Ear Infections

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The Problem

An ear infection is an infection of the middle ear, the space behind the eardrum. Also known as otitis media, it is caused by bacteria. An ear infection is usually a complication of a cold. It occurs after the cold blocks off the Eustachian tube, the passage that connects the middle ear to the back of the throat. As fluid becomes trapped in the middle ear, it becomes infected. As pressure builds up, the eardrum bulges and causes pain. Younger children may cry or scream, tug at the ear, and sleep poorly. Older children may complain of an earache and muffled hearing.

In 5% to 10% of children, pressure in the middle ear causes the eardrum to rupture and drain. The discharge is usually yellow or cloudy. It does not mean the infection is more serious than an infection without discharge. The small tear usually heals in about a week. An ear infection may also be accompanied by a fever.

Most children (75%) will have one or more ear infections during childhood, and over 25% of them will have repeated infections. The peak age range for ear infections is 6 months to 2 years, but they continue to be a common childhood illness until 8 years of age.

If you carry out the following treatment plan, your child should do fine. Permanent hearing loss or damage to the ear is very rare. Ear infections are not contagious. Your child can return to school or day care when he is feeling better and the fever is gone.

Home Treatment

Give antibiotics as prescribed by your child’s doctor. If the medicine is a liquid, use a measuring spoon to make sure you give the right amount. Never use an antibiotic left over from a previous illness because it loses its strength.

The medicine will kill the bacteria that are causing the ear infection. Try not to miss any doses. If your child goes to school or a baby-sitter, arrange for someone to give the afternoon dose. Give the medicine until all the pills are gone or the bottle is empty. Even though your child will feel better in a few days, you must give all the medicine to keep the ear infection from flaring up again.

Give Medicine To Relieve Pain

You can give your child acetaminophen or ibuprofen for a few days to relieve earache or fever over 102° F. Earaches tend to hurt more at bedtime. To help ease the pain, you can put an ice bag wrapped in a wet washcloth over the ear. This may decrease the swelling and pressure inside. Some physicians recommend a heating pad instead. Remove the cold or heat in 20 minutes to prevent unintended frostbite or a burn.

Take Reasonable Precautions

Your child can go outside and does not need to cover the ears. She can also swim as long as there is not perforation (tear) in the eardrum or drainage of fluid from the ear. A trip to the mountains or air travel is generally safe. Just have your child swallow fluids, suck on a pacifier, or chew gum during the 30 to 60 minutes that the airplane is descending to help relieve any pressure buildup in the middle ear. Some re-infections of the ear can be prevented if you protect our child from tobacco smoke (passive smoking).

Be Sure To Keep Follow-Up Appointments

Your child will be given a return appointment in two to three weeks. At that visit, we will look at the eardrum to make sure the infection is cleared up and more treatment isn’t needed. We may also want to test your child’s hearing. Some children develop hearing loss, which is usually temporary and clears up on its own in one to three months. Follow-up exams are very important, particularly if the eardrum is perforated.

Call our office immediately if:

  • Your child develops a stiff neck or severe headache
  • Your child can’t walk normally
  • The pain is severe (your child is screaming)
  • Your child starts acting very sick

Call within 24 hours if:

  • The fever or pain is not gone after your child has taken the antibiotic for 48 hours
  • Your child vomits the antibiotic or refuses to take it
  • You feel your child is getting worse