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- Nov 2003    (View past health issues)
 Ear Infections


As common as the common cold, ear infections strike two out of three babies before age 1. If ear infections are left untreated, they can lead to more serious problems - a hearing loss and/or language delays.

What is an ear infection and how do kids get them?
The most common type of ear infection in young children is acute otitis media (AOM), which occurs in the middle ear, or the space behind the eardrum. Typically, the child's eustachian tubes (the tiny ducts that connect the middle ear to the back of the nose and throat) become swollen, causing fluid to pool in the middle ear. A virus or bacteria then infect the trapped fluid. As pus accumulates in the middle ear, the increased pressure on the eardrum causes an earache. Annually, there are 24.5 million visits to physicians for otitis media.

Why are middle-ear infections so common in babies and toddlers?
There are several factors that make children between three months and 3 years of age easy targets.

  • Their immune systems aren't yet mature enough to defend against colds and other viral infections.
  • Their eustachian tubes tend to be short and somewhat horizontal (in adults, its longer and more vertical), so it's easy for germs to travel from the nose or throat into the middle ear.
  • Their eustachian tubes also ten to be narrow, so even a small amount of swelling in response to a cold or other respiratory illness can trap fluid in the middle ear and create a breeding ground for bacteria.

    What are the risk factors for ear infections?

  • Gender. Boys have more infections than girls do.
  • Ethnic background. Caucasian and Native American children have higher rates of OM than children from other ethnic groups do.
  • Age of onset. The younger a child is when an ear infection first develops, the more likely he or she will have repeated infections.
  • Tobacco smoke. Children exposed to second-hand smoke have a higher risk of developing ear infections.
  • Family history. If a parent or sibling had ear infections, the child's risk is greater.
  • Allergies. Allergies that cause a stuffy nose are sometimes linked to ear infections.
  • Bottle-feeding. Babies who are bottle-fed, especially lying on their back, have more infections than those who are breastfed.
  • Child care. Children in group child-care settings are exposed to more germs and viruses.

    How do I know if my child has an ear infection?
    The first step is to know the symptoms of OM. They are:

  • Irritability
  • Head-shaking or pulling on the ear
  • Fever
  • Loss of appetite
  • Disturbed sleep
  • Decreased attentiveness
  • Temporary hearing loss

    What should I do if I think my child has an ear infection?
    1. Call your pediatrician. He or she will examine your child's ears with an otoscope. In some cases, your pediatrician may also perform a tympanometry test or check your child's hearing.
    2. Stay with the treatment your doctor prescribes. A typical treatment may be a 5-10 day course of antibiotics. However, when children take antibiotics they don't need, it promotes the development of drug-resistant bacteria. Some pediatricians may wait a day or two to see if the infection clears up on its own.
    3. Usually, the ear pain and fever associated with ear infections disappear within two days of starting the antibiotic. However, fluid can remain in the middle ear for several weeks or even months. You will want to schedule a follow-up exam with your pediatrician to make sure the infection clears up.
    4. If your child has fluid in the ears for three months or longer, referral to an ear specialist and hearing testing is recommended.

    The Sight & Hearing Association has developed an Ear Infection Tracking Card, a handy tool to help you keep track of your child's ear infections. This tri-fold card is the size of a driver's license and fits perfectly into a wallet or purse. If you would like us to mail a card to you, please send $1 to cover postage/handling to:

    Sight & Hearing Association
    c/o Ear Infection Tracking Card
    674 Transfer Rd.
    St. Paul, MN 55114-1402

    What are some ways to keep from getting ear infections?

  • If possible, stay away from people who have colds. Wash your hands frequently and try not to touch your nose and eyes.
  • Cigarette smoke can keep the auditory tubes from working properly, avoid smoky places.
  • There is a newer vaccine that fights against many of the bacteria that cause ear infections. Ask your doctor about this vaccine.

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