Middle ear infections are the most common cause of earaches in children. About three-fourths of children have had at least one infection by the time they are 3 years old. The infections develop when bacteria or viruses infect fluid that builds up in the middle ear. The buildup is caused by congestion that blocks the natural channel (Eustachian tube) that allows air and fluid to go in and out of the middle ear.
A child with an ear infection may have many symptoms. Some of them are:
Pain: An older child can tell you about ear pain, but a younger one may just get irritable and cry. This may be more noticeable during feedings, because sucking and swallowing may cause painful pressure changes in the middle ear. Your child may also have less of an appetite and may have trouble sleeping because lying down can increase the pain.
Fever: The child may have no fever or may have a temperature ranging from slightly elevated (100 degrees Fahrenheit) to quite high (greater than 102 degrees Fahrenheit).
Ear Drainage: A yellow or white fluid, possibly blood-tinged, may drain from the child’s ear. This generally indicates that the eardrum has ruptured.
Difficulty Hearing: A child with an ear infection may have trouble hearing, and the problem could continue for several weeks after the infection clears. Watch for the following behavioral changes that may signal that the youngster isn’t hearing well: talking softly, saying “huh?” or “what?” more than usual, not responding to sounds, having more trouble understanding language in noisy rooms, and turning up the television or radio louder than usual.
Contact your pediatrician if your child is having trouble hearing. Being able to hear and listen to others talk helps a child learn speech and language. This is especially important during the first few years of life.
Most ear infections clear up on their own. The pain usually subsides within a day or two. Clearing fluid from the ear may take much longer. If your pediatrician prescribes an antibiotic, however, make sure you give the youngster the entire prescription. If you stop the medication too soon, some bacteria could still be present and cause the problem to recur.
To relieve the child’s pain, the doctor may recommend an over-the-counter, non-aspirin medicine and suggest putting warm (not hot) compresses against the youngster’s ears. You should also keep your child sitting up as much as possible; this may help reduce pressure on the middle ear and ease pain. An extra pillow at night may also help an older child. Never use pillows in a crib. To prevent chronic ear infections, your pediatrician may recommend that your child take antibiotics for an extended period. These drugs are usually prescribed at a low dosage and are taken once or twice a day. Although the child may still suffer from infections, they’ll probably occur less often. In children with allergies, daily antihistamines or decongestants may decrease the incidence of infection.
Another type of preventive treatment is an outpatient procedure in which our ENT surgeons insert small tubes through the eardrums. This maintains equal pressure on both sides of the eardrum and enables the ears to drain. Learn more about ear tubes.
Frequently Asked Questions
How can I tell if my baby has an ear infection?
The easiest way to tell if your baby is sick – with an ear infection or anything else – is by mood. If your baby is crying more than usual or is fussy for no apparent reason, your baby may be sick. Babies are very susceptible to ear infections because their Eustachian tubes (the tubes that drain fluid from the middle ear) are smaller than those in an adult and are horizontally oriented. More than half of all babies will have an ear infection by the time they are one year old. As a child grows, Eustachian tubes grow as well and move vertically. The chances of ear infections are reduced as your child grows.
Do ear infections happen with colds?
Ear infections tend to happen following a cold, so if your baby has recently had a cold you will want to watch for these signs:
- Your baby pulls on ears
- Fever – even a slight fever can be a sign of an ear infection
- Appetite is reduced – an ear infection can make swallowing or chewing painful
- Difficulty sleeping – lying down can make an ear infection more painful
- Yellow or whiteish fluid draining from the ear, which is a sure sign of infection
- Unpleasant smell near or in the ear
If you notice any of these signs, make an appointment to see your baby’s pediatrician to determine the next course of action.
What causes an ear infection and how will the doctor treat it?
Bacteria or viruses cause ear infections. It happens when fluid builds up in the area behind your baby’s eardrum. This can happen after a cold or sinus infection. The Eustachian tubes are much smaller than those in an adult, and they are positioned horizontally so that when the tube is swollen, the fluid does not drain quickly and can accumulate. The accumulated fluid then becomes infected by germs, causing a painful ear infection. Fever may develop as your baby’s body attempts to fight the infection.
Doctors treat most ear infections with antibiotics, although in some cases with older children, your doctor may wait to see if the infection clears up on its own. If your child doesn’t appear to be improving after 24 to 48 hours, call your doctor. He or she may want to re-examine your child or change to a different antibiotic.
Your child must take his entire prescription of antibiotics, even if he seems better. That way, you ensure the infection doesn’t reoccur. Also, make sure you bring your child back in a few weeks for a re-check to make sure that the infection is entirely gone.
Source: CHOC Children’s article by Dr. Qiu Zhong, CHOC Pediatric Otolaryngology