There are many seasonal reasons for the increase in the number of cases of otitis media (middle ear infections), but the No. 1 culprit has got to be colds. Colds are due to viruses, of course, and kids are notorious for collecting them. The children that I see in day-care, pre-school, and the elementary years are usually active members of the “Cold of the Month Club.” Colds are the No. 1 predisposing factor for ear infections. If we could prevent or at least control colds, there would certainly be fewer ear infections.

For generations, researchers have tried to come up with an effective vaccine against colds, but since there are over 200 different viruses — viruses that change/mutate — a vaccine is not likely any time soon. There are some good things about colds  — really. Colds are usually minor and self-limiting in about a week. These little, annoying viruses do stimulate the immune system, and a stronger immune system can fight off the more serious attacks. So, even if we could prevent all colds, it may be messing with Mother Nature, and make things worse. Like it not, colds are here to stay, at least for the foreseeable future. The cold and flu season is closely tied to the ear infection season, or as I call it, snowtitis.

As the weather gets colds, windows close and people tend to stay inside more. In closed spaces, viruses are more likely to spread. If it is raining outside, schools do not let the kids out for recess. Ventilation in some schools is inadequate, and hygiene is often non-existent. The janitorial staff will empty the trash, but it would be rare for them to routinely disinfect surfaces. Bathrooms may be clean at the start of the school day, but tend to look like those outdoor privies in Mumbai by lunch time.

Some children are more ear-infection prone. If one or both parents had lots of ear infections, the apple may not fall far from the tree. Children, who go to day-care or preschool at an early age, are more prone to get sick. Some of those viruses may set the stage for middle-ear infections. After age six, when kids have 50 or so colds under their immunity belt, they get considerably fewer middle ear infections.

Breast-fed children are less likely to get ear infections than children who are bottle-fed, and children who are given a bottle of milk to hold at bedtime are also more prone.

Children who are exposed to cigarette smoke tend to have more ear infections. There have even been studies that show that families who heat with wood stoves or fireplaces in the winter, have a higher incidence. Smoke of any type is not good for kids.

The last risk factor worth mentioning is pacifiers. Several European studies have shown these to be an ear-infection risk in children under four. I suspect kids over four are not using them, at least I hope they are not.

Remember that ear pain is not necessarily an ear infection. Parents and grandparents have been telling kids for generations to cover their ears when they are outside to prevent ear infections. This practice will not prevent ear infections, but can prevent some cold-related ear pain that some (not all) people can experience. The sensory receptors in the ear canal can really fire up from a cold breeze. If you are cold-sensitive, wear a hat or ear muffs, but don’t think it is going to ward off infections. Oh, and don’t tell this to your Grandma. I don’t want to get any nasty postings.

When you are getting out your winter clothing, snow shovels, windshield ice scrapes, be prepared for a few trips to your medical provider. You may want to consider getting a home otoscope to add to your winter supplies.

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