On 20/05/2004, at 1:57, Jamie Mahurin Smith wrote:

> On Wednesday 19 May 2004 11:15 am, you wrote:
>> I'd note that since there is a complete physical barrier (the ear
>> drum) =
>> between the ear canal and the site of the infection (the middle ear),
>> =
>> I'd be a bit dubious about breastmilk having the slightest effect. =
>
> I wouldn't call it a complete physical barrier, though it's a pretty
> good one.
> Have you ever had water in your ear after a swim, and found that it
> drained
> out if you lay on one side for a while afterward?

This phenomenon doesn't depend on water entering the middle ear. The
ear canal is not a straight cylinder; it has a curve. Water gets
trapped in the curve of the canal, and/or behind wax.
http://www.intelihealth.com/IH/ihtIH/WSIHW000/35263/8477/347770.html

> The tympanic membrane is only .07mm thick on average (this comes from
> an
> introductory audiology text by Frederick Martin).  In addition, the
> tissue is
> under some tension so it can vibrate more effectively (imagine pouring
> water
> through a bunched-up cloth versus one stretched tight).  It makes a
> lot of
> sense to me that some breastmilk could pass into the middle ear space
> if
> squirted into the ear canal of a sleeping child.

Permeability is more important than thickness, I would think. The
tympanic membrane is impervious even to air (oxygen and nitrogen are
very small molecules); how are proteins/antibodies and/or live white
cells to penetrate?

> I tried it with my youngest on the couple of occasions when he got ear
> infections.  Of course I can't say objectively what it accomplished
> compared
> to other treatment options, but it seemed to make us both feel a little
> better.

Absolutely. As the vast majority of mild-moderate otitis media will
resolve spontaneously [1], I'm comfortable with any harmless treatment
which makes mother and/or child feel better.

I'd be interested to see any data on the use of breastmilk in otitis
externa or otitis media with perforation, where there is a plausible
biological mechanism.

Lara Hopkins

[1] http://www.aafp.org/afp/monograph/200101/index2.html
(see "Watchful Waiting")

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