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      ATLANTA (AP) — Ear infections, a scourge that has left countless
children screaming through the night, have fallen dramatically, and
some researchers suggest a decline in smoking by parents might be
part of the reason.


      Health officials report nearly a 30 percent drop over 15 years
in young children's doctor visits for ear infections. That's half a
million fewer trips to the doctor on average.


      Why the numbers are declining is a bit of a mystery, but Harvard
researchers think it's partly because fewer people smoke, meaning
less irritation of children's airways. Many doctors credit growing
use of a vaccine against bacteria that cause ear infections. And
some think increased breast-feeding is protecting more children.


      "We're sort of guessing here," said Dr. Richard Rosenfeld, a
New York-based ear, nose and throat specialist who speaks about the
issue for the American Academy of Pediatrics.


      To be sure, middle ear infections still plague many U.S.
children.


      For decades, they were the most common reason parents brought
young children to a doctor, according to health officials. The
Centers for Disease Control and Prevention hadn't bothered to issue
a report on them in nearly 20 years.


      Cases skyrocketed from 1975-1990. The visit rate for children 5
and under more than doubled in that time.


      A big reason, Rosenfeld said, was a steady rise in dual-career
families. More families put their kids in day care, and day care is
a breeding ground for the germs that lead to ear infections.


      But the study by Harvard University suggests another
contributor: cigarette smoke.


      Most ear infections occur after a cold. In children, the ear is
more directly connected to the back of the nose, so infections in a
child's nose and throat can easily trigger ear inflammation. Such
swelling is a fertile setting for the bacteria that cause ear
infections.


      Cigarette smoke, inhaled through a child's nose, can trigger the
same kind of irritation and swelling, said Dr. Gordon Hughes of the
National Institute on Deafness and Other Communication Disorders.


      CDC figures show that 88 percent of U.S. nonsmokers were exposed
to secondhand smoke around 1990, but that fell to about 40 percent
in 2007 and 2008.


      Harvard research indicates the decline coincides with a drop in
childhood ear infections.


      "When people are smoking less around their kids, when homes are
smoke-free, the rate of ear infections can and has decreased,"
said Hillel Alpert, lead author of a study published recently by
the journal Tobacco Control.


      At the request of The Associated Press, the CDC checked its
recent trend data on ear infections, based on annual surveys of a
representative sample of doctors.


      For children ages 6 and under, the number of medical visits in
which the main diagnosis was ear infection dropped by nearly 30
percent from 1993 to 2008 - from an estimated 17.5 million visits
to about 12.5 million.


      The rate of such visits dropped by about 32 percent, from 636
ear infection-related visits per 1,000 children to 431 per 1,000.


      The trend downward for very young children seems to have leveled
off in the last few years.


      A CDC analysis of data from 2004 through 2008 found the
differences year-to-year were not meaningful, said Susan Schappert
of the CDC's National Center for Health Statistics.


      Some doctors have noticed fewer ear infections in their waiting
rooms compared to what they saw years ago. "We don't see them that
much anymore," said Dr. Michael Baron, a family practice doctor in
Stone Mountain, a suburb of Atlanta.


      Another factor in that decline may be growing use of a vaccine
that protects against strep bacteria that can cause ear infections.
The vaccine, first licensed in 2000, would not account for the drop
in cases in the 1990s, but probably has contributed to the decline
since, several experts said.


      Also, some studies have credited antibody-rich breast milk with
lowering infants' risk for respiratory and middle ear infections.
About 77 percent of new mothers breast-feed, at least briefly, up
from fewer than two-thirds in the early 1990s.


      Of course, these are just theories.


      None seems to explain the Willis household in Charlotte, N.C.
Neither parent smokes, both children have had all recommended
vaccines, and Vanessa breast-fed each child for about three months.


      Yet their 6 1/2-year-old son Hatcher got 10 ear infections in only
a year when he was younger. Their 21-month-old daughter Libby
Jeanne has had three or four ear infections, too, including one
just last month.


      Hatcher's first bouts with ear infections were particularly
rough. "He would shriek and cry and we couldn't figure out what
was causing him so much pain," said Vanessa, 35.


      "I remember spending many nights on the couch sitting straight
up, holding him against my chest," the only way the boy would
sleep. "That's a miserable thing for working parents."


      Jessica Hyatt, a 21-year-old mom in Spokane, Wash. whose home is
also smoke-free, said her 2-year-old daughter Chesnie has had four
ear infections, including a recent one that lasted close to two
months.


      Various treatments, including antibiotics, have not worked.
Jessica, a college student, has repeatedly missed classes to be
home with Chesnie.


      "You feel so hopeless. You can't help them and they're so
miserable. It makes you want to sit there and cry," she said.
      

Gallery

Health

Ear infections, a scourge that has left countless
children screaming through the night, have fallen dramatically, and
some researchers suggest a decline in smoking by parents might be
part of the reason.

Trend reversal: Big drop in kids' ear infections

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