Patient Education

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For Your Child

November 2013

Ear Infections: A Frequent Child Malady

It's a common childhood complaint: an earache. Ear pain often heralds an ear infection — the leading reason children visit the doctor. The American Academy of Pediatrics (AAP) recently updated its guidelines for managing ear infections. Arm yourself with the latest about this frequent child malady.

Inside an ear infection

The ear has three parts: the outer, middle, and inner ear. As you might suspect, the outer ear is everything you can see, plus the ear canal. The middle portion involves hearing; the inner part plays a vital role in balance.

Most ear infections attack the middle ear, specifically, the eustachian tube. It's a structure that links the middle ear to the back of the nose. It drains fluid from the ear. When bacteria from an illness infect the tube, it swells up and blocks fluid inside. The result: a buildup of pain-producing pressure. Children often develop an ear infection after a cold, the flu, or another respiratory ailment.

Besides pain, other common symptoms of an ear infection include fever, listlessness, and irritability. Your child may also have problems hearing, eating, or sleeping. Children too young to talk may cry or pull at the infected ear.

Signs suggest treatment

To diagnose an ear infection, your child's doctor will use an otoscope — an instrument with a lighted end. He or she will look at the ear drum for bulging or redness. The doctor may also test for fluid in the middle ear.

According to the latest AAP guidelines, treatment may include antibiotics. But your child's doctor may first suggest waiting two to three days to see if symptoms improve. Ear infections can go away by themselves. Plus, waiting can protect your child from possible medication side effects. It can also limit antibiotic resistance — when bacteria become immune to the healing power of antibiotics.

Your child's doctor may immediately recommend antibiotics if your child is younger than 6 months or has a severe ear infection. Medications such as acetaminophen or ibuprofen can help ease pain. If your child has reoccurring ear infections — more than four in a year — surgery may be best. Ear tubes implanted in the eardrum can help drain fluid from the middle ear.

The AAP counsels against using complementary and alternative medicine treatments for ear infections. These include plants like Echinacea and chamomile and even chiropractic, a health discipline that focuses on disorders of muscles, bones, and nerves, and the relationship of those disorders to overall health. Solid research on the effectiveness of these approaches is scarce. Always talk with your child's doctor first if you suspect an ear infection.


Watch this video for more about middle ear infections.


Averting Ear Infections

Experts say that 75% of children will suffer an ear infection before age 3. To lower your child’s odds, follow these steps:

  • Keep your child up-to-date on vaccines. A yearly flu shot and the pneumococcal vaccine can prevent bacteria responsible for ear infections.

  • Avoid tobacco smoke. Children exposed to it tend to have more ear infections.

  • Put down the bottle. Studies have shown that breastfeeding for at least the first 6 months of a child’s life can lower his or her future chances for ear infections.

  • Teach your child proper hand washing. It can help stop the spread of germs.


Online resources

American Academy of Family Physicians

National Institute on Deafness and Other Communication Disorders

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