Recurrent ear infections in newborns?
December 31, 2017 4:57 PM   Subscribe

Our very cute son will be seven weeks tomorrow. He's currently on ear infection number... five, I think? Any advice/experiences with this in a newborn?

I see lots of info on the internet about recurring ear infections in babies six months and up, but much less about younger babies.

Our pediatrician has been great - meeting us after hours and on weekends, if necessary, taking us seriously every time, answering all our questions - but we're still getting a little worried about this kind of recurrence. At this point, I think our little guy has been on antibiotics more days of his life than he's been off them.

The pediatrician is treating them with shots of Rocephin in the office on various schedules, plus attempts to treat with oral meds (Omnicef, which didn't work, and Augmentin, which he's on now) or prophylactic Amoxicillin between longer courses of Rocephin. The ear infections clear up every time on the 3-5 day courses of Rocephin shots, but tend to come back within 5 days or so.

Our son got his 2-month vaccines early, at 6 weeks, which the pediatrician hopes will help prevent colds that might lead to ear infections. We've also been keeping him pretty far away from anyone who might be sick, practicing good hygiene, and avoiding crowds to try to keep him away from germs.

We assume at this point we're headed for ear tubes as soon as possible, but that sounds like he would need to be 2.5 or 3 months old at the very earliest.

Other potentially relevant info: I'm pumping and he's getting about 5% breastmilk from the breast, 40% pumped breastmilk in a bottle, and 55% formula in a bottle. When bottle feeding, we try to keep him at a 30-45 degree angle so he's not laying too flat. He probably has a tongue tie and lip tie that we haven't revised yet (because of all the ear infections!), which is why he's not eating more from the breast. He's had one definite cold (before the fourth ear infection) and had an eye infection before, I think, the first and second ear infections. He's taking two kinds of probiotics daily to try to help with the diarrhea presumably caused by all the antibiotics, and I'm taking probiotics as well.

Did this happen to your kid or a kid you know as a newborn? Any advice or suggestions?

We're also interested in hearing about tubes, since that sounds pretty likely for our little guy. Did your kid get tubes (even if they were older)? Did they help? Anything we should know or watch out for or that you'd recommend doing differently?

posted by bananacabana to Health & Fitness (26 answers total) 1 user marked this as a favorite
My daughter had ear infections pretty much constantly after she went to daycare at 12 weeks. She would go on an antibiotic and then the infection would just come back, with 5-6 courses of antibiotics overall. She got ear tubes when she was 6 months old and never had another ear infection and has been a pretty healthy kid for the last six years. Hang in there and good luck!
posted by kittydelsol at 5:05 PM on December 31, 2017 [1 favorite]

My son got his first ear infection at 4 months old. Seven weeks! That's so rough. I'm so sorry. Poor little guy and poor you!

He had tubes put in at ten months old. It was great, it totally fixed the issue and he suddenly started talking. I'd worried that he had a speech delay, but no, he just coudn't hear us clearly!

I was TERRIFIED the day of the surgery. I cried when they took him away to actually do the surgery. Like, I couldn't watch the nurse carry him in his little hospital gown down the hallway. But it was incredibly fast. Literally six minutes. I sat down in the waiting room, pulled out my phone to text my mother, and the surgeon came out to get us. It was so fast, I thought he'd forgotten something. We had a small problem called emergence delirium which they warned me about: babies and young children often cry and scream and don't seem to know their caregivers when they wake up from the medication. My son had a worse than usual case of this where he screamed and fought us for a solid hour but then it tapered off and he was completely fine.
posted by Aquifer at 5:09 PM on December 31, 2017

Go find yourself a pediatric ENT. You need a second opinion as to treatment strategy because this strategy isn’t working. It’s not as if he’s in daycare being constantly exposed and you are using good hygiene I’m sure- changing clothes, washing hands, etc. If you’re in S. Florida I can give you a rec for an amazing, amazing ped ent.

Does your pediatrician have you giving him probiotics? BioGaia Protectis Baby actually has clinical studies to back up its claims and has been helpful for us. I’m concerned for your baby’s gut as our gut plays a large role in our immune systems.
posted by PorcineWithMe at 5:42 PM on December 31, 2017 [14 favorites]

Sorry, somehow missed your probiotics comment! Glad you’re being proactive.
posted by PorcineWithMe at 5:44 PM on December 31, 2017

The tongue tie can prevent him from swallowing properly, not just latching on, which can affect the ears. So I'd definitely second the ENT referral at this point.
posted by fshgrl at 5:45 PM on December 31, 2017 [10 favorites]

Aaaand one more... (I also have a 7 week old baby so my brain is mush.) My pediatric ent clipped my son’s tongue tie in office. It’s a very, very simple procedure that could be done right now, ear infection or not. I had called several ped ENTs in my area and they all wanted to schedule for ‘surgery’. This wonderful ENT scoffed at the idea and simply clipped back the frenulum. She told me that it would get us through breastfeeding, but that I MIGHT have to have it clipped farther back once he was older and that would require a stitch. We ended up doing his tongue the same time that she did his ear tubes at about 3 years old. Tubes were dead easy and so was the tongue revision. I really, really highly recommend that you ask other parents for their ent recommendations. You’ve got a couple issues that could be solved.
posted by PorcineWithMe at 5:50 PM on December 31, 2017 [2 favorites]

I third the ENT referral. A poor swallow could be contributing to the ear infections. My daughter didn't have ear infection problems but did have a swallowing problem and ear infections were a thing we were warned to watch for. Try holding him more upright during feeding (almost seated, with your hand holding his neck up), and ask if a swallow study might be appropriate at this point.
posted by peanut_mcgillicuty at 5:50 PM on December 31, 2017

Our pediatrician put our daughter on liquid Zoloft as a last resort before tubes. I thought it would never, ever work, but it did and she never got another ear infection.

I hope your baby is well soon!
posted by 4ster at 5:50 PM on December 31, 2017

Maybe also get an opinion of a Second pediatric ENT, if possible.

It’s a tough field where there are still a lot of mysteries, and chronic re-infection is serious business.
posted by SaltySalticid at 6:42 PM on December 31, 2017

I agree with peanut_mcgillicuty about holding him more upright as he feeds. I read somewhere that the length of the eustachian tube and how it drains influences ear infections.
posted by PJMoore at 7:34 PM on December 31, 2017

A friend's newborn had this issue. She was breastfeeding exclusively and the pediatrician put her (mom, not baby) on an elimination diet to see if something in her diet was irritating the kid's digestive system, because apparently reflux can cause ear infections. (I'm really not clear on the mechanics, but...). She had to cut out dairy entirely, but the ear infections stopped. I think they also told her what others have said about an upright feeding position, but she was already doing that.

Good luck. It sounds like you have been working awfully hard even by parents-of-newborn standards. I hope things get better so you can all get some rest soon.
posted by xylothek at 7:59 PM on December 31, 2017 [4 favorites]

My grandson had his tongue tie dealt with almost immediately, a few weeks after he was born. His Dad had constant ear infections as a child and the tubes were the best thing ever. He never had another ear infection. Don't wait. The infections are incredibly painful and the risk of blowing out an eardrum, resulting in hearing damage is very real.
posted by Enid Lareg at 9:20 PM on December 31, 2017

I learned that burping the baby is important and not letting them drift off with milk or food in their mouths. So using a binkie might help the baby suck the last of the milk down so it doesn't pool when side sleeping.
posted by Oyéah at 10:02 PM on December 31, 2017

Also you can put a tiny amount of yogurt with cultures on the nipple the baby uses to help build the good biome, the baby needs to fight ear infection. This is a tiny amount 1/8 tsp, or less than a drop.
posted by Oyéah at 10:05 PM on December 31, 2017

I am a UK- based paediatrician- this number of ear infections in a less than 2-month old would be unusual. I would second the other posters' advice for an ENT opinion. Is your son tracking along his growth centile?

The last I checked, the evidence for the benefit of tongue tie surgery was still mixed- many babies do improve their feeding after surgery but it is difficult to attribute that to the surgery as babies do feed better as they grow older anyway.

Hope your son gets better soon.
posted by kylethekonqueror at 2:44 AM on January 1, 2018 [2 favorites]

Our pediatrician put our daughter on liquid Zoloft as a last resort before tubes.

I'm resolved to correct strangers on the internet less frequently, but I feel very confident this was a typo for Zantac (a GERD medicine, vs. Zoloft, an antidepressant). There's no role for using Zoloft for ear infections, nor for infants. I'll echo the chorus recommending a pediatric ENT.
posted by telegraph at 5:20 AM on January 1, 2018 [9 favorites]

Kylethekonquerer- Apparently the current metric being used in the US is to clip only if the tongue does NOT reach half way to the palate/roof of the mouth. The studies show that in babies whose tongue reaches halfway or higher, even if it does not touch (which was the old metric), clipping the frenulum makes no difference in ability to feed. My truly fabulous ENT went over this with me for my newest child who has the tiniest little bit of a tie. We ended up not clipping my youngest son because statistically speaking it wasn’t likely to help.

Parenting is damn hard- just saying. OP, I hope you are able to get this solved for your little one. You’re a freaking rockstar. Seven weeks of newborn ear infections is no joke.
posted by PorcineWithMe at 5:21 AM on January 1, 2018

Our son got his 2-month vaccines early, at 6 weeks, which the pediatrician hopes will help prevent colds that might lead to ear infections.

This stands out to me as something that would make me question the pediatrician's overall judgment and understanding of infections. What sort of explanation/evidence was offered? I'm with everyone else suggesting getting another opinion--even though this doctor may be extremely kind and generous with their time, someone else may have more expertise.
posted by cogitron at 10:49 AM on January 1, 2018

You also mention two eye infections and a cold. I am wondering whether your pediatrician has done any general immune system workup? If not, that might be something to ask your pediatrician (or the doctor you go to for a second opinion!) about.
posted by snorkmaiden at 3:10 PM on January 1, 2018

+1000 go to a pediatric ENT.
posted by potrzebie at 3:34 PM on January 1, 2018

I had a severe tongue tie and the roof of my mouth and upper jaw arch did not develop correctly, although I had no problems feeding and no ear infections. My brother had the ear infections and sinus issues tho. We both needed significant dental work later on to widen our jaws. The baby's jaw and palate grows around the tongue, the pressure from swallowing is a significant trigger for correct growth. I'd remedy the tongue tie as soon as you can tbh.
posted by fshgrl at 9:32 PM on January 1, 2018 [1 favorite]

I'd definitely try a pediatric ENT.

Did your kid get tubes (even if they were older)? Did they help?

Our son got them after about 10 ear infections (ages 9-12 months or so?) and hasn't had one since he got them (he's almost four now). Miracle.
posted by Pax at 1:35 PM on January 2, 2018

Definitely see a pediatric dentist who specializes in tongue tie revision. Common practice in the US may be to leave them be, but the procedure is quick and heals well with about a week of regular aftercare. My son had a revision done at the same time as my nephew, and my sister-in-law literally said "this feels like a different baby" when my nephew latched on after we left the office.

Proper swallow is a big deal - a lot of doctors think "oh, as long as they're eating enough it's fine," even if nursing is affected or the baby is a hot colicky mess from swallowing air during feeding. Worth a shot.
posted by checkitnice at 6:57 PM on January 2, 2018

In addition to an elevated position during feeds, it is important that your baby not turn his head towards one side or the other. Keeping the head in a neutral position, (looking straight ahead), allows the eustachian tubes to remain in the best position possible.
posted by Sunnyshe at 9:03 PM on January 2, 2018

Response by poster: A belated but very heartfelt thank you for all these great answers.

In case this is useful for future readers: Since we asked the question, we have taken baby banana to a pediatric ENT who confirmed no anatomical problems, had the tongue tie and lip tie revised by a pediatric dentist, had an immune workup that found a low IgA value which our immunologist says he may grow out of before age 4, switched to Alimentum and a special diet for me for food allergies, started on reflux meds, and are getting tubes later this week now that he's six months old.

Things are SO MUCH BETTER. There seem to be a lot of pieces to the puzzle but it feels like we're making a lot of progress.

Thank you especially to the folks who confirmed we were doing a good job and this was hard - it was very uplifting and validating to hear that :)

Not marking best answers because they were all helpful and much appreciated.
posted by bananacabana at 8:36 PM on May 22, 2018

Telegraph is correct. It was Zantac, and not Zoloft.
posted by 4ster at 8:24 AM on May 23, 2018

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