Ear infections are a common childhood woe and are equally tough on the kids who suffer from them and the adults who must nurse them through the infection! Ear infections are the leading reason why parents bring their children to the doctor and it is estimated that 5 out of 6 children will have had at least one ear infection before their third birthday.

What Causes an Ear Infection?

An ear infection happens when bacteria or viruses enter the middle ear (which is between the eardrum and the inner ear) and then populates, causing inflammation and other symptoms as part of the body’s immune response to this invasion. Because the Eustachian tube connects the middle ear to the back of the throat, this is usually the route the micro-organisms take. Ear infections usually happen after a child has had a cold or other respiratory infection such as a throat infection.

What Puts Kids at Risk?

Children are more vulnerable to ear infections for several reasons. One is that because their Eustachian tube smaller and is at a less acute angle than that of adult’s, it is easier for fluid to gather there and become infected. Also, children’s immune system tend to be less developed and therefore less able to ward off infections in general. It is also important to remember that children have larger adenoids than adults and this can help to accidentally block the Eustachian tube.

Apart from just being a kid, other risk factors parents should be aware of include:

  • Being bottle-fed
  • Attending a day care (due to increased risk of exposure)
  • Being a boy (boys are more likely to get ear infections than girls)
  • Having a family history of ear infections
  • Being exposed to secondhand smoke

What are the Most Common Signs and Symptoms?

While the particular signs and symptoms of an infection can vary from one child to another, some of the most common ones to look for include:

  • Reports of pain (in children old enough to speak)
  • Crying or fussiness in babies or young children
  • Pulling or tugging at the ear or trying to put objects (like the edge of a pillowcase) in the ear
  • Redness of the outside ear
  • Increased ear drainage which can sometimes have blood or pus
  • Low grade fever
  • Difficulty sleeping
  • Decreased appetite and/or nausea/vomiting

How is an Ear Infection Treated?

Not too long ago, when a child had an ear infection, the doctor would automatically prescribe antibiotics to help treat it. Now, however, it is believed that:

  1. Many ear infections are viral and cannot be helped with antibiotics.
  2. Many ear infections, whether viral or bacterial will go away on their own with basic home care.
  3. Antibiotics do not help with pain relief.
  4. Overuse of antibiotics has led to the rise of antibiotic resistant bacteria that can make even simple infections difficult to treat.

Because of this, antibiotics are no longer routinely prescribed, and generally only if the following requirements from the American Academy of Pediatrics are met, especially for children between the ages of 6 months and 2 years:

  • The child has a fever.
  • The child is in severe pain.
  • The child’s condition does not improve within 48-72 hours.

To treat a viral ear infection, rest and plenty of fluids is the best plan of action, along with comfort measures such as the use of Tylenol to reduce pain and bring down fevers. Again, antibiotics are not effective against this kind of infection which will go away with the passage of time.

However, parents should be aware that there are cases in which antibiotics should be started immediately, such as for kids who:

  • Have a cochlear implant, due to increased risk for developing bacterial meningitis
  • Have a genetic condition such as Downs syndrome
  • Have a cleft palate
  • Have a compromised immune system

For children who have chronic or severe ear infections, sometimes the surgical implantation of tubes in the eardrums to help drain excess fluids is sometimes suggested. These can help reduce the frequency and severity of ear infections.

How can Ear Infections Be Prevented?

The good news is that there are some ways to prevent an ear infection from happening to begin with. These include:

  • Preventing children from being exposed to secondhand smoke, which has been proven to increase the risk of ear infections
  • Breastfeeding, if possible, for the first year
  • Minimizing a child’s exposure to other groups of kids
  • Never put a baby to sleep with a bottle
  • Keeping up with vaccines, especially the flu vaccine and the PCV-13, which can protect children from a number of infection-causing bacteria

In short, ear infections are a common cause of stress for parents and kids alike and are in fact the frequent cause of pediatric doctor visits. However, in most cases, these infections are viral and can be treated with at-home comfort measures. Surgery should be considered for children with severe or frequent infections and prevention measures are available to avoid getting an infection to begin with.