Middle ear infections develop when viruses or bacteria start growing in the space right behind the ear drums. Getting the common cold or flu often creates the opportunity for these germs to grow. This is because these types of infections cause the eustachian tube to become inflamed. The eustachian tube is like an exit point from the middle ear that flows right into the region of the throat and back of the nose. Once the exit becomes swollen or blocked with mucus from a cold, it loses its ability to keep the middle ear space clear and free of pressure. If enough germs get into the space, the end result is an ear infection.
Ear infections are more common in younger children, especially under the age of 2 years old since the eustachian tube is shorter and on a horizontal slant. Infections become less common as children grow because the eustachian tube becomes longer and repositions itself into a downward/vertical angle. This allows for more effective drainage and clearance of material.
If your child develops an ear infection, symptoms can include fever, ear rubbing/tugging, changes in sleep pattern, excessive crying, or fussiness. For the older child, a quick onset of pain will often occur. The use of acetaminophen or ibuprofen can provide effective pain relief. Remember, ibuprofen should not be used in infants younger that 6 months old.
It is important for your doctor to directly visualize the ear drums in order to confirm an ear infection. This will help your pediatrician avoid unnecessarily prescribing antibiotics in the event that it is not needed. Harboring antibiotic-resistant bacteria that results from over prescribing, is the last thing you want your child’s body to do. Resistant germs are hard to kill.
If antibiotics are started, you can expect to see an improvement in your child’s condition within 48 to 72 hours. If this does not happen, you should return to your doctor for reevaluation. Depending on the age of your child and severity of infection, the length of antibiotic treatments can range anywhere from 5-10 days. Upon completion of medication, your child should be reexamined to make sure that the ear(s) have healed completely.
In some instances, ear infections can be complicated to treat. As a result, your child may require another course of antibiotics. Sometimes ongoing follow-up or a referral to a specialist is also needed. Referral to an Ear, Nose, and Throat doctor is recommended after prolonged or repeated infections. This specialist will help decide whether it is best to monitor your child over time or perform surgery to place special ear tubes that will reduce the number of ear infections.
Here are a few recommendations to help reduce the risk of ear infections:
Keeping up with the recommended vaccine schedule will help reduce the risk that your child will get sick with certain viruses or bacteria that affect the respiratory tract. There are two vaccines in particular that are recommended, the influenza/flu vaccine and the pneumococcal vaccine.
Good Hand Hygiene
Cold, flu, and other germs are spread by directly touching your face or being sprayed with droplets when another person coughs or sneezes. Frequent hand washing helps prevent the spread of germs which cause infections that put your child at risk for developing ear infections.
Avoid Second-Hand Smoke
Children who are exposed to second-hand smoke suffer more ear infections compared to children who aren’t exposed.
Breastfeed and Do Not “Bottle Prop”
Breastfeeding until infants are at least 6 months old have been shown to reduce the number of ear infections as well as the chance of repeated infections. For infants who are fed formula or breast milk using a bottle, always hold the bottle at an angle during feeds. Babies who lay flat while feeding tend to have more ear infections.