Health and Safety Notes
California Childcare Health Program
Ear Infections (Otitis Media) and
Hearing Loss in Young Children
What is Otitis Media?
When should a child be excluded?
Ear infection, also called otitis media or in?ammation
Since ear infections themselves are not contagious,
of the middle ear, is an infection of the part of the ear
there is no reason to exclude the child from your
behind the eardrum. Next to the common cold, otitis
facility unless he or she has a high fever, cannot
media is the most common illness diagnosed during
participate in activities because of pain, or needs more
childhood. It’s also one of the most common reasons
care than you can give without compromising the care
for the prescription of antibiotics and other medica-
given to other children.
tions to children.
How can reduce ear infections?
Who gets it and how?
Prevent the spread of colds and other upper respira-
Middle ear infections are common in children between
tory infections which may lead to otitis media.
the ages of 1 month and 6 years, and most common
• Practice good hand washing.
under age 3. Ear infections can run in families, and
• Teach children to cough into their elbow and away
boys are more affected than girls. Some children de-
from people.
velop ear infections a few days after a cold starts. Some
• Wipe noses with clean tissues, dispose of them
children have one infection after another, whereas
properly and wash your hands.
others never have any. Conditions that increase a
child’s risk of ear infections are frequent colds, allergic
• Don’t share food, bottles, toothbrushes or toys that
runny noses, bottle propping, exposure to smoke and
can be put in the mouth.
attendance in group settings such as child care.
• Play outdoors often. Let fresh air into your
program daily.
What are the signs and symptoms?
Symptoms result from swelling of the middle ear.
How do I care for children who get
The child may cry persistently, tug at the ear, have
frequent ear infections?
a fever, have trouble sleeping, be irritable and have
• Never use cotton swabs and never put anything
hearing problems. When infection occurs, pus de-
smaller than your ?nger into a child’s ear. Do not
velops, pushes on the eardrum, and causes pain and
allow the child to do so either.
often fever. Sometimes the pressure is so great that
• Do not feed or bottle-feed infants lying on their
the eardrum bursts and the pus drains out into the
backs. Never prop bottles while feeding.
ear canal. Although this yellow-white discharge may
frighten parents, the child feels better and the hole in
• Be especially alert for any sign of hearing or speech
the eardrum will heal over. Sometimes the child may
problems that may show up. Refer the child to the
have diarrhea, nausea and vomiting.
family’s health care provider or other community
resources.
What are the complications?
• Be sure that prescribed antibiotics are taken for the
full amount of time to avoid resistant infections.
Most of the time ear infections clear up without caus-
ing any lasting problems. However, if not treated,
otitis media can cause problems such as hearing loss,
How do I care for children with
infection of the inner ear, and even meningitis. Fluid
ear tubes?
may remain in the ear as long as six months after an
An ear tube creates a hole in the eardrum so ?uid and
infection is gone.
pus may drain out. It usually stays in for three to six
California Childcare Health Program
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months. Since pus can drain out, water from the out-
have problems as they grow older. Hearing problems
side world (which has germs in it) can also run into
can be temporary or permanent. Hearing loss can be
the middle ear easily. Therefore, you must be very
caused by ear infections, injuries or diseases.
careful that children with tubes do not get water in
their ears. This usually means no swimming unless
If your child or a child in your care has a hearing
there are special earplugs and permission from the
problem, the primary health care provider should be
health care provider. Watch for any sign of hearing
consulted.
or speech problems.
References
The impact of hearing loss
American Academy of Audiology, “Hearing Loss in Neonates
and Infants: Hearing screening.” 8201 Greensboro Drive #300,
Frequent, undetected or untreated ear infections can
McLean, VA 22102, 800-AAA-2336.
lead to permanent hearing loss, delayed speech and
language development, social and emotional prob-
The National Institute on Deafness and Other Communication
lems, and academic failure. The earlier hearing loss
Disorders, “Silence Isn’t Always Golden.” NIDCD Information
is identi?ed, the sooner effective treatment can begin.
Clearinghouse, 1 Communication Ave., Bethesda, MD 20892-
3456, 800-241-1044.
Some babies are born with hearing problems. Other
children are born with normal hearing and begin to
By Rahman Zamani & Pamm Shaw (1/13/00)
Baby’s Hearing Checklist
Use this checklist to share with parents or health providers to determine if there is a hearing loss.
Yes No Birth to 3 months

Yes No 10 to 15 months

? ? Reacts to loud sounds
? ? Plays with own voice, enjoying the sound
? ? Is soothed by your voice
? ? Points to or looks at familiar objects or people
? ? Turns head to you when you speak


when asked to do so
? ? Is awakened by loud voices and sounds
? ? Imitates simple words and sounds; may use a
? ? Seems to know your voice and quiets down


few single words meaningfully


if crying
? ? Enjoys games like peek-a-boo and pat-a-cake
? ? Smiles when spoken to



15 to 18 months



3 to 6 months

? ? Follows simple directions (“give me the ball”)
? ? Looks up or turns toward a new sound
? ? Often knows 10 to 20 words
? ? Imitates his/her own voice
? ? Uses words he/she has learned
? ? Responds to “no” and change in tone of voice
? ? Uses 2-3 word sentences to talk about things
? ? Enjoys toys that make sounds

? ? Begins to repeat sounds (like ooh and ba-ba)


18 to 24 months

? ? Becomes scared by a loud voice
? ? Enjoys being read to

? ? Understands simple “yes-no” questions


6 to 10 months



(“are you hungry?”)
? ? Responds to own name, telephone ring,
? ? Understands simple phrases (“in the cup”)


someone’s voice, even when not loud
? ? Points to pictures when asked
? ? Knows words for common things (cup, shoe)



and sayings (“bye-bye”)


24 to 36 months

? ? Makes babbling sounds, even when alone
? ? Understands “not now” and “no more”
? ? Starts to respond to requests such as “come
? ? Chooses things by size (big, little)



here.”
? ? Follows simple directions such as
? ? Looks at things or pictures when someone talks


“get your shoes,” and “drink your milk.”


about them
? ? Understands action words (run, jump)


California Childcare Health Program • 1950 Addison St., Suite 107 • Berkeley, CA 94704-1182
Telephone 510–204-0930 • Fax 510–204-0931 • Healthline 1-800-333-3212 • www.ucsfchildcarehealth.org
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California Childcare Health Program

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