to be over diagnosed.
  • If your child has severe symptoms and for some reason an effective ear exam is impossible to conduct (inconsolably screaming baby, narrow ear canals), it is also okay to prescribe an antibiotic
  • In babies younger than 6 months old with severe signs or symptoms
  • In children ages 6 months to 2 years with severe infection or if they have infection in both ears at once
  • In children aged 6 to 24 months with non-severe ear infection, either antibiotic therapy or observation with close follow-up is appropriate.
  • Antibiotic therapy should be started if symptoms worsen or fail to improve within 48 to 72 hours after onset.

As parents we have to do our part in the process of reducing antibiotic overuse – be informed and work in partnership with our children’s’ physicians – which sometimes may even mean educating them on antibiotic overuse (a great resource is CDC Get Smart!) . If you want to try alternatives, set up a reasonable plan for follow-up and switching to the antibiotic if needed, and offer to sign a waiver or informed consent that your doctor has explained the options and you have chosen the watch-and-wait approach.

Remember to refer back to 6 Sure Fire Tips for Preventing Kids’ Ear Infections Naturally of this article for the prevention of ear infections! And check out my amazing course, Healthy All Year, if you feel you’d like to take a deeper dive into healthy immunity and natural remedies for your kids. You’re going to love it! Now let me know how you roll with ear infections with your kids in the comments section below!

To your family’s good health,




Hersch A et al. Antibiotic Prescribing in Ambulatory Pediatrics in the United States. Pediatrics 128:6, 2011.

Kummeling, I et al. Early Life Exposure to Antibiotics and the Subsequent Development of Eczema, Wheeze. Allergic Sensitization in the First 2 Years of Life: The KOALA Birth Cohort Study. Pediatrics 119;e225, 2007.

McCormick, D et al. Nonsevere Acute Otitis Media: A Clinical Trial Comparing Outcomes of Watchful Waiting Versus Immediate Antibiotic Treatment. Pediatrics 115:1455–1465, 2005.

Plasschaert, A. Trends in Doctor Consultations, Antibiotic Prescription, and Specialist Referrals for Otitis Media in Children: 1995–2003. Pediatrics 117;1879, 2006.

Romm, A. Overprescribing of Antibiotics for Children’s Upper Respiratory Infections, Alternative and Complementary Therapies, 17:6, 2011.



  1. I’ve used essential oils for ear infections and know others who have also avoided tubal insertion. Be sure they are pure and therapeutic though as there are many impure or synthetics on the market.

  2. Thank You! Aivia! I look forward to the course.
    I rember getting ear infections when young, it’s No Fun!
    Much Love keep the blogs coming! 🙂

  3. Lovely article, thank-you so much! A comment and a question: I have added yarrow tincture to my garlic-mullein oil and find it really relieves the pain quickly; I’m not clearly understanding how to make the Echinacea-elderberry syrup-anise seed blend. Do the ingredients ever get strained out? Thanks so much for all you do. I turn to your books all the time for advice and recommend them whenever I get the opportunity.

    • Yes, yarrow is a wonderful herb to use as it is also antiseptic. The blend is made with tinctures and elderberry syrup, so nothing to strain -you just mix and store. Thank you for your generous support of my books and your very kind words! <3 Aviva

  4. Thanks you for this info. I’m just wondering when you mention the “Echinacea -Elderberry Syrup-Anise Seed Blend” is that echinacea and anise seed tincture blended with the syrup in equal parts?

    • I expect Aviva means for you to purchase elderberry syrup, kids echinacea Glycerite, and anise seed glycerite and mx them together. I rescanned the article to find her recipe, myself, though I am a master herbalist. It is always interesting to read others recipes.
      Good article, Aviva. Could’nt agree more heartily. My own nine were totally breastfed for two years with no juice or milk and I had no baby ear infections. The only ones we had later were when dairy was Introduced around three. When we took out the dairy, infections were no more. What a small price to pay!

  5. my kids are grown now but i had really good luck with homeopathic remedys and earaches.it takes a little deduction to figure out which remedy is closest to the symptoms but my kids responded very quickly to them

  6. I had a question on the bolded section which states “any child with severe infection defined as:”. Is the infection defined by having all/most of those symptoms or any one of them? For instance, my daughter currently has a 102.5 fever, which meets one of the criteria under “severe infection”. Would I give an antibiotic with that symptom AND some of the other symptoms – or based on that symptom alone?

    • Hi Rachel, She’s also have to have the visible infection on ear exam – and even then if she is not a baby, they will often still clear but I’d definitely use the herbs. I’ve treated hundreds of kids with ear infections even with symptoms of severe infection – as long as they were over 6 months – and were otherwise doing ok. But it’s a good idea to check with your pedi if she’s not getting better in 48 hours or if she gets worse or you are outside of your comfort zone for her. Watch closely and if you need to do the antibiotic – don’t feel badly!

  7. Love your blog. I wish I would have thought of natural remedies long ago. My daughter, now 8, had a horrible time with ear infections and seemed like she was on antibiotics for 6 months when she was about 1. So she recently got an ear infection but had a swollen gland and fever with it so I did take her to the doctor. And of course, antibiotics. She took them, still had the infection and swollen gland. I went to a wonderful herbalist at a local pharmacy and she gave me Congaplex. It worked awesome combined with Elderberry and she was good to go. I could not take having her be on antibiotics for a second round especially after the 10 days she had it. But will definitely try your suggestions above if needed (hopefully not).

  8. My 1 year old had an earache just last week. I reread some info which encouraged me to avoid antibiotics. It took a while to clear up from onset, but only 2 days after starting garlic/mullein drops it was gone! I was reluctant to start them because they stink! They do work, though. With my 6 year old who is prone to them, I do regular chiro care and homeopathic drops as needed. She hasn’t had antibiotics for them in 3 years and only mild pain when they come.

  9. Hi Aviva!
    How does this information transfer to adults? I’m sure it isn’t all that common for adults to get ear infections, but it happens to me often enough. Great article! This is so helpful! Thanks!

    • You’ll want to use dried only because if you put fresh into oil they can get moldy – so if you’re just learning how to make oils, dried is a good bet. Mountain Rose is a great on-line herbal supply company. Have fun!

  10. Thank you for the article! Please tell me more re. The anise seed blend, I have never used that. Also, what type of echinacea tincture do you recommend? Flowers, roots etc? For elderberry syrup we have used sambucus (sp?), is that the same?
    Thank you!

    • I use a combination of echinacea roots and flower tops around my house – but if you suspect pollen allergies stick with root- only products. Anise seed tincture is a sweet tasting herbal tincture that herbs to break up and thin out mucus – making it easier to drain from the upper respiratory passages. I mix this together with the echinacea and elderberry syrup. Many of them are Sambucus nigra but there are several usable species. Enjoy!

  11. Thanks for the article! Can you recommend any store bought preparations? I currently use Wally’s Ear Oil and Sambucus for kids. Thank You.

  12. hi, thanks very helpful. My son had such a bad ear infection when he was 5, he ended up being admitted to hospital for iv antibiotics and rehydration!! We didn’t know it was his ear because he doesn’t complain of pain much ever. The ent doc wanted to do grommets the next day,while he was so sick! We ditched that idea and he has been fine since!

  13. I was so grateful for this post, as I got an ear infection yesterday! I’ve never had one in my adult life and they are SO painful! I’m trying to avoid antibiotics, so your advice is amazingly timely.

    I have heard you mention zinc supplements to help boost the immune system, if the multi vitamin doesn’t have enough. How much is “enough” for adults and then for children under 12?

    Also, where can I find zinc for children? I’ve looked in our local health food store and couldn’t find one specifically for children, am I missing something? I have a few children who won’t swallow pills and I would like to find a chewable or drops. Is that possible?

    Thanks so much! I love reading your blog! And I am excited for your Pediatrics for Parents!

    • Thank you so much. And ouch – sorry to hear that you’re sick! Zinc up to 50 mg/day for adult – but a lotta’ folks get nauseated after 40 mg/day. It does have a toxic level so nausea = don’t take more than that dose. Kids under 12 I usually say max 20 mg/day, and really, 5 for babies and toddlers. Chewable lozenges are usually available at places like whole foods. Feel better!

  14. Hi,
    I have a question. My 19-months-old son keeps on getting ear infections all the time (and by all the time I do mean all the time, in last 6 months we’re on the 7th ear infection – recognized by his pediatrician during ear exam). In majority of the cases he’ll have very runny nose, coughs, low fevers (usually less the 102F, rarely higher) and that’s about it. He very, very rarely pulls on his ears, he isn’t unusually moody or inconsolable, he doesn’t cry much or complain about “ouch-y”, he’s a pretty normal happy toddler. But whenever we go for a routine checkup or vaccination or even to check on the runny nose&cough, he always seems to have an ear infection. We live in Hawaii, where the climate is hot and humid and we spend a lot of time on the beach and playing in the water, just for the record, so that may contribute to getting the infections. My question is, what can I do to help him stop getting the ear infections. I really do want another round of antibiotics, since even though they help clear it, they surely don’t prevent another infection from following soon after and doing antibiotics monthly doesn’t seem like a good idea at all. Any suggestions? Oh, and for the record as well, even though he was solely breastfed until 13 months, his ear issues and common colds started when he was about 6 months and mobile (and in daycare).

    • Hi Asia,
      I would start with diet first. Also, if this persists in spite of a really tight control on all juice and dairy, I’d get your son checked to make sure all of his immune markers ok – as constant colds and infections, even living by the ocean, shouldn’t happen…Daycare is a big culprit. See me blog for prevention ideas.
      Best wishes, Aviva

  15. Hi, My 4 year old son has epilepsy and has been getting frequent ear infections. He currently takes Valporate which controls his seizures. He tends to have seizures more when he is sick. I was wondering if the Elderberry blend would interact with his Valporate? He has had 3 ear infections since April and I want to try and prevent them. Thanks

    • GREAT question Kara. Neither valproate nor echinacea should interfere with valproate. Some other herbs yes, but these, no. Good luck!

    • Kara, I have a son with similar issues. Seizures started at age 10. We saw top neurologists and tried 6 different anti-seizure meds. They all increased seizures and caused reactions. After almost a year, we saw a D.O. who helped us figure out it was a gluten intolorence! He’s gluten-free, drug-free, seizure-free, and hasn’t had an ear infection since. Might be worth a try? Best of luck 🙂

  16. Hi Dr. Aviva! Quick question about the garlic mullein oil. Well, I guess just about garlic oil since that’s what I made as I didn’t have access to mullein at the time. I made the oil, and stored it in the fridge but it solidifies when chilled. In order to get any drops out of it, I basically have to leave the whole dropper bottle on the counter to warm up to room temp. Is that normal or did I do something wrong?

    • Hi Leila,
      Sure does get solid in the fridge! I keep a 1 oz bottle out so that’s available at the ready, and store the rest in the fridge. 🙂 Aviva

  17. Hello. I love your blog and website! I have a question regarding antibiotics for ear infection. My 7 month old son just got back from the ped where we had a follow up appointment since she noticed he was starting an ear infection in his left ear last week. He had just gotten over a sinus cold and is about to get two teeth. She noticed his ear was still red and inflamed when she looked inside and also noticed fluid in the right ear. She prescribed amoxicillin. I was wondering if I should try the garlic-mullein oil first. He has not had a fever and still doest not, shows no signs of pain, is sleeping through the night, etc. it is only open examination of the inner ear do we know he has a slight infection. But it has been 7 days and the ear is still red. Do you recommend starting the Rx or trying the garlic-mullein remedy first! Thank you for your help.

    • Hi Julie,
      Take a look at the CDC GET SMART site for when you can skip the antibiotics — there are great guidelines there. I often use garlic mullein oil instead of abx in a generally well child. But unfortunately can’t give out medical advice and without seeing the ear…. CDC will give you decent insights! No fever? No symptoms? Not USUALLY an indication for abx.

  18. What experience have you had with chiropractors and ear infections? My daughter has gone to one starting when she was only a couple weeks old. She’s almost a year old and hasn’t had a single ear infection, cold… Nothing. He’s treated many babies and helped with their ears and euchstation (sp?) tubes.

  19. Thank you Aviva for always sharing great info! My little one (12 month-old) hasn’t had any ear infections yet but I know they’re common so knowing this is great.

  20. Dear Aviva, I’ve heard much about the risk of botulism with fresh garlic oil. Reading your blogue left me the impression that there is not much concern about it, at least for the use inside ears. Is that correct ? Is the risk of being affected by the botulism toxin is only a treath if the oil is ingested ?
    Thanks a lot

    • hi catherine,
      i believe some caution is needed with bottled products used for salad dressings. i do not know of any instances of problems with properly prepared and stored garlic earache oil.

  21. My 13 month old had a cough and a cold and then a fever came.. When I took her to the doctor she was diagnosed with an ear infection… He prescribed anti biotics but I chose to go the natural route and use the garlic mullein drops and a trip to the chiropractor… He looked at her ear 6 days after the adjustment and said it was clear but she still has the cold… Do you think that means anything? Should I be worried?

    • hi danielle,
      hard to say from a distance but colds can last for a couple of weeks and fluids in kids ears can last for weeks after infection has resolved. CDC says don’t treat that with antibiotics. best, aviva

    • Hi Anna
      The main thing is don’t put anything in the ear if the drum is rupture. Antibiotics may or may not be needed, and the rupture itself relieves a lot of the pain.
      Best, Aviva

  22. My 3 1/2 year old has had a cold off and on for the past month and in the past week has had a pretty difficult time hearing. It was a pretty drastic shift; I took her to the pediatrician to make sure she didn’t have an ear infection but they just told me she had fluid in her ears. I’m concerned with how much it is affecting her hearing. I’ve been running a humidifier at night with eucalyptus oil, but wondering what else I can do to assist in the drainage. Would goldenrod be helpful as an astringent for the sinuses? or plantain? Any advice would be greatly appreciated!

    • Have you taken out all dairy? juice? sugar? wheat? Would try that first. I’d go with elderberry, garlic lemonade (see my blogs, book, or FB page for a recipe)and you could consider quercetin and eyebright, as well as low dose zinc (5 mg) in a lozenge. Best wishes! Aviva

  23. Hi Aviva, a friend of mine refered me to your blog and I’ve just signed up for the newsletter. I cam across this blogpost about ear infection and I must tell you that as a child I always had ear problems, my mum always treated me with homeopathics until antibiotics were the only solution. As a teenager I had 3 ear surgeries and now I hear less then I should in one year (I’m 29). Anyway, about 9 years ago I stopped eating dairy (yoghurt, milk, cheeses everything) – self diagnosed really and I haven’t had a problem with my ear since…such a shame noone was able to tell my mum this when I was little. Thanks for spreading the word!!!

  24. I’m reading your recipe for the echinacea, elder berry and anise seed mix. It says “For prevention I give 1-2 teaspoons daily for children 2 and over (1/2-1/2 of that for babies), and or an acute infection, I give ¼-1 teaspoon 3-4 times daily” I cant understand what you mean for babies 1/2-1/2? Also what is the measurement for babies with acute infection?

  25. I just now started using garlic oil for my son who’s a year, one does has made such a difference!!! I wish I stared 6 years ago I have 2 older boys who had chronic ear infections and we had so many ear infections we had to get tubes. They still get infections and are placed on antibiotics which I hate.

    I think I know the answer, but I’m going to ask anyway can I use these drops for my older boys? I’ve seen a few posts where moms used the drops on kids w.tubes that have had success. I called my ped, but they didn’t even recommend it for my 1 year old. I just had to try it just by reading all the success stories and I’m so glad I did!

    Thank you,

  26. My 1 year old son has had ear drainage for about 2 1/2 weeks now. No fever but does have a mild cold. He was scheduled for his 1 year check up a week about 5 days into the ear drainage and the doc wanted to prescribe an oral antibiotic which I declined. I did accept the ear drops. Baby is fine during the day but does get a bit grumpy at night so I have given him ibuprofen only at night so he can sleep pain free. Just when I think the drainage is stopping it seems to start again a day or two later. He is due back at the docs in a coupe of days. If this doesn’t clear by then, do you think I need to start the oral antibiotic? I really do not want to if this is something that may just take some more time to heal but also don’t want to incur any hearing damage.

    • Hi Jill
      If symptoms persist then yes, it might be appropriate, especially if there is drainage. IF there was no draining and just still fluid in the ears, and if he were more like 2 years old, then not necessarily so. The CDC GET SMART website offers indications for when antibiotics are necessary — that would be a good resource to look at and also review in the office with your little guy’s doc. Hope he recovers super fast! ~Aviva

  27. As a doctor, don’t you think providing “recipes” for home remedies dangerous? Making something you are going to put into a child’s ear that needs to sit in the sun for three weeks is, in my opinion, dangerous. Aren’t you concerned about bacterial contamination?

    • hi anne,
      several things:
      1. folks are going to use home remedies regardless. therefore it’s best to get info from a reliable source
      2. one should not put anything into the ear when there is discharge or suggestion of a perforated TM — that would certainly open the door to risk from contamination
      3. garlic oil has been used in the ear for centuries with no reports of infection from the use of the product or any association of bacterial contamination.
      i think the overuse of antibiotics in kids is what is actually dangerous — for kids and for public health globally.
      but thanks for sharing your thoughts. i hope you’ll look deeper into the options and safety of many natural home remedies. some are quite reliable and safer than pharmaceutical options.there are several studies looking at garlic oil in the ear — check out pub med.

  28. Hi,

    After reading this I am nervous. My daughter had a really bad head cold and wheezing for almost a week. Went to doctor Monday, they heard wheezing, so we did nebulizer for a day. Then she had bad ear pain. I tried onion on her ear, but am new to this. She woke up with pain, so my reflex was to take her to doctor. They said it had pus and was very red and infected and gave us augmentin. They did not advise to wait for 48 hrs, which now I think I should have. Gave her two doses, but now I am worried that it was not the right decision to start her on that-after reading this. But I know stopping the meds is bad, if not worse. Feel like I dont know what to do now. Like this round of antibiotics might hurt her. Any advice?

  29. Hi Aviva! I follow your blog and have been anxiously awaiting your Pediatrics course to become available. Our 4.5 month old was just prescribed amoxicillin for an ear infection in both ears (one ear worse than other). I brought it home just in case, but the Urgent Care doctor approved me doing the “wait and see” approach. Your blog (and I’m assuming the CDC recommends), treating with antibiotics for under age 6. Is this right? Thoughts on doing “wait and see” for her age? She has no fever. She has had a runny nose for 2-3 weeks and the last 7 days the cold was much worse. She is much better now, however, aside from the ear infections.

    Also, for a breastfed baby, would eliminating dairy from the breastfed mother’s diet help?

    • In a baby under 6 months old, with ear infection in both ears, an antibiotic is definitely indicated so you could treat or wait and see if your doc is on board. Ask you baby’s doc whether it is ear infection or effusion — those are two different issues and antibiotics are not always indicated — and that might be what’s going on if she’s otherwise doing really well.

  30. hello! please help!
    my toddler 2 years and 3 months started having a cough and a fever on the third day we took him to the neighbourhood pediatrician , I’ve never been before to this specific doctor , she diagnosed otitis in the right ear and prescribed 10 day s (!) of antibiotics, i didn’t want to give him antibiotics and everyone around me thought i was crazy two days later his fever was still high….and i finally gave in and gave him a dose at ten a night and then even though during the day he seemed perfect still coughing but no fever, another dose the followong night (last night) he is fine again today, with a horse voice and bit of cough but he seems fine, he never complained of his ear and I’m just sure she misdiagnosed it. now that I’ve started the antibiotics must i continue to give them? please help , i feel like I’m giving my kid poison! thanks,

  31. Hi Aviva,
    This is a great article – thank you! My 8 month old son was diagnosed with a double ear infection in mid-December (after flying with a cold). We saw our ND immediately and started him on Garlic-Mullein Ear Oil, homeopathic pulsatilla, ear massage, and warming sock treatments. We have been going back to the ND every 1-2 weeks since for an ear check and each time she tells us that his ears still look slightly red around the edges and “dull”. About a week ago, he woke in the night with an acute ear ache, which we treated as mentioned above while also giving him some ibuprofen (not my favorite and as I read this and realize I had Children’s Herbal Compound I am wishing I had thought to use that instead). The pain lessened within 24 hours though he still pulls his ear and sticks his finger in it. We have continued the ear oil 2-3 times per day and warming socks 3-5 times per week. We plan another ear check this week and my intuition is that it has gone from acute back to mild, but still present. This has now been going on for 8+ weeks. Any thoughts? Thanks so much!

  32. My grandson is 2. His right ear drum ruptured on 2/15 . He was put on antibic . Which are not working. He is still running a fever of 99.4 to103. We alternate motrion and tynol every 4 hrs. They are putting tuibs in his ears. He is screaming with. .his head hurting.he cant even walk right. Crawls. And falls over . What can i do for him.

    • So sorry– poor little guy! you’ll love my upcoming course, coming at the end of 3/2015, healthy all year, for boosting his immunity and preventing future ear infections! right now, though, best to go with the local docs recommendations as sounds like a pretty severe ear infection.

  33. Aviva,
    Would you also use the garlic oil in cases of Swimmer’s Ear Infection or would this type of ear infection be treated differently?
    Thanks, Teresa

    • Hi Teresa,
      That would be a different treatment — I usually treat with strong antimicrobials like goldenseal, but often, swimmer’s ear responds best to an external antibiotic-steroid combination. ~AR

  34. Love this information! Thank you!! All I have is Oregon wild harvest’s ear drops which includes St. John’s wort in addition to the garlic and mullein. Would the St Johns Wort be contraindicated for babies (1year)?

    My daughter has been really snotty for 10 days, now it is gone and she has a fever 102 and is cranky but no pulling on ears. I am assuming ear infection. So fever alone can give the 48 hour test?

    • Hi Eve,
      Yes, the studies on earaches and kids include the benefits and safety of SJW in ear oils. For more details on ear infections, fever, and when to treat with antibiotics or watch and wait see the CDC GET SMART or check out my FREE e-book on my website. Warmly, Aviva

  35. Hi Dr. Aviva!
    I had seen both articles some time ago, but I didn’t pay much attention- we had never experienced an ear infection with our first three kids and I really hoped I’d never need the info… So, now baby no 4 -6 mos old- had been crying inconsolably for days, wouldn’t nurse well and was very miserable. She had no fever though. We took her to the doc this morning and she could find anything wrong with her either. Just concluded that it might be teething irritability and we gave a sample to check for a UTI. Shortly after we came back home the baby calmed down some, and then I saw thick greenish mucus coming out of her ear. Apparently the rupture of her drum relieved her of her pain. I don’t know how serious that is, so I went ahead and gave her the first dose of the antibiotic and then started trying to figure out what’s best… For the last 6-7 years with the other 3 kids I’ve been using your wonderful book(+ the pregnancy book) I never had to give antibiotics nor Tylenol, your herbal remedies worked fine for us. Now I have to use both( antibiotics and Tylenol). How do I ‘save’ her wonderful gut flora now? Shall I give S.bulardii and therapeutical grade probiotic while she’s on the antibiotic? And instead of the Tylenol shall I use the ‘children’s defense’? I know it’s not the same but if it’s not absolutely necessary I’d like to avoid it. I am a pharmacist but I so much dread giving medicine to my kids. Any suggestions? I got the ‘healthiest kids university’ but I’ still in unit 1( I love it by the way!), could you point me to a certain unit that could be useful for me right now? Thank you so much, I wish we had doctors like you in Greece

  36. Thank you for the information. I’m late to post on this but my 11 month son has had constant ear infections since 6 months old (5 rounds of antibiotics- ouch). Has the classic Allergic rhinitis symptoms of constant congestion, dark circles under the eyes. Of course the infections coincided with stopping breastfeeding- he has been in daycare since 3 months old. I’ve been seeing a naturopathic doctor and we took him off formula and switched to goats milk. That is not helping so now she is suggesting a yogurt-water mixture because she doesn’t want to recommend processed milk-alternatives (almond milk, etc.). My question if he has dairy sensitivity will the yogurt be any better? The rest of his diet is all fruits and veggies, rice, and some meat/beans. All organic. Thanks for any input you can provide. We may have to go the tubes route if we can’t get this turned around 🙁

    • Hi Jessica,

      This is Megan from Dr. Aviva’s team. I am sorry to hear that your little one has had so many ear infections. I know how hard this can be for both of you! Typically if someone is sensitive to “dairy” they are reacting to the proteins in the dairy. Yogurt does indeed have the same proteins (casein and whey) as other forms of dairy.Here is an article that Dr. Romm wrote on doing an elimination diet that has some really good tips and is incredibly helpful http://avivaromm.wpengine.com/elimination-diet . I hope this helps!

      Megan- Dr. Aviva Romm Nutritionist

  37. Hi

    My 3 year old daughter had a cold and a cough and a stuffy nose. She can’t blow here nose so I feel this has a lot to do with the following. After the cold had died down a bit she got a fever (highest 38.5 ) and she said my ear hurts the left one. So i immediately thought oh no ear infection. I gave her paracetamol and the fever went and didn’t last more than 24 hours. So i assumed that it had gone. A couple of weeks later she got a fever again and complained of ear pain but it wasn’t severe she didn’t cry or complain much and she seemed healthy and playful. I took her to the doctor and he said that it wasn’t very clear to see but it seems she has a mild infection in the left ear, wait 48 hours and see what happens and if she doesn’t get a fever and it goes down with paracetamol then thats that, on other hand if it reaches 39 and above call me and i will prescribe an antibiotic (Azithromycin 200mg/5ml SUSP) So i waited and she didn’t get another fever and that was that. But now 3 weeks later she got a fever 38.2 max (armpit) and held her ear and said it hurt. So now i don’t know what to do i really don’t want to use antibiotics if i don’t need to. Her fever cleared up with paracetamol and it hasn’t returned. But I am scared that if it is the mild infection it will gradually get worse. I want to take her to the doctor again to check before and if i do start antibiotics. Your advice will be much appreciated.
    Thank u

  38. My daughter 4yrs has had her first ear infection. We are on day 8 it started out pretty bad and then settled then raged again today after a day with dairy and juice. She cried all morning until I went out and got some tylenol which we haven’t had since she was a babe at which time she threw it up so we never used it again. Desperate today though and we are out of our regular province staying above people so extra keen to make the crying stop. It worked, she passed out and then I looked at her ear which had heat on it. The ear drum had ruptured leaving wax, fluid and a trace of blood. I cleaned it with olive oli. Wondering if there are specific treatment once ruptured as I know I cannot use drops now. Thanks!

  39. Thanks so much for taking the time to do this. I have studied holistic health for many years, and still am learning every day. My frustration lies in the doctors we have in the small town area we live in. They do like to prescribe things everytime. I actually rarely take my kids in unless it’s something like the ears not getting better because it is so discouraging. So, my question is, my 15 year old son started with a fever almost a week ago, the next day his ear started hurting. I did oil and garlic in the ear, and the pain went away. The next day the other ear started. It was a little more resistant to the garlic and oil, but did seem to lessen the pain. Mind you, he still continued a fever most of the time, including sinus junk and a cough that made the pain worse. 4 days in, he seemed to be getting better, then yesterday (5 days in) his other ear started hurting again and the pain got worse, fever came back, and the left ear ruptured. This morning I took him to the ER and they confirmed it, and said it was bacterial(without a swab. Can they tell that?) and that it was pretty bad on the side that hasn’t ruptured. They prescribed Amoxicillan and I’ve made an appointment with an ENT. I absolutley hate to give antibiotics knowing it could end up making things worse for him and making it possible for chronic ear infections, but hate to keep him in pain while I continue my natural remedies/antibiotics. Do you think I should go ahead and use what they prescribed? Thank you 😉

    • Hi Kelli,

      So sorry that we are just now seeing this! Hopefully your sweet pea is all healed up.

      Warm wishes,
      Megan- Aviva Romm’s Executive Assistant and Online Nutrition Expert

  40. Hi Dr. Aviva,

    My 16 month old son as been sick with runny nose and cough for the past 3 months. We have given him antibiotics 2x now and the pediatrician is recommending a third, stronger dose. I do not want to go that route but I do not know what else to do! My wife and I are now trying your natural remedies (THANK YOU FOR THIS ARTICLE!). I worry that all this time being sick with ear infections may adversely affect his growth and/or hearing, but more antibiotics (that may or may not work!) is not what I want for him. I do not know what to do and would LOVE your advice.

    Thank you,

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