Understanding Your Child’s Ear Infections Step by Step (Pedcast)

Ear infections, or otitis media, are a painful part of childhood. Understanding the biology behind the development of ear infections can help parents see the warning signs and take preventative measures. Thus, in this pedcast, Doc Smo walks you through the stages of ear infections and provides listeners with ways to help prevent them.



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By some estimates, 40% of visits to pediatricians are for ear infections.

Most children have otitis before the age of 2 years.

I Thought today, we would talk about why children get them, should they be treated, and can they be prevented?

Parents have these questions all the time.

So lets get started with our discussion with a trip down, you know where, science lane.


There are loads of germs in our nose that can cause ear and sinus infections…all the time!  That’s right, sinus and ear infections are usually an overgrowth of germs we already carry.

So why don’t we have ear infections all the time?

To understand the answer to that question, need to know how our noses work.  That’s right, our noses.

Remember the structures that are attached to our noses, our sinuses in every direction around our nose, our ears through the Eustachian tubes, our eyes up through the lacrimal ducts, and our throat pulling up the rear.  

Normally every time we take a breath through our nose, we put fresh air into our sinuses and ears. If our noses are working properly, each breath opens the windows and lets in fresh air into our sinuses and ears and at the same time equalizing the pressure with the ambient pressure around us.

In addition, the cells that line our nose, sinuses and ears secrete a steady trickle of mucous that is kept moving by our cilia, little brooms that constantly sweep the mucous into our throats.  A gentle river of mucous flows through our noses, sinuses, ears and bronchioles all the time cleaning and moving away dirt and germs away from our healthy respiratory system.

The combination of moving mucous and fresh air keeps germs from ganging up on us.


Now think of a child, especially a baby.  A cold means a swollen nasal passage without air moving and loads of extra mucous. Babies don’t blow their noses, remember! This is the recipe for a sinus and ear infection.

Stagnant mucous in airless places.

Here is the sequence of events:

Virus attaches itself to the nasal membrane causing swelling lining cells.  The medical jargon for this is apoptosis or swelling of cells.  We can feel that at the beginning of a cold.

The children’s tiny sinus and ear Ostia become obstructed from airflow causing a VACUUM to form in the ears and sinuses.

Your body doesn’t like a vacuum and fills up these spaces with mucous (when your child’s doctor says, fluid in ear…this stage).

Remember that bacteria in the nose, now it has warm, sugary pockets of stagnant fluid to grow in and BAM, a hot ear infection.

Since bacteria grow so fast, it can be only a matter of hours between fluid in the ear and a raging infection.

The body’s natural defenses, moving mucous and fresh air are not there to keep the germs from taking over.

Children who carry the allergy gene have all the same events occur but the swelling inside their noses is from both dust and pollen allergy and viral infections.  These children are especially prone to ear infections.

So what’s the perfect storm for ear infections?

Under 2 years of age….Promotes…Small nose and no blowing.

Remember this Doc Smo pearl, “Rivers that don’t flow are nasty!”

Being in an environment where infection with respiratory viruses is frequent…..  Being around a lot of other young children.

Remember this Doc Smo pearl…. “Infectious diseases are contagious!”


Being a child with eczema, food allergy, or recurrent wheezing…  having the allergy gene which means lots of swelling in the nose and loaded with mucous.


If your child is prone to ear and sinus infections…practical tips that might help.


1. Avoid crowds of children to play with especially when they are very young and put things in their mouths.  Touch is the method of spread.

2. Be especially careful with group care if your child exhibits signs of allergy.

3. Play with other children outside whenever possible, even when it is cold.  Unlikely to transfer germs outside.

4.Unless your child has clear allergy, Avoid cold medicines with antihistamines, which can make nasal mucous thicker… poor flow means more infections.

5. If your young child has loads of otitis media, try a milk free diet for 2-4 weeks to see if it helps.

6. Hose those little noses with saline a lot… water is a natural cleaner.  Use it!

7. Try and avoid treating ear infections in children older than 2, after your child can talk.  More on this subject listen to “Bugs and Drugs”



That wraps up todays “Pedcast” Thank you for listening.  I hope your understanding of ear infections is better now.

If you enjoyed this talk, try some other DocSmo episodes which you can find at my website, DocSmo.com, at my face book page or on ITunes.

Comments are welcome.


This is Dr. Paul Smolen.

Recording in full digital sound from studio 1E in Charlotte, NC.

Wishing your children noses full of warm breezes and years without sneezes


Until next time
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Swimming, A Basic Life Skill All Children Need to Know (Pedcast)

Swimming lessons are a crucial for every child’s safety–drowning is one of the leading causes of death for children. As parents, you can help protect your children and lower the number of needless drownings by teaching them water safety skills. In this pedcast, Doc Smo emphasizes the importance of child swim lessons and gives parents some practical advice about teaching their children to swim.

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Shaping Your Child’s Character, Leading by Example (Pedcast)

Children are easily influenced by who and what’s around them. Thus, their characters are shaped not only by their peers but by you, their parents. As Doc Smo says, you create your child’s reality, and the reality you choose to create helps mold your child into the person he or she is going to become. So, learn some practical tips for shaping your child’s character through your own actions.

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*By listening to this pedcast, you are agreeing to Doc Smo’s terms and conditions.

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Spicy Feet, The Latest Recommendations Regarding Cough and Cold Medicines for Young Children from FDA and Moms (Pedcast)

In this pedcast, Doc Smo explores the effectiveness and safety of cold medicines for young children–from what the FDA recommends to Grandma’s home remedies. Learn some practical advice for dealing with this year’s cold season.


Cough is one of the most common symptoms that children have.

Disturbs sleep and is very unpleasant for everyone.

Parents hate to see kids cough.

Anyone with young children knows. children get sick a lot, on average 7-12/yr.  Usually at least monthly.

Treatment of cough and colds is a big deal in my world and anyone with young children.

Today, we discuss recent developments with regards to cough and cold medicines.


Recently, had a 3 year old in the office with croup, a coughing illness whose mom happened to be Indian.  From India that is.

We were talking about the treatment of cough and I started to tell her about the FDA statement on the use of cough and cold medicines in children under 4 years of age.


If you don’t know, Jan 2008 the FDA and the manufacturers agreed to alter labels of these meds.  The change says, not to use in children under 4 years old. Not removed from the market!


FDA’s concern was that many of these medications had no efficacy data to prove effectiveness AND reports of hundreds of children a year in emergency departments  with adverse affects.  There have even been some deaths from these medicines.


The MANUFACTURERS claim they are safe when used properly, and we don’t need efficacy data since they have been around sooooo long.


As a consequence of all this discussion, people like me, pediatricians, are now encouraged not to recommend cough suppressants and cold meds for young children.


So we are left with grandma treatments.  Nothing against grandma.  I think she was a genius.  How did she figure out that whole cod liver oil thing???


Back to my patient, I was telling her about her options with regard to cough relief in a three year old since older treatments are off the table (OTC, alcohol, codeine cough syrups)

Humidifier-lets loosen those secretions.  Breathing warm steamy vapor in the bathroom can also help.

Honey or other syrup to coat throat.

Propping semi-erect. Lets let gravity help.

Vicks Vapor rub (Commercial Brand of Menthol Rub)…  I started to tell her about the latest rage, Vicks on the soles of the feet covered with socks.  She interrupted and said.   “Oh the spicy feet, I know, I know!”


Spicy feet. Wow. I love it!  The essence of western medicine summarized in just 2 words.. And invented in NC! Spicy feet!

You’ve heard the Vicks Vapor rub on the feet, haven‘t you? .   Urban legend or an effective therapy. I don’t know. Many parents swear by it.  It does fit into my treatment paradigm, however which is, “ Do no harm!”


Vicks ok for throat, chest and feet, but not under the nose… rarely, this can cause problems.


Bottom line:

Cough is a good thing, protective reflex keep airways open.  Really don’t want to stop it.

Cough can be a sign of real trouble.

Cough with high fever, or chest pain, or sob,  can mean pneumonia.

Cough till vomiting can mean whooping cough.

Cough with wheeze can mean asthma, foreign body, or other bronchial problems.

Cough with a barky quality usually means croup, which can be serious at times.


In young children, Suppressing coughs in my opinion is only for sleep and only with mild measures such as humidifiers, honey, and maybe, just maybe, spicy feet!



Thanks for joining me for another pedcast.

Hopefully you got some information and a smile.

Check out DocSmo.com for references used in this pedcast as well as other pedcasts.

Feel free to leave comments.

This is DocSmo, Dr Paul Smolen from beautiful studio 1e wishing you and your children just the right application of herb so that their cough won’t disturb.


Until next time.

Smo Notes:

Subscribe on iTunes!1. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048515.htm?sms_ss=email&at_xt=4cb0eac23d26f42a,0

2. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048682.htm?sms_ss=email&at_xt=4cb0eb184620ac31,0
Subscribe on iTunes!

*By listening to this pedcast, you are agreeing to Doc Smo’s terms and conditions.

All Rights Reserved