By Traci French MD
 

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It’s 3am and your child is crying out in pain and holding her ear. What do you do? Otitis media or ear infections are a common problem in childhood which cause kids and parents a great deal of grief. Both kids and adults can get ear infections, but small children and infants are more likely to get ear infections due to a weaker immune system and a smaller Eustachian tube. Acute ear infections are the most common cause for kids to receive antibiotics and the most common reason for children under age 5 to see the doctor. About 75% of all kids will suffer from this condition, which occurs when puss collects behind the eardrum during an infection and blocks the Eustachian tube, which helps drain the ear. Pressure from the infected ear causes pain and hearing loss. Symptoms of otitis media include fever, ear drainage, ear pain, tugging at the ear, fussiness, inability to sleep and headache. Children between the ages of 6 to 18 months are at the greatest risk of developing an ear infection. Otitis media often occurs during or after an upper respiratory infection and can be caused by bacteria or viruses. There are many risk factors for otitis media, some of which are:

  • exposure to cigarette smoke during or after birth
  • formula use in infants
  • pacifier use
  • history of allergies or asthma
  • family history of ear infections
  • medical conditions such as cleft palate or Down’s syndrome
  • other siblings in the home and daycare attendance

Treatment

The typical treatment for an ear infection is antibiotics, which your medical provider will prescribe after examining your child to ensure that other, more serious conditions are not the cause of your child’s pain. Be sure to take the entire medication dose in order to avoid recurrent infection or antibiotic resistance, which will cause antibiotics to be less effective the next time an infection occurs. Tylenol or ibuprofen are excellent pain relievers, but please follow label directions for proper dosing. A warm (not hot) washcloth or heat pack is excellent for relieving pain due to infection. Please do NOT use ear candles on a child as they are ineffective and very likely to cause skin burns. Some sources recommend mullein tea which is often combined with garlic. Tinctures made from mullein may be easier to ingest than a tea as there are small hairs in mullein tea preparations which can cause skin irritation. Please consult a knowledgeable herbal practitioner regarding proper use of all herbal remedies. Both remedies are considered safe for short term use for all ages. Warm oil is a common home remedy for relieving ear pain, but please consult a healthcare provider before using substances inside the ear canal as serious damage may result if the eardrum is ruptured. Children typically have some hearing loss during an ear infection, but symptoms should resolve within 2-3 weeks. If you notice that your child has difficulty understanding conversations 4-6 weeks following an infection, please bring your child in for further evaluation as recurrent ear infections or persistent fluid collection behind the eardrum can cause permanent hearing loss and learning disability.

Prevention

The best way to prevent ear infections is to avoid exposing your child to cigarette smoke. Kids are two to three times as likely to get an ear infection if their parents smoke, especially if the child was born prematurely. Breastfeeding your baby is also an excellent way to prevent infections including otitis media. Studies show that infants that receive any formula in the first 6 months of life are twice as likely to get an ear infection (1). Treating seasonal or allergic rhinitis (hay fever) seems to decrease the risk of developing ear infections, as well by soothing chronic inflammation in the ear canal. If your child develops multiple ear infections during the course of a year or her symptoms last after the antibiotic course is completed, please follow up with your healthcare provider to determine if there are other preventable causes for this condition.



Citations:

1) Sonia Shoukat M.D., Thomas W. Hale Ph.D. 2017 Texas Tech University Health Sciences Center. Breast Feeding and Otitis Media in Infants. http://www.infantrisk.com/content/breastfeeding-and-otitis-media-infants

2) Ear Infections in Children. Feb. 2017. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/ear-infections-children

3) Middle Ear Infection and Hearing Loss. 2016. American Academy of Otolaryngology–Head and Neck Surgery. http://www.entnet.org/content/middle-ear-infection-chronic-otitis-media-and-hearing-loss