Middle-ear infections, which doctors call otitis media, are less common during middle childhood than at younger ages.
When an ear is infected, the eustachian tube—the narrow passage connecting the middle ear (the small chamber behind the eardrum) to the back of the throat—becomes blocked. During healthy periods this tube is filled with air and keeps the space behind the eardrum free of fluid; during a cold or other respiratory infection, or in children with allergies, this tube can become blocked, fluid begins to accumulate in the middle ear, and bacteria start to grow there. As this occurs, pressure on the eardrum increases and it can no longer vibrate properly. Hearing is temporarily reduced, and at the same time the pressure on the eardrum can cause pain.
Your pediatrician should examine your youngster's ears with an instrument called an otoscope, with which inflammation and fluid behind the eardrums can be detected. If an infection is present, your physician may prescribe antibiotics to destroy the bacteria and diminish the buildup of fluids. Antibiotics are not always necessary. Acetaminophen can help ease the pain. Heat—using a heating pad or a warm towel over the ear—can also make your child feel better.
Occasionally, when a child has repeated ear infections, and when fluid in the ears tends to persist despite medication, the doctor may suggest inserting small drainage tubes through the eardrum to help remove the trapped fluid. To date, however, the research examining the potential benefits of these tubes is inconclusive, and there are clearly some drawbacks to them—namely, anesthesia is required for insertion, and the tubes can sometimes come out by themselves.
With recurrent ear infections (more frequent than one a month for two to three months), your doctor may decide to place your child on low doses of antibiotics on a long-term basis to prevent infections. This therapy has been shown to decrease the frequency of ear infections. However, this therapy can increase the risk of resistant infections. Some doctors may also suggest surgical removal of the adenoids (adenoidectomy) if they are blocking the child's eustachian tube.
Ear infections are not contagious. Your child can safely return to school after the pain and fever subside. However, he should continue taking the antibiotics as prescribed until the pills or liquid are used up.
