March 5, 2011

Kids’ Ear Infections Reduced

Health officials have reported close to a 30 percent drop in young children's visits to the doctor for ear infections over the past 15 years, and some researchers suggest the decline is partly due to a decline in smoking by parents.

Why the numbers are falling is somewhat of a mystery, but researchers at Harvard University think a decline in the number of smoking parents could be contributing, meaning less irritation of children's airways. Many doctors credit the growing use of a vaccine against bacteria that causes ear infections. Others think increased breast-feeding is protecting more kids.
Dr. Richard Rosenfeld, an ear, nose and throat specialist form New York, speaking for the American Academy of Pediatrics, said: "We're sort of guessing here."

While once being the most common reason parents brought their young children to a doctor, the Centers for Disease Control and Prevention has not issued a report on ear infections in nearly 20 years.

Between 1975 and 1990 visit rates for children under 6 more than doubled for ear infections. One of the main reasons, according to Rosenfeld, was a steady rise in dual-career families. More families put their kids in daycare, and daycare is a breeding ground for germs that can lead to ear infections.

But a Harvard University study suggests that cigarette smoke could be another contributor.

Most infections of the ear occur after a cold. In children, the ear is more directly connected to the back of the nose. So infections in a child's nose and throat can easily cause ear inflammation, which can then lead to infection.

When a child inhales cigarette smoke through the nose, it can cause the same level of irritation and swelling in the ear, said Dr. Gordon Hughes of the National Institute of Deafness and Other Communication Disorders.

Figures from the CDC show that exposure to secondhand smoke declined from 88 percent in 1990 to about 40 percent in 2007/08.

Harvard research indicates the decline is in line with a drop in childhood cases of ear infections.

"When people are smoking less around their kids, when homes are smoke-free, the rate of ear infections can and has decreased," Hillel Alpert, lead author of a study published recently by the journal Tobacco Control, told The Associated Press.

The number of medical visits in which the main diagnosis was ear infection dropped by nearly 30 percent from 1993 to 2008 in children 6 and under -- from about 17.5 million to 12.5 million. The rate of visits for ear infections dropped by 32 percent, from 636 visits per 1,000 children to 431 per 1,000.

The downward trend, however, has seemed to level off in the past few years.

Some doctors said they have noticed fewer ear infections in their waiting rooms compared to years ago. "We don't see them that much anymore," said Dr. Michael Baron, a family practice doctor in Stone Mountain, a suburb of Atlanta.

A vaccine meant to protect against strep bacteria could be another factor in the decline of ear infections in children. The vaccine was first licensed in 2000 and would not account for the drop in cases in the 1990s, however, but has probably contributed to the decline since, according to several experts.

Some studies have also credited antibody-rich breast milk for lowering infants' risk for respiratory and middle ear infections. Breast-feeding mothers have been on the incline with 77 percent now, up from less than two-thirds in the early 90s.

But for some, these theories may not seem to hold water.

In the Willis household in Charlotte, NC, neither parent smokes, both children had all recommended vaccines, and the mother breast-fed each child for about three months.

Yet their 6 ½-year-old son Hatcher got 10 ear infections in one year when he was younger, and their 21-month-old daughter Libby Jeanne has had four.

Jessica Hyatt, a 21-year-old mother in Spokane, Washington, whose home is also smoke-free, said her 2-year-old daughter Chesnie has had four ear infections, with one lasting nearly two months.


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