Ear infections are one of the top reasons parents visit the pediatrician during their child’s first few years. Infants and toddlers are more likely to be diagnosed with ear infections than older children and adults. It's difficult to watch your little one suffer from the pain and discomfort these infections cause. Let’s dive in to see how and why ear infections happen, common treatments and ways to prevent future infections.
Ear Structure and Function
Your ear is divided into three sections known as the inner, middle and outer ear. The outer ear comprises the part you can see and the ear canal. The eardrum is a thin membrane that separates the outer and middle ear. The middle ear is like a small room filled with air and the tiniest bones in your body, which vibrate when sound waves reach them. There is a small passage called the eustachian tube that connects the middle ear to the back of your throat. This tube lets fluid drain out of the middle ear and helps regulate ear pressure. Finally, the inner ear turns sound wave vibrations into electrical signals that are sent to the brain for processing.
What Is an Ear Infection?
Ear infections, also known as acute otitis media (AOM), occur when fluid builds up in the middle ear and causes inflammation of the eardrum. The fluid usually gets to the middle ear through the eustachian tube and gets trapped behind the eardrum. It’s a perfect environment for bacteria and viruses to cause an infection. Middle ear infections can affect one or both ears and are most commonly diagnosed between the ages of 6 months and 3 years.
Common Causes and Risk Factors
Infant and toddler anatomy contributes to why little ones are more likely to suffer from ear infections. When babies are born, the eustachian tube is short, narrow and straight. The eustachian tube gets longer as we grow, making it more difficult for fluid to back up and get stuck in the middle ear.
Ear infections can be caused by bacteria or viruses. Respiratory illnesses, such as colds, flu or allergies, are common causes of fluid backup that turn into an ear infection. Other risk factors include cigarette smoke exposure, daycare attendance and having a family history of frequent ear infections.
Ear Infection Symptoms
Recognizing an ear infection in babies and toddlers can be a bit tricky. Ear pain is common, but little ones can’t tell you that just yet. Common symptoms include:
- Rubbing, tugging or batting at the ears
- Fever
- Fussiness and irritability
- Difficulty sleeping
The fluid can make it more difficult to hear and affect balance. Sometimes parents will notice their child isn’t responding to sounds as normal, or seem more wobbly than usual. These symptoms usually go away once treatment is complete.
Diagnosis and Treatment
If you think your little one has an ear infection, it’s time to go see the pediatrician, who will ask questions and examine your child’s ear using a tool called an otoscope.
Antibiotics
If the pediatrician diagnoses a middle ear infection, the physician considers several factors before prescribing antibiotic treatment, including
- Age
- Most likely cause (bacterial vs. viral)
- Length of symptoms
- Severity of symptoms
- History of previous ear infections
Antibiotic treatment is not always indicated. Research shows that most ear infections resolve on their own in a few days. As your little one gets older, your health care provider will be more likely to say, “Let’s watch and wait” for two to three days to see whether symptoms worsen or improve. Waiting allows the immune system a chance to clear the infection without medications that can cause significant side effects.
Other Treatments
Ear infections are uncomfortable, and it’s hard to feel like you’re not doing anything to help. Comfort measures and over-the-counter (OTC) medications are often enough to help soothe the pain and discomfort.
The two most common OTC medications are acetaminophen (Tylenol) and ibuprofen (Motrin). Always follow the directions on the box and label if you choose to administer either of these medications to your child. Ibuprofen cannot be given to infants less than 6 months old.
As for comfort, extra snuggles are great. You can also try putting a heat or ice pack on the ear. Just make sure to wrap it in a towel so it’s not directly touching the skin. Avoid oils, ear drops or other remedies unless you ask your pediatrician first.
Prevention
The American Academy of Pediatrics recommends the following measures to prevent ear infections:
- Breastfeed throughout the first year.
- Wash hands regularly.
- Avoid others who are sick.
- Avoid secondhand smoke.
Your little one will most likely experience at least a few ear infections before the fifth birthday. These measures can help decrease the frequency.
Frequent Ear Infections and Ear Tubes
Most ear infections clear up without long-lasting problems. However, if your child is experiencing frequent ear infections, he’s at risk for hearing-related problems as he grows. Your pediatrician may refer you to an ear, nose and throat (ENT) provider for management and possible ear tube placement. These tiny tubes are placed in the eardrum and help keep fluid from accumulating in the middle ear. Ear infections can still happen when ear tubes are in place but are less likely.
Childhood ear infections are frustrating for both you and your little one. It helps to know the frequency usually declines as your child grows. Early diagnosis, treatment and guidance from your pediatrician can decrease the chance of long-term hearing problems.
References
“Ear Infection Information,” HealthyChildren.org.
Joleen Sams lives with her family in Shawnee. She’s a family nurse practitioner who has always loved taking care of kids and their families.