Cafe LaLeche Information Library/Archives

Pregnancy and Breastfeeding

Breastmilk and Ear Infection Treatment

Adapted from a discussion thread at bf.com

Research strongly supports the fact that breastfed babies get fewer ear infections than do bottle-fed babies. Even so, breastfed babies may occasionally get ear infections. Parents often ask for alternatives to antiobiotics for treating this illness. DO NOT PUT BREASTMILK IN THE EAR.

This is an old wives tale and it is potentially dangerous way to self-treat ear infections and could make his illness worse. I speak from experience, having followed this folk "wisdom" when it was recommended to me here at this board. As stated, the eardrum is not permeable. That means that fluids can't get past it, causing the bm to pool in the ear canal where it can breed more bacteria and lead to another infection called "otitis externa" - an infection in the canal. Which is exactly what happened to Joshua when I tried to self-treat him with BM in the ear. I have a significant hearing loss in my right ear from an infection that went undetected and untreated for a long period of time when I was in junior high school. I take ear infections very seriously. Research now shows that ear infections are as likely to be caused by viruses as bacteria. My chosen course of treatment now is to have the kid checked by the doctor and then make an informed decision as to whether or not to wait a week before starting antibiotic treatment. If the infection is viral, it will clear up on it's own in that time. Some lay practioners do advise putting breastmilk in the ear.

There have been articles at mothering.com on the topic. However, all the health care professionals I"ve ever spoken with advise straongly against the practice, explaining that the ear drum is impermeable and the BM can grow bacteria in the ear canal. *** Member mommychille (aka pedsrnp, leo), a pediatric nurse practioner, write: I agree with Creme. The TM is impermeable. Any macrophages etc would not be able to get past it to help with a middle ear infection. The most common cause of otitis externa is pseudomonas. This is a bug that bm is not particularly helpful at fighting in terms of direct application. In fact there have been many outbreaks of psuedomonas infection in neonates in the NICU due to contamination of pumped milk.

BM does not kill psuedomonas on contact. It does not penetrate the TM. At best it will feel soothing due to some mild anti-inflammatory properties.

Here's one article on TM permability. It discusses some studies on topical antibiotics which have been shown experimentally to be absorbed through one specific area of the TM called the Round Window Membrane. It also discusses that most antibiotics and topical applications will not be in contact with the RWM long enough or in high enough concentration to be able to be absorbed, even if it is theoretically possible. The qoute below further highlights the uncertainty about TM permeability during AOM.

Basically they are pointing out that the TM is significantly thickened during infection and that tiny area where absorption may theoretically occur is further compromised. Just food for thought. Maybe some day we will learn otherwise. It is an area of intense research as people are desperate to find a topical treatment for OM. Most of the research on medications absorbed through the TM involve placing the medication directly on the Round Window under an occlusive dressing. Even with this technique absorption is very poor or nondetectable for most substances.

Obviously it would be impossible for a typical mom with a wiggly baby to place BM directly on the round window and place an occlusive dressing on it. Article on tympanic membrane permeaibility. It should be noted that during middle ear infections, there is often an abundance of mucosal edema, microorganisms, and fluid that might occlude the round window niche and further inhibit the absorption of ciprofloxacin and other topical medications.

Here's a nice article on OE from AAFP. I can't seem to find any user-friendly discussions about TM permeability, but I'll keep looking around if I have time. Article on Otitis Externa. It is the only skin-lined cul-de-sac in the human body. The external auditory canal is warm, dark and prone to becoming moist, making it an excellent environment for bacterial and fungal growth. The skin is very thin and the lateral third overlies cartilage, while the rest has a base of bone. The canal is easily traumatized. The exit of debris, secretions and foreign bodies is impeded by a curve at the junction of the cartilage and bone.

There are many precipitants of this infection (Table 1), but the most common is excessive moisture that elevates the pH and removes the cerumen. Once the protective cerumen is removed, keratin debris absorbs the water, which creates a nourishing medium for bacterial growth. When disruption occurs, a new pathogenic flora develops that is dominated by Pseudomonas aeruginosa and Staphylococcus aureus.5,6,15,16

**** Originally posted by Mommy to C: Leo, I'm an audiologist, and for the record, the Round Window seperates the middle ear from the inner ear. Your article discusses intratympanic ciprofloxacin drops that are used when there's a perf in the TM, and whether the drops enter the inner ear. And also, I agree the TM is impermeable and that BM is not a good solution for a middle ear infection.

*** Breastmilk is a safe, proven and well researched remedy for conjunctivitis (pink-eye). Just squirt it in the eye several times a day. There's a link in the info archives to research. See other research on the immunological properties of breastmilk here.