Do you have a kid who gets ear infection after ear infection? Are you worried about your child having numerous antibiotic treatments because of frequent middle-ear problems? You’re not alone: after the common cold, ear infections are the most commonly diagnosed childhood illness in Canadian and American kids, and most kids will get at least one before they turn three years old.
But knowing it’s common probably isn’t much comfort if your baby is screaming in pain, or your preschooler comes home with yet another infection. Kids with infections can experience diminished hearing and speech delays if the problem becomes serious or chronic. And even a one-off infection, or a mild one, could be painful and cause a fever.
The good news is that most kids outgrow ear infections as they age and their ears continue to develop, and there are ways to help prevent infections before they develop and get rid of them effectively once they do.
What is an ear infection? The eustachian tube connects the middle ear to the back of the throat behind the nose. This tube does the important job of equalizing air pressure in the middle ear and letting mucus drain from the middle ear to the throat. But when the eustachian tube becomes blocked by congestion or mucus, fluid can build up in the middle ear and bacteria or viruses can breed in that trapped fluid, leading to a middle ear infection or otitis media.
What causes it? "Ear infections are caused by the eustachian tube that drains the middle ear being swollen and blocked,” Deonne Brown Benedict, a nurse practitioner who runs a Washington-based family clinic, tells HuffPost Canada Living. "This typically happens in response to a virus like a cold or bacteria, or as an allergic response. Most likely, the virus itself causes pressure and inflammation behind the ear drum. Sometimes, when a cold or allergy has caused the eustachian tubes to be blocked, later bacteria enters into the fluid trapped behind the eardrum and causes a bacterial ear infection."
Why do kids get so many? Anybody can get an ear infection but some babies and toddlers seem plagued by them. This is a function of their age and how the ear’s structure changes over time. "Babies and toddlers already have narrower and more horizontal eustachian tubes, making them more likely to be blocked, and some children are also born with more horizontal eustachian tubes,” Brown Benedict says. This explains why they’re more common in young kids overall, and why some kids are more likely to get ear infections than others.
Who is more likely to get them? Ear infections are more common in kids younger than five because of their shorter eustachian tubes. Children who are exposed to secondhand smoke usually get ear infections more often and have more severe ear infections. Children who get frequent colds are more likely to get frequent ear infections because the two can go hand in hand. Cleft palate has been associated with more ear infections, as has giving a baby a bottle while they are lying flat instead of at an angle.
Can they be prevented? There is some evidence that breastfeeding in the first six months of life can reduce the likelihood of ear infections in early childhood. Protecting your child from upper respiratory infections, such as practicing regular hand washing, can also hep prevent related ear infections. Frequent hand washing can also help keep your child from inserting bacteria and viruses into their ears via their fingers. And the pneumococcal vaccine may help: the bacteria is tied to ear and sinus infections, and the vaccine protects against several strains. Getting the flu vaccine can also help, as some children get an ear infection along with influenza.
What are the symptoms? One symptom of an ear infection is temporary hearing problems: kids might not be responding as usual to softer sounds; ask to have the TV turned up louder than normal; or seem to be inattentive at school. Other symptoms can include fever, nausea, dizziness, and even vomiting. If your child is old enough they might describe their ear as feeling full or popping, like on an airplane. You might also notice symptoms like a runny nose or cough — this isn’t from the ear infection itself, but because they often show up in conjunction with upper respiratory tract infections. But some kids don’t have symptoms at all.
How are ear infections diagnosed? If your kid watches "Doc McStuffins," you’ve heard of an otoscope, the instrument doctors use to look in the ear and see the eardrum in order to check for signs of infection like fluid buildup, redness, or pus.
How long do ear infections last? Many ear infections go away on their own without treatment in a couple of days. Doctors do sometimes prescribe antibiotics, but these will not be appropriate in every case; even if antibiotics clear up a particular infection fluid can stay in the ears for months, making re-infection possible.
Are they contagious? Some kids who attend daycare seem to have ear infections constantly, leading parents to wonder if they are travelling from child to child in the classroom. The colds that often precede an infection are contagious, of course, and the bacteria that can breed in trapped ear fluid can be spread from kid to kid, but ear infections themselves are not contagious.
How are infections treated? Some infections don’t require any treatment at all and will heal in a couple of days. Antibiotics may be prescribed, but because many infections heal on their own or aren’t going to respond to antibiotics (for example, if they’re viral) some doctors take a wait-and-see approach. Your physician may treat the pain, if your child has any, but not the infection itself. Heat applied to the ear via a warm washcloth can also help with any pain associated with an ear infection.
What about ear tubes? If your child has chronic ear infections, or if ear problems are leading to hearing loss or speech delays, your doctor may recommend ear tubes. Tympanostomy tubes are inserted surgically in the tympanic membrane in order to let fluid drain from the middle ear and stabilize pressure when the eustachian tube can’t do the job on its own. The tubes usually fall out on their own as the ear heals, usually after six to 18 months.