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Health Issues

When is it an Ear Infection?

A typical middle ear infection in a child begins with either a viral infection (such as a common cold) or unhealthy bacterial growth. Sometimes the middle ear becomes inflamed and causes fluid buildup behind the eardrum. In other cases, the eustachian tubes — the narrow passageways connecting the middle ear to the back of the nose — become swollen.

Children are more prone to both of these problems for several reasons. The passages in their ears are narrower, shorter, and more horizontal than the adult versions. Because it’s easier for germs to reach the middle ear, it’s also easier for fluid to get trapped there. And just as children are still developing, so are their immune systems. Once the infection takes hold, it’s harder for a child’s body to fight it than it is for a healthy adult’s.

The symptoms of an ear infection may be hard to detect. A child who constantly tugs or pulls at the ear could simply be exploring, or simply showing a self-soothing reflex — even though that tops the list of signals listed in many books and Web sites.

Other symptoms can include:

  • More crying than usual, especially when lying down
  • Trouble sleeping or hearing
  • Fever or headache
  • Fluid coming out of the ears

Doctors can use special instruments to see if an infection is present.

Treatment: Less May Be More

Perhaps the most surprising news is that common ear infections rarely require medication or any other action, except when severe or in young infants. “The body’s immune system can usually resolve them,” says Dr. Robert M. Jacobson, chair of the Mayo Clinic’s Department of Pediatric and Adolescent Medicine. “More and more studies show that children treated or untreated are at the same place 10 days out. We are constantly amazed at how many ear infections resolve on their own.”

It’s true: Fewer doctors are relying on antibiotics. As Dr. Jacobson points out, it’s important to understand that taking antibiotics might or might not speed recovery, and overusing them can lead to bacteria developing resistance to the drugs, as the germs mutate to defend themselves against medicine. As a result, many pediatricians have adopted a wait-and-see approach, rather than prescribing antibiotics at the first sign of infection.

Asking the parents to observe the child for 48 to 72 hours is becoming the most common first step among pediatricians. That doesn’t mean that an office visit isn’t a good idea, however. Doctors can prescribe numbing drops and suggest over-the-counter pain relievers to treat symptoms, which can help the child feel better as she recovers. 

Along with getting away from prescriptions, pediatricians are also shying away from ear tubes, a procedure in which a small tube is surgically inserted in the ear to drain fluid. According to Dr. Jacobson, tube placement is best used with those children who have recurring hearing problems caused by multiple infections.

“Tubes don’t actually stop ear infections, just symptoms and fluid retention,” says Dr. Jacobson. “We don’t want to do it too often because there is an increased risk of damage to the eardrum.”

According to Dr. Jacobson, diagnosis and treatment should be a three-step process:

  • First, the pediatrician determines whether or not an ear infection is present.
  • Second, the pediatrician and parent discuss risk factors and how to reduce them.
  • Finally, observation and treatment of symptoms ensure the child is recovering without pain.

Reducing the Risks for Ear Infection

While parents can’t head off every germ that’s headed for their children, they can take steps to reduce their children’s risks.

Avoid Secondhand Smoke Exposure

Smoking is a huge contributor to childhood illness. Ear infections are no exception to that rule. Smoking is addictive and hard to quit, but not every smoker realizes the harmful effects that secondhand smoke could have on his or her child. Quitting is just as important for your child’s health as your own.

Proper Hygiene

Bad hygiene habits are another major problem. Children in child care are more exposed to widespread bacteria, as are those who drink from a bottle as opposed to a sippy cup, says Dr. Jacobson. That’s because bottles have more surface area for germs to live on. Teach children to wash their hands frequently to prevent the spread of germs that spread illness.

Keep Your Child Up-To-Date with Vaccines

Talk with your child’s doctor about the vaccines that protect against pneumonia and meningitis. Studies show that vaccinated children experience fewer ear infections.

Breastfeed Your Baby

Breastfeed infants for the first year. Breast milk has many substances that protect your baby from a variety of diseases and infections. Because of these protective substances, breastfed children are less likely to have bacterial or viral infections, such as ear infections.

Get A Flu Shot

Consider getting immunized against influenza. Aside from protecting against this yearly disease, it can help prevent ear infections.

 

Last Updated
5/11/2013
Source
Adapted from Healthy Children Magazine, Summer 2007
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.