Ear pain or otitis media (OM) is one of the most common ailments in children. By definition, OM is a group of inflammatory diseases of the middle ear. The two most common types are acute otitis media (AOM) and otitis media with effusion (or discharge) (OME). AOM usually has a rapid onset with ear pain and fever.

Otitis media is a common health issue for children as their eustachian tubes are still developing.

Children who are old enough complain of pain while younger children become fussy or cry. Oftentimes the pain interferes with sleep and may cause changes in appetite. In contrast, OME is not usually associated with pain. There may be a sense of fullness in the ear caused by non-infectious fluid build-up. Repeated AOM or chronic OME can cause disruption or distortion of hearing. In a baby or toddler, this can interfere with appropriate language acquisition. This article discusses effective Naturopathic support for otitis media that are proven to show results.

What Causes Otitis Media?

Children are susceptible to OM for two reasons: eustachian tube anatomy and still developing immune systems. For little ones, the eustachian tube angle does not provide easy draining, so fluids collect and can become a source of infection. Likewise, younger children’s immune systems are in the process of developing and their illness fighting capacity is not yet optimum.

Naturopathic doctors aim to address the root causes of illness, so for OM that includes: decreasing inflammation and pain, reducing mucus formation and congestion, promoting immunity and attending to structural anatomy. 

Decreasing the Pain and Discomfort of Acute Otitis Media

To decrease pain and inflammation, naturopathic doctors have many effective tools, so it is best to consult with a licensed naturopathic doctor rather than try to treat it yourself. With in-depth study of botanical medicine, NDs can offer helpful herbal approaches to decrease pain. Research points to topical treatment drops made from herbs, which reduce pain as much as numbing drops but have the added benefit of stimulating localized immune response that decreases the pain-causing inflammation. There are many herbs used in such preparations including garlic (Allium sativum), mullein (Verbascum thapsus), marigold (Calendula flores) and St John’s wort (Hypericum perforatum). Your ND will advise the correct formulation. 

Another approach that shows promising results for earache pain is homeopathy. Homeopathic remedies are given based on how the child presents at home and in the office with special focus on mood, digestion, sleep and other symptoms that accompany ear pain. Most homeopathic remedies are made from mineral and plant sources and are prepared according to the Homeopathic Pharmacopoeia of the United States. See here (Table 2) for a list of commonly prescribed homeopathic remedies for otitis media.

Creating a warm area around the painful ear can also be helpful. Hot compresses gently held against the ear may reduce discomfort. Naturopathic doctors may recommend other hydrotherapy treatments to draw congestion away from the head and ears, which may reduce the pain. With regard to the anatomy component, many NDs also recommend gentle massage and other manual therapies to help promote the best possible anatomic angle for the eustachian tube and drainage of fluids. 

Reduce Mucus Load

By reducing mucus formation and congestion one can help prevent the onset of AOM. Scientists have found significant reduction in nose and throat secretions when dairy is removed from the diet. Naturopathic doctors are trained extensively in identifying food intolerances in their patients, so if dairy is contraindicated, a family may be advised to avoid dairy in all forms.

Helping keep secretions from becoming thick and gluey is also a goal in order to decrease congestion. Both supporting adequate hydration through drinking fluids and using a room humidifier can help to keep the mucus thinner, so mucus will not accumulate in the nose and ears, where infection can begin.

Promote Immune Health

In order to promote immune function, NDs recommend supplementing with evidence-based vitamin D and probiotics. Herbals such as elderberry (Sambucus nigrans) and garlic (Allium sativa) help as well. Limiting refined sugar is also important as it can depress immune function.

Drawing from extensive training in nutrition and botanical medicine, NDs will invite you to work on your child’s microbiome to create a robust and diverse set of healthy bacteria in the gut, which in turn helps support immune function. A 2019 research article read, “a target-specific probiotic strain may have a preventive role, significantly reducing the number of episodes in children with recurrent AOM and the number of antibiotic doses required to treat them. This is a relevant finding within the context both of the present “antibiotic resistance crisis” and of the steady rise in autoimmune diseases associated with host microbiota disturbances.”  Offering foods that are fermented or cultured as part of the everyday diet is another way to achieve the goal of a robust and diverse microbiome. 

Use of Antibiotics

As state licensure allows and if natural medicine falls short, some naturopathic doctors will prescribe appropriate antibiotics. It’s important to understand that NDs are in agreement with the Wait and See Protocol of other pediatric medical colleagues, which encourages sending caregivers home with an antibiotic prescription but an instruction not to give the antibiotics right away. Many times, especially with the application of naturopathic approaches, the child will heal and the earache is gone without the use of antibiotics. If your doctor advises because your child is still symptomatic after a 48 hour waiting period, he or she may suggest the antibiotic. Studies reveal that this posture leads to fewer antibiotic prescriptions which is both good for the child and good for public health challenges related to antibiotic resistance.

More to Consider with Otitis Media

You may have come across information related to ear candling for the treatment of OM. Naturopathic doctors do not recommend ear candling which can lead to candle residue in the ear canal, burns, closing off of the ear canal, and causing a hole in the tympanic membrane.

It is also important to know that children exposed to secondhand smoke are more susceptible to many upper respiratory tract infections as well as OM. Ongoing caregiver education is key to encouraging smoking cessation.

For those children who have chronic OME or continue to fall victim to AOM, treatment shifts that focus on prevention with an emphasis on investigating and removing food allergens or sensitivities, alongside reducing overall mucus load and stimulating immune function, may be in order. This is ideally a better option that consistently relying on antibiotics. 

Working with a licensed naturopathic doctor can give you an array of effective tools to help when otitis media impacts your family. Helping children successfully fight acute illness makes good sense. Our bodies are well-equipped to do so, with the proper care and support.


This article is sponsored by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing health care systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following  initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

This article was written with the contributions of Kat Martin, ND and Amy Rothenberg, ND. 

Dr. Kat Martin, a Naturopathic Physician and trained midwife, is a Licensed Primary Care Provider at East Side Family Medicine in Washington State. She maintains a family care practice that deals with acute and chronic health issues of all types. Attracted to obstetrics, pediatrics, and women’s health since she was young, Dr. Martin graduated from Bastyr University, receiving her doctorate in Naturopathic Medicine and becoming certified as a midwife. Dr. Martin focused her education and experience on being responsive to a person’s entire life-cycle: pre-conception care, pregnancy, infant heath, well-child checks, emotional development and counseling, and support of our aging bodies. 

Amy Rothenberg ND, DHANP is a contributor to INM and practicing licensed naturopathic doctor in Northampton, Massachusetts. Dr. Rothenberg is the American Association of Naturopathic Physicians 2017 Physician of the Year. Dr. Rothenberg’s writing can be found on NaturalMed.org, Better Nutrition’s Naturopathic Health Hub, Medium, Thrive Global, and The Huff Post. She is the proud mother of 3 adult children.