Supplementation with a multivitamin-mineral supplement together with cod-liver oil can reduce rates of ear infections in children, according to a clinical trial published in the Annals of Otology, Rhinology and Laryngology (2002;111:642- 52).

Ear infections are the most common reason for acute pediatric visits in the United States. While ear infections are not generally life threatening, they are often chronic, and can require extensive antibiotic or surgical treatment. There are many treatments available for an acute ear infection, but to date there is no commonly accepted medication for the prevention of the condition.

In this clinical trial, eight children between the ages of ten months and four years who suffered from frequent ear infections were supplemented with a multivitamin-mineral formula and 1 tsp (5 ml) of cod-liver oil per day for an average of almost four months. In the three to four months prior to supplementation, these children had been treated with antibiotics on 16% of the total days of observation. During supplementation, however, only two of the children required antibiotic treatment, and the number of days of antibiotic treatment was only 5% of the total days of observation. Five of the seven children experienced no ear infections while taking the nutritional supplements.

Prior to the beginning of this clinical trial, the authors studied the nutrient concentrations in the blood of children with chronic ear infections. They found lower concentrations of vitamin A, selenium, and a fatty acid called eicosapentaenoic acid (EPA) in children with ear infections than in a population of healthy adults. Those findings led the researchers to use cod-liver oil (a source of concentrated EPA) and a multiple vitamin-mineral as the treatment protocol.

The authors reported difficulty getting the children to take the cod-liver oil. One child dropped out for this reason, and another would only take half of his daily allotment (but experienced improvement, nonetheless). To combat the problem, the authors recommend using a lemon-flavored cod-liver oil supplement, and mixing it into food such as applesauce, oatmeal, or yogurt.

Cod-liver oil was once a commonly used nutritional supplement in the United States and elsewhere. It was used mainly to prevent infections and rickets (a vitamin D deficiency that causes softening of bones). Although it is no longer widely used, cod-liver oil can still be found readily at grocery stores, health-food stores, and pharmacies.

Multiple previous studies have found that the incidence of ear infections could be reduced up to 86% by eliminating food allergens from the diet. Milk, in particular, seemed to be a common trigger for symptoms. In addition to taking cod-liver oil and a multiple vitamin-mineral formula, children with recurrent ear infection should be counseled to avoid potential food allergens.

Matt Brignall, ND

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