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Dr. Bill and Martha Answer:
Is it possible that my baby's ear infections are caused by nursing while lying down?

Question:
My daughter is now 16 months old and we continue to breastfeed happily. Unfortunately, she has had 10 ear infections and we are currently being referred to an ear, nose and throat specialist. At this point, primarily all of my daughter's nursing is done lying down on her side in bed. Is it at all possible that she is getting ear infections because we nurse lying down?

Answer:
Ten ear infections within the first 16 months means something is going on that predisposes your infant to frequent ear infections. While in general, breastfeeding babies have a lower incidence of ear infections because of their increased immunity, some infants are prone to ear infections when they nurse lying down. Nursing lying flat sometimes allows breastmilk to travel up the eustachian tube into the middle ear and serve as a culture-medium for bacteria.

Other causes of middle-ear fluid and consequent ear infections are allergies to dust in her sleeping environment. I suggest you defuzz her sleeping environment by removing all the fuzzy dust collectors from her bedroom. Also, nurse her propped up at at least a 30-degree angle, which should lessen fluid in her middle ear.

Nasal passages are often an entry point for germs to the middle ear. Finally, keep her nose clear by periodically flushing ("hose the nose") it with saltwater nasal spray.