Ear Infections

Ear Infections

Almost every child gets at least one ear infection before the age of one year. Sometimes, the child is very sick and
gives us signs that the ear hurts, such as fever and pulling on the ears. Or a young child may act tired, irritable, less
hungry or have trouble sleeping. Other times, the child may seem perfectly fine, but an ear infection is noticed on a
pediatric examination.

What exactly is an ear infection? It is an infection of the middle ear, the part of the ear behind the drum. Pediatricians
refer to this infection as otitis media. The eustachian tube connects the middle ear to the furthest point in the back of
the throat. This tube is responsible for helping to equalize pressure in order to keep the ear drum from rupturing when
air pressure rapidly changes. This is why our ears "pop" when we fly in an airplane. In infants and toddlers, the
eustachian tube is shorter and has less of an angle, so it is more easily blocked. Once the tube gets blocked, the middle
ear can develop an infection.

Usually, ear infections occur after a child has a cold. During the winter months, viruses which cause the flu, colds or
breathing problems may also cause ear infections. Sometimes viruses cause the infection, other times the virus just
causes the cold symptoms that result in swelling of the eustachian tube and blockage. Bacteria then get into the middle
ear and produce a painful infection.

Other risk factors for developing ear infections include exposure to cigarette smoke and frequent exposure to viruses
such as in daycare settings. Sometimes people have a genetic predisposition to ear infections due to eustachian tube
abnormalities and may have many family members with a history of ear infections. Repeated ear infections can cause
hearing loss. If you suspect an ear infection in your child, make an appointment to see the child's doctor.

Sometimes the ear infection occurs so quickly that a child may actually rupture the ear drum. This results in pain and
drainage from the ear. Never put anything in the ear to remove the drainage.

If your child gets an ear infection, your doctor may decide that the infection is viral and does not require antibiotic
treatment. Without any antibiotic, most infections will get better within a few days. If the infection appears to be
bacterial, there are many antibiotics which can be used for treatment. The most commonly prescribed antibiotic is
amoxicillin. This treats the more common bacteria such as streptococcus pneumoniae. If symptoms continue, the
antibiotic may be changed to another type. This doesn't mean that amoxicillin will not work in the future for a different
ear infection. In addition, applying warm compresses to the affected ear and taking acetominophen may relieve the ear
pain.

For more information:
Iowa Health Book: Middle Ear Infection: Information for Parents and Patients
(http://www.vh.org/Patients/IHB/Peds/Infectious/Otitis/OtitisMedia2.html)

Ann S. Botash, MD

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