How to Tell If Your Child Has an Ear Infection
Ear infections occur when the buildup of fluid behind the eardrum causes inflammation in the middle ear. Although anyone can get an ear infection, children are more vulnerable because their eustachian tubes, which connect the middle ear to the back of the nose and throat, are smaller. This makes it more difficult for fluid to drain out of the ear. Young children may not be able to clearly communicate any pain or discomfort they’re feeling in their ear, according to Peter J. Koltai, MD, a pediatric otolaryngologist and division chief of pediatrics otolaryngology at Lucile Packard Children’s Hospital at Stanford in Palo Alto, Calif. However, he said there are a number of common warning signs that parents can watch for:
Pulling at one or both of earsIrritability or excessive cryingTrouble sleeping or waking up during the nightFeverFluid draining from the earUnusual trouble balancing or clumsinessTrouble hearing
Other Clues in Diagnosing Ear Infection
Ear infections in young children are also often associated with a viral upper respiratory infection, Dr. Koltai added. When kids get a cold or a respiratory virus, their eustachian tubes may become swollen or blocked with mucus, preventing fluid from draining from their ear, he said. Kids who attend day care and those exposed to secondhand smoke are also more likely to get an ear infection, noted Koltai. RELATED: Is It a Cold or an Ear Infection? A 2010 study conducted by researchers from the Harvard School of Public Health found that, when the number of families instituting no-smoking rules at home nearly doubled between 1993 and 2006, the reduced exposure to secondhand smoke was associated with fewer ear infections in children.
Treating Ear Infections
Although most ear infections are caused by bacteria, not all children need to be treated with antibiotics. In fact, 95 percent of the time, ear infections clear up without medication within a few days. In some cases, however, children should be examined by a doctor and may require treatment with antibiotics. “If parents see that a child is irritable, not eating well, and has a fever, they should make an appointment with a pediatrician,” he advised. He added that children should see their pediatrician right away if they have any of the following symptoms:
A fever higher than 101 or 102° FDischarge of blood or pus from the earsSymptoms that persist or worsen after more than a few daysChanges in wakefulness or alertnessRedness behind the ear
“We worry about any changes in the eardrum that suggest damage to the eardrum or infection spreading outside the ear to adjacent areas, causing complications,” Koltai said. Kids with recurrent ear infections may also be candidate for ear tubes, which opens up the middle ear and prevents fluid from accumulating.
Antibiotics for Ear Infection
How an ear infection will be treated depends on the germ that’s causing the infection. Antibiotics will not help improve ear infections caused by viruses. Doctors will also consider a child’s age and how severe symptoms are, said Koltai. For children with recurrent ear infections, a pediatrician will also take into account the child’s health and how many infections he or she has had in the past few months in determining how to treat the infection. The American Academy of Pediatrics published criteria for doctors to help them better diagnose ear infections to help them prescribe antibiotics more effectively. Using antibiotics when they’re not necessary can contribute to the development of antibiotic-resistant bacteria. Antibiotics can also cause side effects, such as allergic reactions, diarrhea, rashes, and upset stomach. Children younger than 2 years old with infections in both ears, children with a ruptured eardrum, those with severe pain and fever of at least 102° F that do not improve after a few days, and kids with recurring infections may require antibiotics. But many children with ear infections may simply be treated with over-the-counter pain medications, such as acetaminophen and ibuprofen, to help them feel more comfortable until the ear infection clears on its own.
