Q: My daughter is 3 years old and has had several ear infections, mostly during the winter months. After reading your article this past January about having her “pop her ears”, I taught her the technique, which she picked up fairly quickly and she only had one other infection the rest of the winter. Is there anything else I can do to help her avoid these infections entirely?

A: There is! The vast majority of pediatric ear infections (otitis media) is caused by several different strains of an organism named Pneumococcus.

This past summer, a new vaccine against 20 different Pneumococcal strains, called Prevnar 20 was approved by the CDC for use in certain infants over 6 weeks of age (particularly those with a history of otitis media and/or with strong family histories [such as both parents] of childhood otitis media), and for all children over two years of age at increased risk of severe outcomes from Pneumococcal infections (these include children with chronic heart, lung [such as asthma], or liver disease and those with diabetes).

A full list of such conditions can be found on the ACIP page at www.CDC. gov.

These measures are in addition to the previously recommended step of having the child start “popping the ears” (see description below) at the first indication of an upper respiratory infection (scratchy throat, low-grade fever, nasal stuffiness, and clear nasal drainage) and avoiding the use of decongestants, which tend to dry out the fluid that can collect in the middle ear chamber, making it much more difficult to clear out in order to restore the child’s hearing.

Popping the ears is best accomplished by taking a fairly deep breath, pinching the nose shut, closing the mouth tightly, and trying to push air out through your nose, building pressure in the entire upper throat area; keep bearing down until one or both of the ears pops, then stop and breathe normally for several minutes.

This may have to be repeated a number of times because the amount of fluid pushed out each time is small and, in an adult, there can be as much as a full teaspoon trapped in the chamber. Children as young as 3-4 years old can be taught to do this. Continued use of these measures should ensure that your daughter will have no more ear infections for the rest of her life.

Thanks to Sarahbeth B. for this question. To learn more about this and many other health topics, visit the American Academy of Family Physicians’ website familydoctor.org, where you can click on the Search box in the upper right corner of the website, and enter your topic of interest.

If you have a particular topic you would like to hear more about, message me at paulmdake@gmail.com.