by Gregory Kelly

Introduction

Ear infections (otitis media) are a childhood medical problem accounting for almost 50% of all pediatric medical visits. It has been estimated that about two-thirds of the infants in the U.S. will have an ear infection prior to age two.

The most well recognized risk factors for ear infections include: · day care attendance · wood-burning stoves · parental smoking and/or exposure to second hand smoke · food allergies · formula feeding (as opposed to breast-feeding)

The Blood Type Connection

An often-unrecognized risk factor is blood type. While any blood type can have an ear infection (or recurrent ear infections), blood type A children (or even children who have a blood type A mother) are much more routinely affected. In general, type A children have about a 50% higher rate of infection. This appears to be a case of adhesion/anti-adhesion factors predisposing blood type A to far greater ease of bacterial attachment. Certain strains of bacteria most likely to cause ear infections have very strong preferences to anchor to the blood type A antigen (N-acetylgalactosamine), hence creating a strong predisposition to infection.

In addition to this likelihood of infection, blood type A children are the most susceptible to more severe and repeated bouts of ear infections. In fact, blood type A has such a strong tie to severity of ear infections that just knowing the mother's blood type allows for an ability to predict the child's relative risk for having an ear infection requiring treatment. If you are a mother with blood type A, your child has a 282 percent increase in risk of developing an ear infection requiring medical treatment. While this increase in risk is dramatic, it pales in comparison with what occurs if your child has an ear infection prior to his/her first birthday. The combination of being a child with a blood type A mother and having an ear infection prior to your first birthday increases your relative risk of having recurrent ear infections by 2677 percent.

The Standard Approach

The first step of the standard medical approach to deal with ear infections is administration of antibiotics. These are sometimes accompanied by pain-killing medicines (like aspirin or Tylenol) and antihistamines. If an infant continues to have problems with ear infections, surgery to promote normal drainage of fluid from the ear into the throat is often recommended.

Although these treatments are the standard of care within medicine, several studies have indicated that these interventions might not be any more effective than doing absolutely nothing. In fact, when it comes to antibiotic treatment, in 1997 an article in the prestigious British Medical Journal stated the following:

"We conclude that the benefits of routine antimicrobial use for otitis media, judged by either short-term or long-term outcomes, is unproven." And; "We conclude that existing research offers no compelling evidence that children with acute otitis media routinely given antimicrobials have a shorter duration of symptoms, fewer recurrences, or better long-term outcomes than those who do not receive them."

Certainly an underwhelming statement about the most likely intervention most children encounter. To make matters worse, not only is the evidence demonstrating any benefit to this approach weak (or non-existent), some evidence actually suggests that children receiving antibiotics might have a higher probability of having future ear infections.

The Blood Type Approach

The best approach to any problem is to attempt to prevent it rather than to try and manage its consequences. This is the case with ear infections. For mothers with blood type A, or mothers with a blood type A infant, this information is particularly important and should be put to use in an attempt to reduce your child's risk for ear infections.

For mothers, this means you should take measures to ensure you are healthy prior to giving birth. The current prenatal advice provided by the medical establishment is quite rational as a foundation. These recommendations include following a healthy diet (though there is wide spread disagreement as to what a healthy diet might actually entail), supplementing with appropriate nutrients, and abstaining from cigarette smoking and alcohol intake.

The single biggest factor to consider is the decision to breast-feed. Breast-feeding for a minimum of 4 months has shown a protective effect. Conversely, formula feeding is associated with a greater risk for ear infections. Under all circumstances, bottle feeding while your child is lying on his/her back should be avoided, since this will greatly increase the likelihood of regurgitation of the bottle's contents into the middle ear.

The foods with the strongest association to ear infections are cow's milk, wheat, egg whites, peanuts, soy, corn, tomato, chicken, and apples. The appropriate blood type diet for the mother is of importance, with particular emphasis placed on avoiding the above foods that are challenging for your blood type. Similarly, when introducing solid foods to your infant, begin with easy to digest fruits and vegetables from those that are "highly beneficial" for your infant. Emphasize the avoidance of the foods listed above (if they are an "avoid" for the child's blood type), and delay the introduction of grains, legumes, nuts, and seeds until the infant's digestive tract has developed stronger barrier mechanisms (at least 3 months but preferably 6-9 months).

Lifestyle factors such as eliminating exposure by a child to cigarette smoke, and limiting or eliminating the mother's intake of alcohol when pregnant should also be considered as critical.

There are also several additional factors to consider. Frequent exposure to friendly probiotic bacteria by both the mother and the infant is a critical aspect of resistance and immune system health. This exposure might come in the form of foods such as cultured dairy products (like yogurt or kefir) and/or cultured soy products (such as miso and tempeh). An easy method to increase the exposure to these forms of cultured foods is to utilize the appropriate blood type specific probiotic product. These are encapsulated beneficial foods cultured with 10 strains of friendly probiotic bacteria. Bifidobacteria are possibly the type of friendly bacteria of greatest importance to the infant digestive tract, so if you are utilizing some other form of probiotic, it might be prudent to ensure that Bifidobacteria are included.

Dr. D'Adamo is also quite fond of larch arabinogalactan as a dietary supplement for infants. This fiber acts to preferentially promote the growth of Bifidobacteria and acts to promote a balanced and healthy immune system. Since it dissolves readily in juice or water, and since it can be easily mixed into foods, it is (unlike many supplements) relatively easy to give to children.

If your child develops an acute ear infection, medical advice is advisable. Although, about 80% of acute ear infections will respond to placebo and resolve within 48 hours irrespective of treatment, it is best to have your child monitored by a physician to ensure no complicating factors exist.

References

Steuer MK, Hofstadter F, Probster L, et al. Are ABH antigenic determinants on human outer ear canal epithelium responsible for Pseudomonas aeruginosa infections? ORL J Otorhinolaryngol Relat Spec 1995;57:148-152

Mortensen EH, Lildholdt T, Gammelgard NP, Christensen PH. Distribution of ABO blood groups in secretory otitis media and cholesteatoma. Clin Otolaryngol 1983;8:263-265

Gannon MM, Jagger C, Haggard MP. Maternal blood group in otitis media with effusion. Clin Otolaryngol 1994;19:327-331

Froom J, et al. Antimicrobials for acute otitis media? A review from the International Primary Care Network. Br Med J 1997;315:98-102

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