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Could Foods Be Causing Your Child's Ear Infections?

Jennifer Kazemka, PharmD Candidate 2005
Nesbitt School of Pharmacy, Wilkes University, WilkesBarre, PA

Prepared during Consumer Health Information Corporation Clerkship
McLean, VA

How many sleepless nights have you spent trying to comfort your child who is crying from the pain of an ear infection? Most parents take the child to the doctor if they think he or she has an ear infection and get a prescription for an antibiotic. It is important to get rid of the ear infection and take steps so that the child does not have permanent damage.

But many parents find that their child gets ear infections over and over again and don't know why. Many parents make the mistake that ear infections are just something most children have and nothing can be done to prevent them.

But, it turns out that there may be something parents can do!

What many parents don't know is that the "hidden" cause of many ear infections in children may be due to food allergies. Children can be born with allergies to food or may develop them because certain foods were introduced into their diet too early.

Food allergies are common especially in the first three years of life. As many as 79% of children with recurrent ear infections get them because of allergies. The most common foods that children may be allergic to are:

  • Milk
  • Soy
  • Egg whites
  • Wheat
  • Fish
  • Peanuts

How can these foods cause an ear infection?
It is possible that your child may have an allergic reaction to one of these foods. The allergic reaction can cause the tube connecting the ear to the throat to swell. When this happens, fluids that normally contain bacteria in the throat get trapped in the ear. The warm, dark tube in the ear is a perfect place for bacteria to grow. This can cause an ear infection. Signs that your child may have an ear infection are runny or stuffy nose, cough, fever, or irritability.

Should my child be tested for food allergies?
Parents should consider food allergy testing if he or she has frequent ear infections. Talk with your child's doctor to see if your child should be tested. Three of the most common tests are:

Skin prick test
Small amounts of substances of different allergies are put on the child's skin. Tiny needles are used to gently prick the skin so that the substances can get underneath the skin. It is usually done on the forearm. In children younger than 3 years old, it may be done on the back.

Results are known within 15-20 minutes. If your child is allergic to any of the foods, the skin usually will become red, swollen, or itchy. If the reaction is negative nothing will be seen around the skin prick. Sometimes the doctor may have to do additional tests to double-check the results.

Food elimination/challenge test
This is a test where you do not give your child one or more of the suspected foods for about one week. Milk is usually tried first since that is the most common food allergy that may lead to ear infections.

After a certain period of time (usually around one week), there should not be any of that food left in the child's body. The doctor will give your child one of the foods that was taken out of the diet to see if your child will have an allergic reaction. Food challenge tests should always be done under a doctor's care in case a serious allergic reaction happens.

Allergy blood test
This is a newer type of allergy test that only requires a sample of your child's blood. The blood sample is taken at the doctor's office and sent to a laboratory to be analyzed. This test, called ImmunoCAP, is extremely accurate and can help your doctor quickly determine if your child is allergic to certain foods. It can test for 6 of the most common food allergies in children (egg white, milk, fish, peanut, soybean, wheat). ImmunoCAP can also test for hundreds of other causes of allergies such as weeds, trees, pollens, mold, and animal dander.

Skin prick test
  • Results available quickly
  • Can test for many allergies at the same time
  • Results may not always be 100% accurate and another test may need to be done to make sure the result is correct
Food elimination/
challenge test
  • Very accurate results
  • May take a long period of time to find out what allergy is
ImmunoCAP blood test
  • Only requires one sample of blood to test for many allergies
  • Extremely accurate
  • Faster results than the food elimination/
    challenge test
  • May take longer to get results than the skin prick test because the sample needs to be sent to the lab
  • Not available in every city yet

Talk with your doctor to see which test will be best for your child!

Avoid the Problem Foods
If your child has a food allergy, avoid giving your child this food. Be sure to read all labels carefully because many foods may have "hidden ingredients." Your child may need to avoid the following foods:

  • Milk: yogurt, cream, cheese, butter, whey, cottage cheese, ice cream,
    pudding, baked goods
  • Soy: soy sauce, worcestershire sauce, tofu, some cereals, some infant formula, soy nuts, soy milk
  • Eggs: anything fried or batter-fried, waffles, pudding, pretzels, cakes, cookies, ice cream
  • Wheat: many breads, cookies, cakes, and other baked goods, bread crumbs,
    crackers, many cereals, pasta
  • Fish: worcestershire sauce, caesar salad, caviar, imitation seafood
  • Peanuts: many foods may contain traces of peanuts including cookies and other baked goods, cereals, whole grain breads, ice cream, salad dressings

Make sure your child gets the right balance of foods and nutrients if your child must avoid one or more of these foods!

Other tips
Here are some other tips to help prevent ear infections:

  • Wash your hands often to avoid spreading germs
  • Keep the child away from second hand smoke
  • Breastfeed if possible. Mother's milk helps the child fight off infections better than formula.
  • Keep your baby's head up when bottle feeding so that milk (and bacteria normally in the child's mouth) are not pushed up into the ear.

Protect your child's health! Find out if your child's ear infection could be due to food allergies. Talk with your doctor about having your child tested. This could mean less doctor visits, less antibiotics, less time off work caring for a sick child, less sleepless nights trying to console your child...and a healthier and happier child who will thank you later in life!

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