Health First - Ear Infection In Children

Ear infections are fairly common in children. The middle ear or the outer ear may be infected. Middle ear infections (otitis media) involve the area behind the eardrum. They are more common in winter months when colds and flu are more likely. Germs from common nose or throat infection may enter the Eustachian tubes that connect the ear to the nasal passages. These tubes are more horizontal and shorter in children, making the infection more likely to spread from the nose or throat to the ears. With a cold, these tubes become swollen. The swelling can block these small tubes causing fluid build-up in the middle ear. If infections last too long or occur too often, they can lead to rupture of the eardrum, scarring, and permanent hearing loss.

Because an ear infection often occurs with a cold, other common symptoms are runny or stuffy nose, coughing and loss of appetite. When fluid builds up in the middle ear, it can cause a feeling of dizziness or loss of balance. This build-up of fluid puts pressure on the eardrum and can cause it to tear or rupture. The ear may drain a thick yellowish-white fluid. Ruptured ear drums usually heal up by themselves.

Most middle ear infections usually respond well to antibiotics. In children with confirmed acute otitis media, the use of certain antibiotics reduced the length of infection by five days and doubled the overall cure rate compared with no treatment, a Finnish study reported in Pediatrics (May 2003). However, recent studies have shown that not all middle ear infections need antibiotics. Ask your doctor to recommend an over-the-counter medication to relieve the ear pain. Your doctor may also prescribe ear drops containing an anaesthetic to decrease the pain locally. A warm moist washer over the ear may also help reduce the discomfort. Extra cuddling and activities like reading a book can help comfort a child.

If the eardrum bulges too much, treatment may also include a small incision to relieve pressure. If the child has repeated episodes, other treatments may be considered. One fairly common procedure is to place tiny tubes (grommets or ventilator tubes) in the eardrum. The child must then be careful not to get the ear wet in pools and baths. The tubes usually fall out by themselves in 6 to 12 months.

While there are no specific immunisations against viral respiratory infections or bacteria that cause middle ear infections, there are a few things that can help avoid repeated ear infections. Children who have been breast-fed have fewer ear infections. Infants that nurse from a bottle should not be lying down when they are fed. Smoking in the home or in vehicles should be avoided because exposure to secondhand smoke increases the risk of middle ear infections. Try to limit contact with anyone that has a cold, sore throat, or the flu. Be sure to get the recommended vaccinations for your child to help prevent infections they may be exposed to.

Outer ear infections in children are even more common. They occur in the canal outside the eardrum or in the external ear itself. One cause is water that stays too long in the canal. That is why it is sometimes called "swimmer's ear." Carefully dry the ear canals after swimming to help prevent swimmer's ear.

Another cause of outer ear infections is putting a foreign object into the ear. Irritation from the object can lead to an infection. The entire canal could become blocked by pus. The outer ear may be tender to touch and there may be a hearing loss. The best way to prevent outer ear infections is to keep all objects out of the ear, including fingers and cotton buds, and to keep the ears as dry as possible.

Article #4452