Ear Infections: Holistic Treatment & Support
- Natalie Wescott
- Aug 16
- 10 min read
Updated: Dec 19
2 nurses, 1 topic: Ear Infections
This guide and Instagram post was a collaboration with Jessica, FNP. She is a functional nurse practitioner with her own practice providing holistic care to local families in her community.
An ear infection is inflammation and infection of the ear, often caused by bacteria or viruses. It can affect different parts of the ear (outer, middle, or inner) leading to pain, discomfort, and sometimes temporary hearing issues.
Types of Ear Infections
Outer Ear Infection (Otitis Externa / Swimmer’s Ear) Infection or inflammation of the ear canal, usually caused by bacteria or fungi. Common in swimmers or those who frequently have moisture in the ear. Symptoms include ear pain, redness, swelling, and sometimes drainage.
Middle Ear Infection (Otitis Media) Infection behind the eardrum in the middle ear. Often occurs after a cold or respiratory infection, especially in children. Symptoms include ear pain, fluid buildup, hearing difficulty, and sometimes fever. Subtypes include:
Acute Otitis Media: Rapid onset infection with noticeable pain and possible fever.
Otitis Media with Effusion: Fluid remains in the middle ear without active infection; can cause mild hearing loss or a feeling of fullness in the ear.
Recurrent Otitis Media: Multiple episodes of acute infections over a short period
Inner Ear Infection (Labyrinthitis / Vestibular Neuritis) Infection or inflammation of the inner ear, often viral. Affects balance and hearing, sometimes causing vertigo, dizziness, nausea, and hearing changes. Less common than outer or middle ear infections and warrants medical treatment.
Risk Factors (who is most susceptible)
Age (children, especially under 5, are more prone)
Recent colds or upper respiratory infections
Allergies
Exposure to smoke or irritants
Swimming or frequent water exposure
Root causes of ear infection:
Viral: Viruses can directly infect the ear or weaken the body’s defenses, creating conditions where bacteria thrive. Common viral root causes include:
Upper respiratory infections (colds, flu, RSV, adenovirus): These inflame the nasal passages and Eustachian tubes, leading to fluid buildup in the middle ear.
Viral sinus infections: Congestion and pressure changes can spread into the ear canal.
Measles, influenza, or other systemic viral illnesses: Less common today but still possible, especially in children.
Weakened immunity during viral illness: Allows opportunistic infections to take hold.
Bacterial: Bacteria often invade after a viral illness has already caused congestion and fluid retention. Root causes include:
Secondary infection after a viral cold/flu: Trapped fluid in the middle ear becomes a breeding ground for bacteria such as Streptococcus pneumoniae or Haemophilus influenzae.
Sinus infections: Bacteria spread from the sinuses to the ear.
Allergies: Cause inflammation and fluid buildup that can predispose the ear to bacterial overgrowth.
Anatomical factors: Enlarged adenoids, cleft palate, or chronic congestion can impair drainage and increase bacterial infection risk.
Swimmer’s ear (external ear infection)
Can be caused after swimming when the water does not all drain from the ear canal. Since it is a dark space and now moisture is in there as well, there is the increased possibility of bacteria present from the water, infection can occur. This type of infection usually causes more pain externally, sometimes even itching.
Eustachian Tube Dysfunction:
The cause of the actual infection is lack of drainage in the eustachian tube. This tube connects to the nasal sinuses and drains. In children the tube is more horizontal vs in adults it is more vertical, allowing gravity to more easily assist with drainage. This is often why we see a decrease in ear infection frequency as kids get older and in adults. However, even in adults, if there is swelling in the tubes or around the tubes, whether from colds, allergies, or even if the adenoids are enlarged; drainage can become impaired causing bacteria/viruses to cause an infection.
Prevention Tips (Holistic & Practical)
Encourage hand hygiene and reduce exposure to colds/viruses
Limit secondhand smoke exposure
Keep ears dry after swimming or baths
Support immune health with nutrient-rich diet and hydration
Otoscope
When planning on treating ear infections (especially if using home remedies), having an otoscope on hand is important! Reminder - pull down on the earlobe when looking into a child's ear under 3 years old. Pull up on the earlobe when looking into an older child's or adults' ear!
Here are links to a few options:
Otoscope 1: This one includes a picture chart and a hard case
Otoscope 2: This one is an ear camera which may provide a better picture
Otoscope 3: This is a variation with a soft case (the one I have!)
Here are 2 charts of what you may see through the otoscope. The chart above shows simply what a normal, infected, or perforated eardrum may look like. The chart to the side is a bit more complex with a few more common ear disorders pictured.
Traditional treatment:
Traditional treatment for otitis media includes antibiotics which are often prescribed at the first sign of ear infection, whether viral or bacterial. There are a few pediatricians who will wait and see if antibiotics are absolutely necessary before prescribing.
Amoxicillin or Augmentin are first line for these and typically taken twice a day for 5-10 days.
Traditional treatment for otitis externa, swimmers ear, is antibiotic ear drops and in some cases oral as well. In addition to this, they suggest avoiding swimming for a few days to allow the infection to clear and to keep the ears dry.
Antibiotic Over-Prescription for Ear Infections
Ear infections are one of the most common reasons children come into urgent care or the pediatrician’s office, yet antibiotics are prescribed far more often than the evidence supports. What most parents don’t realize is that the majority of ear infections resolve on their own and that truly bacterial infections (the ones that do benefit from antibiotics) are less common than most clinicians acknowledge.
Most Ear Infections Aren’t Bacterial
Not every irritated or painful ear is a bacterial infection. In fact, most childhood ear pain comes from:
Viral infections
Fluid buildup (otitis media with effusion)
Allergies or congestion
Eustachian tube dysfunction
Inflammation from a cold
Antibiotics do not help any of these.
According to a large Cochrane Review, 70 to 80 percent of children with acute otitis media improve within 48–72 hours without antibiotics (Venekamp et al., Cochrane Database of Systematic Reviews, 2015).
This is why guidelines worldwide emphasize caution when prescribing antibiotics.
What Counts as a True Bacterial Ear Infection?
Here’s the part almost no one explains to parents. A true bacterial acute otitis media (AOM) has very specific diagnostic features.
According to the American Academy of Pediatrics (AAP) and multiple otolaryngology guidelines, a child must have ALL of the following:
Bulging of the Tympanic Membrane
This is the most important sign.
A bulging eardrum indicates true pressure from pus behind the eardrum.
A red eardrum alone does not mean infection. Crying, fever, coughing, and even a bright exam light can make the eardrum red.
Middle Ear Effusion (Fluid) Confirmed by Exam
This is verified using:
Pneumatic otoscopy (checking mobility)
Tympanometry
Without trapped fluid, there is no bacterial infection.
Signs of Acute Illness
Ear pain
Fever
Irritability
Reduced eating or sleeping
Symptoms lasting less than 48 hours
If these three elements aren’t present, it’s not the type of ear infection that benefits from antibiotics!
Research shows that many children diagnosed with “ear infections” in routine practice do not meet these criteria yet are still given antibiotics.
The Misdiagnosis Problem
Misdiagnosis is surprisingly common.
Some providers diagnose based on:
Redness alone
Mild fluid without pressure
A quick, non-mobility exam
Parental concern
“Just to be safe” reasoning
But research shows that up to half of children diagnosed with AOM in primary care do not actually have true bacterial AOM when evaluated with proper diagnostic tools.
This leads to antibiotics being given when they were never needed.
Why Antibiotics Seem Like They’re Working
This is one of the most misunderstood parts of the entire conversation.
Because 70–80 percent of children get better within 48–72 hours without antibiotics, antibiotics often appear to have caused the improvement.
But what really happened is:
The illness was going to resolve naturally
The child hit the typical recovery window
Parents assumed the medication was the reason
This creates a powerful illusion that “antibiotics always fix ear infections,” even though the recovery was simply the child’s immune system doing what it naturally does.
This illusion is a major reason antibiotic over-prescription continues.
Why This Matters
Unnecessary antibiotics aren’t harmless. They create a ripple effect that impacts children long after the ear pain is gone.
Microbiome Disruption
Antibiotics wipe out beneficial bacteria in the gut, sinuses, skin, and ears.
This can lead to:
Increased risk of future infections
More antibiotic-resistant bacteria
Chronic gut imbalance
Higher risk of eczema, allergies, and asthma (documented in multiple studies)
Nutrient absorption problems, especially in toddlers
Higher Risk of Recurrent Ear Infections
This is rarely discussed. When antibiotics disrupt the natural flora in the upper respiratory tract, children become more vulnerable to future infections. Many parents find themselves stuck in the “antibiotic cycle”: one round leads to another.
Increased Risk of Secondary Infections
Yeast overgrowth, diaper rash, gut issues, and weakened immune signaling are all more common after antibiotic use.
Antibiotic Resistance
Overuse contributes to resistant strains of bacteria, making future infections harder to treat, not just for that child, but for the entire community.
Side Effects Often Mistaken for Ongoing Illness
Antibiotics can cause:
Stomach pain
Diarrhea
Vomiting
Rash
Behavioral changes
Parents sometimes interpret these symptoms as the illness getting worse, not as drug side effects.
They Don’t Improve Comfort Any Faster
Multiple studies show that antibiotics do not significantly reduce pain in the first 24 hours, and only minimally after that, because most improvement happens as part of natural recovery.
When Antibiotics Are Appropriate
Antibiotics absolutely have a place. They are appropriate when:
The eardrum is clearly bulging
Symptoms are severe
A child is under 6 months
There is a ruptured eardrum with purulent drainage
Symptoms worsen after 48–72 hours of observation
But these cases are a minority compared to what is diagnosed.
What Parents Deserve
Parents deserve:
Clear diagnostic criteria
Honest conversations about the natural course of ear infections
Transparent discussion about the risks of unnecessary antibiotics
The option for evidence-based “watchful waiting”
Supportive care strategies that help a child feel better while their body heals
Understanding the true science behind ear infections allows parents to make confident, informed decisions, not rushed ones based on outdated habits.
Holistic treatment:
Lymph Massage: can be very beneficial for both otitis media and externa. You do this by using your hand to massage down from around your ear and jaw down towards your collarbone.
Ear oil:
Garlic oil: Garlic has long been used as a natural remedy for infections because it contains allicin, a compound with strong antimicrobial and antiviral properties. Garlic oil drops can help:
Soothe pain by calming inflammation in the ear canal.
Fight bacteria and viruses that may be contributing to the infection.
Support immune function locally, right where the infection is brewing.
Colloidal silver: Colloidal or ionic silver has been traditionally used as a broad-spectrum antimicrobial, known to inhibit the growth of bacteria, viruses, and fungi. When used as drops in the ear:
It may target infection-causing microbes and prevent further spread.
It can reduce irritation and support healing of inflamed tissue.
Some parents use it alongside garlic oil for a synergistic effect.
Silver works differently than herbs as it interferes with microbial replication and weakens pathogens so the body can clear them out more easily.
If using just colloidal silver, apply 1-2 drops into the ear, then drain it back out in 5 minutes.
Recommendations:
Rowe Casa Earache Oil contains both garlic and colloidal silver
Earthley Earache Ease: Natalie10off for 10% off
contains mullein which is antibacterial
Hylands Naturals Ear Drops: homeopathic remedy
Homeopathy:
Belladonna: Chosen when the ear infection comes on suddenly with intense pain, redness, and throbbing. The child may also have a high fever, flushed cheeks, and sensitivity to light/noise.
Pulsatilla: Useful when the pain is shifting, mild to moderate, and the child is clingy, whiny, or seeking comfort. Often used when earaches follow a cold, with thick yellow/green mucus. Symptoms are often worse at night and better with fresh air.
Chamomilla: Considered when the pain is severe and makes the child extremely irritable and inconsolable. One ear may be red and hot. The child might seem angry or hypersensitive to touch/pain.
Hepar sulphuris: Used if the pain is sharp, sticking, or feels like a splinter. Ears may be sensitive to the slightest touch or draft. The infection may be moving toward pus formation.
Ferrum phosphoricum: Often recommended in the early stages of an ear infection, especially when there is fever, redness, and mild pain but not yet severe symptoms.
Silicea: Chosen when infections are recurrent or when fluid/discharge seems trapped behind the eardrum. May be useful in children prone to repeated earaches.
Breastmilk has antimicrobial properties. Can put a few drops in and around the ear
Warm compresses can also help alleviate some of the pain and help with drainage. Can use a warm wet washcloth, hot pack, or a bag of warm water.
Staying hydrated can help thin any mucous out and allow for easier drainage.
Chewing gum and yawning can help to open the tubes as well and promote drainage.
Hydrogen peroxide can help clear out any ear wax that could be hindering the healing process. Does not heal infection, use sparingly.
Chiropractic care by a licensed chiropractor including adjustments of the ears can help with the flow through the eustachian tubes.
Treatment Cheat Sheet
At first sign of illness/congestion, start with facial lymph massage several times a day. If your child is prone to ear infections, consider a visit to the chiropractor before ear pain starts.
Once a confirmed infection with an otoscope:
apply warm compress to affected ear
lymph massage
apply garlic oil / colloidal silver into ear and allow to sit for 5 mins before draining. Follow with Hyland’s Naturals eardrops or Earthley Earache Ease for pain relief (I would rotate between the two).
Repeat these steps every 4 hours! If child has a fever, remember to support the fever rather than suppress it to help the body fight the infection.
Consider medical treatment if no improvement in 3 days.
When to seek medical treatment:
Typically, an ear infection will clear up with holistic methods within 3-5 days. Some lasting up to 7. Typical suggestions are to try holistic methods for about 3 days, or as long as your child tolerates.
Seek medical care: (antibiotics may be warranted in these situations)
If symptoms persist without improvement by day 3
If any drainage that looks like blood or pus occurs from the ear
If swelling of external ear or surrounding area occurs
If ear drum is perforated, and would like to try managing symptoms holistically, NOTHING can enter ear canal, but lymph massage, hydration, chiropractic care, chewing gum, and warm compresses can all still be very helpful. Ear oil or remedies cannot be put in the ear, but it can be put around the ear externally which may provide some benefit.
If dizziness occurs, seek medical treatment as this most likely turned into an inner ear infection and can affect balance and hearing.
Ear infections can also have fevers accompany them. Check out the full fever guide with how to support and treat fevers, and when to get medical care: Fever Guide: Home Remedies or ER?
We hope that this guide is helpful for you and your children in navigating how to support ear infections at home! As always, this is not medical advice. If you ever have concerns or a gut feeling that something is wrong, talk to your trusted provider. You got this!
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