Ear Infections

Infection and inflammation of the middle ear — or otitis media — is one of the most common diseases of early childhood. Seven out of 10 children have at least one ear infection by age 3. Roughly one-third of them will suffer three or more infections.

Otitis media is usually the result of bacteria entering the ear via the eustachian tube, the tiny passageway that connects the middle ear to the back of the throat. Normally, this tube allows air into the middle ear. But if the tube becomes inflamed and blocked — as can happen during a cold or when allergies flare up — bacteria may be trapped inside. Fluid infected with the bacteria builds up, putting pressure on surrounding ear-structures. The pain may be slight to severe.

Young children are more susceptible to otitis media than are older children because their eustachian tubes are shorter and nearly horizontal, making it easier for bacteria to reach the middle ear. Plus, their bodies’ defenses are less developed. Other factors that contribute to otitis media:

Call your child’s doctor if she experiences any of these symptoms:

Depending on your child’s diagnosis and age, your doctor may prescribe antibiotics. The standard course of antibiotics runs for 10 to 14 days; however, some of the newer antibiotics are given for only five days. Even if your child seems better after a day or so, you must keep giving the medication until it’s all gone. Stopping the antibiotics not only raises your daughter’s risk of a relapse, but also contributes to the resistance of some bacteria to antibiotics — making all infections harder to treat. 

You may give acetaminophen, such as Tylenol®, for fever or pain. Older children may hold a covered heating pad or warm water bottle against the ear. Never put
anything in your child’s ear unless recommended by your child’s physician.

Although oral decongestants have been prescribed to open the eustachian tube, they may not decrease fluid in the middle ear.

Careful follow-up is a must. While antibiotics may eliminate the infection, they do not always eliminate the fluid in the middle ear. Nearly four in 10 patients will have fluid in the middle ear a month after they finish their antibiotics. The fluid drains slowly, usually within three to four months.

Because ear fluid blocks sound waves, chronic fluid in the middle ear for three months or more has been associated with temporary hearing impairment and possible speech delay. The younger the child, the greater the risk of complications. Doctors can use a quick, simple and painless test to check for the presence of fluid in the middle ear.

If antibiotics and other tactics don’t work, surgery may be needed. The placement of pressure-equalizing tubes eliminates the fluid in the middle ear, which helps prevent further infection, and restores hearing to normal. 

Although there is nothing in particular that will prevent otitis media, you can take steps to reduce your child’s risk of infection.

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