Is It an Ear Infection?
Fevers, ear tugging and irritability may indicate a child’s ear infection, but many doctors say to avoid antibiotics.
Stella was cranky. A recent cold had left the 15-month-old tired and out of sorts. Although her cold symptoms were clearing up, Stella's mood wasn't improving. In addition to being irritable, Stella cried whenever her mother laid her down for sleep and she wasn't eating as much as usual. Was the cold still bothering her? Was it just a phase? Or had she developed an ear infection?
Middle ear infection, or otitis media, is the most common illness affecting babies and young children. Three out of four children have had at least one ear infection by the time they are 3 years old.* Although painful for children and distressing to their parents, new evidence shows just 10 percent of kids will need antibiotics to resolve an ear infection. Therefore we're exposing a large number of children to medication side effects for no cause.
For years, antibiotics have been standard treatment for ear infections. But recent concerns about the development of antibiotic-resistant bacteria have led doctors to take a more cautious approach when prescribing antibiotics. Every time we take antibiotics we put selective pressure on the bacteria in and on our bodies, which makes surviving bacteria more likely to develop resistance to antibiotics.
Since 80 to 90 percent of ear infections heal on their own,** doctors will likely recommend a wait-and-see approach to ear infections if the child is older than 2 years, is otherwise in good health and has mild symptoms. If a child isn't improving within 48 to 72 hours, or if symptoms get worse, antibiotics may be the best treatment plan.
However, knowing when to consult a doctor, how to cope with the pain and what preventive measures to take may help parents and children deal with this common childhood ailment.
What Causes Ear Infections?
Often originating with a viral infection, such as the common cold, middle ear infections are caused when fluid collects in the middle ear, creating a breeding ground for bacteria. Ear infections most commonly affect children between the ages of 4 months and 4 years, in part because their Eustachian tubes (the passages connecting the ears and the nose) are shorter and more horizontal than adults', which allows fluid to more easily reach the middle ear. In addition, children's immune systems are not fully developed and make them more susceptible to infection.
Is It an Ear Infection?
Older children may complain of ear pain, but parents will need to look for other signs of ear infection in babies and toddlers. The following symptoms, especially if they appear shortly after an upper respiratory infection, may indicate an ear infection:
- Tugging or rubbing the ear
- Disturbed sleep
- Decreased appetite
- More frequent crying, especially when lying down, chewing or sucking
- Clear fluid draining from the ear
When to Call the Doctor
Most ear infections will heal without treatment; however, a visit to your pediatrician may still be helpful. Your doctor can assess the severity of the infection and determine which treatment course is best.
In addition to the doctor's recommended pain reliever, other methods of easing your child's discomfort include:
- A warm compress or hot-water-bottle placed over the ear.
- Plenty of rest and quiet activities to help the body fight the infection.
- Chewing gum for older children, or drinking plenty of fluids for babies and toddlers, to relieve some of the pressure of fluid build-up.
- Using a clean humidifier or cool-mist vaporizer to relieve congestion.
Take Preventive Measures
Most children will outgrow their susceptibility to ear infections, but an ounce of prevention may be worthwhile in those early years. Keep in mind:
Feeding position. Babies held upright during feeding tend to have fewer ear infections than babies who drink from a bottle while lying down.
Air quality. Second-hand smoke and air pollution increase a child's risk of ear infection.
Hygiene. Frequent hand washing will help your child avoid the illnesses, such as colds, that may lead to ear infections.
For some children, multiple infections may cause hearing problems. This can prompt doctors to recommend myringotomy, otherwise known as ear tubes, the surgical insertion of a small tube in the ear to assist drainage. Do you need a pediatrician? Call our FREE Find-a-Physician line at 818-908-8677 or search online.
* Source: National Institute on Deafness and Other Communication Disorders
** Source: New York Times Health Guide, May 21, 2009.