Female Speaker: For most kids standard antibiotic treatment proves effective but not always. Christian Cahill just celebrated his first birthday. Already he has had about nine ear infections. Lately they've averaged to one a month. Danielle Cahill: When I first noticed there was a problem, he was tugging at his ears, digging in them, there was redness. And that's when I knew crying, just very uncomfortable, and it's not like Christian to be that way. It wasn't the norm for him. Female Speaker: Antibiotic treatment became the norm. Danielle Cahill: When he is on the antibiotic, he is a totally different child, plays nice, eats well. Female Speaker: But for Christian the relief would prove only temporary. Danielle Cahill: The infection kept coming back so we were switching off to different antibiotics. Female Speaker: Does that ear hurt? Female Speaker: A lot of the problem we see now is that the parents are working and that they have to remain in work and therefore they want the child to return to school or daycare as quick as possible. Suzanne Laskas: So there has been an over usage of antibiotics for things that are not appropriate. Dr. George McCracken, professor of pediatrics at the University of Texas, Southwestern Medical Centre in Dallas has seen an increase in resistance among the actual bacteria that causes middle ear infection. Dr. George McCracken: The two most common causes of acute otitis media in children are the pneumococcus and an organism called Haemophilus influenzae. We know that in the developed world, these two organisms have become increasingly resistant to the common antibiotics. This is a problem that has evolved because of the common, perhaps over use of antibiotics in early infancy. Female Speaker: These resistance strains are then passed along to other children, especially on daycare settings where many kids are together. While some cases of otitis media are viral there are no simple diagnostic test to rule out bacterial infection. So each year, more than 30 million prescriptions for antibiotics are given for ear infections alone. When standard therapies for otitis media fail, there are other options. For Christian, recurrent ear infections have made him a candidate for surgery. Surgical procedures that drain fluid from the middle ear are reserved for tough to treat cases. In one procedure, an incision is made, fluid is drained and the hole is allowed to heal. For children with recurrent problems, small plastic tubes may placed to allow for continual drainage. The tubes fall out on their own in six to 18 months. Rather on many treatments for ear infections, it's best to prevent them if possible. And that brings us to our first Kids Health Works Q&A. How can parents help prevent ear infections? Let's start with breast feeding. Breast feeding even for as little as three months has been shown to prevent ear infections. That's because breast milk contains important antibodies and it encourages the optimal feeding position. Feeding position is important when bottle feeding too. When a child lies on his back while drinking a bottle, fluid can back up into the eustachian tubes and cause blockage. Try to keep the child in a slightly upright position. Downsizing daycare can help limit your child's exposure to colds and fluids that can lead to ear infections. If your child is prone to ear infections, it may be good to choose a smaller group setting or one on one care. And doctors urge parents not to smoke. Dr. George McCracken: Smocking is an irritant. So in infant or a young child in the setting of an active smoker in the household has irritation of the upper respiratory tract mucosa and this is a clear predisposing event to middle ear infection. Speaker: Pneumococcus is responsible for about 30 to 40% of ear infections. If we had an effective vaccine against pneumococcal infections we will prevent many of those of pneumococcal episodes. Female Speaker: Vaccines can help in the battle against ear infec