EAR INFECTIONS - PART I
By: Sanjay Shah, M.D.
Ear infections (acute otitis media) are one of the most common childhood infections. It will affect most kids at least once before their 2nd or 3rd birthday. While some children never have ear infections, others seem to have repeated and seemingly incurable ear infections.
The ear has three main parts; outer ear, middle ear and inner ear. What is commonly known as ear infection is in fact infection of the middle ear. There is a small tube called the Eustachian tube that connects the middle ear to the back of the throat and nose. In a child this tube is more soft, short and straight, making it easy to be blocked when a child has a cold or allergies. This leads to fluid accumulation in the middle ear which can easily be infected by bacteria, usually from the back of the throat causing an ear infection.
Apart from colds and allergies the following factors also lead to ear infections. Ear infections tend to run in families. Children whose parent or a sibling had repeated infections are at much greater risk. Bottle-feeding deprives babies good protective antibodies in mother’s mild and bottle feeding while lying down can cause the formula to enter the middle ear from the throat. Children who are exposed to second-hand smoke have much less resistance to all kinds of respiratory infections. Ear infections themselves are not contagious, but the cold viruses that lead to ear infections are contagious, children who attend daycare are more prone to ear infections for this reason.
How can you tell if your child who is suffering from a common cold has developed an ear infection? Pain is the most common sign of ear infection. Ear pain in a young child may be manifested as minor fussiness, irritability, reduced appetite or refusal to lie down, to screaming or inconsolable crying. Some babies may dig in their ears, rub or tug at their ears. High fevers and difficulty in hearing, vomiting and diarrhea can be caused by ear infections.
Doctors treat ear infections with antibiotics. It is important to give your child all the doses of antibiotics on a regular schedule. An unfinished or irregular course of antibiotics may give the bacteria a chance to become resistant to these antibiotics leading to failure of treatment. An untreated ear infection can lead to complications like ruptured ear drum, infection of the bone behind the ear (mastoiditis) or even meningitis. Younger children are at more risk for developing complications and should be brought to medical attention sooner. Your doctor may also choose to recheck your child’s ear in 10-14 days to make sure there is no sign of any residual infection. Some fluid may remain in the middle ear for a few weeks but usually clears up within three months.
If your child has very frequent ear infections (more than 4 in 6 months or six in a year), or persistent fluid in the middle ear which interfered with hearing he may be referred to an Ear, Nose, and Throat doctor (ENT) for placement of ear tubes.