Ear Infections

By Tim Taylor

A common condition

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An ear infection is a common condition among children, but that doesn’t mean you should ignore your child’s complaints when they tell you their ear hurts. Five out of six children will have an ear infection by the time they are three years old. An ear infection is an inflammation of the middle ear, usually caused by bacteria, that occurs when fluid builds up behind the eardrum. Anyone can get an ear infection but children are more likely to get them than an adult because their immune systems are still developing. Adenoids are small pads of tissue located behind the back of the nose, above the throat, and near the Eustachian tubes. They fight off infection by trapping bacteria that enter through the mouth. As part of the immune system, the adenoids respond to bacteria passing through the nose and mouth. Sometimes bacteria can get trapped in the adenoids, causing a chronic infection that can then pass on to the Eustachian tubes and the middle ear.

No cotton swabs

 

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It’s a good idea to take a look at your child’s ear if they are complaining that it hurts but don’t attempt to clean out the ear with a cotton swab. According to the American Academy of Otolaryngology – Head and Neck Surgery, only one in 10 children and one in 20 adults have a problem with wax building up in their ears. Earwax actually plays a vital role in the health of your ears. It keeps your ears healthy by trapping dust and dirt so that they don’t travel deeper into your ear. Having a waxy coating on your delicate ear canal skin also helps to protect it. Chewing, other jaw movements, and skin growing inside your ear will push old earwax out naturally. Using cotton swabs, however, can push the wax deeper into your ear canal. You might also seriously damage sensitive ear canal skin or your eardrum. Pain or itching or a feeling that your ear is full are possible signs of earwax blockage and should be addressed by a physician or health care provider.

Antibiotics

 

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Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring the problem. Your child’s physician may recommend over-the-counter medications such as acetaminophen or ibuprofen, or eardrops, to help with fever and pain. Ear infections in infants and severe cases in general often require antibiotic medications. However, today’s doctors are cautious about prescribing antibiotics for ear infections unless they are chronic and frequent. If your doctor prescribes an antibiotic, it’s important to make sure your child takes it exactly as prescribed and for the full amount of time. Even though your child may seem better in a few days, the infection still hasn’t completely cleared from the ear. Stopping the medicine too soon could allow the infection to come back. It’s also important to return for your child’s follow-up visit, so that the doctor can check to make sure that the infection is gone.

Ear tubes

 

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If your child has frequent ear infections, signs of hearing loss, or speech delays because of that hearing loss, your doctor might refer you to an ear, nose, and throat specialist for ear tube surgery. Each year, more than half a million ear tube surgeries are performed on children, making it the most common childhood surgery performed with anesthesia. The tubes are inserted through an outpatient surgical procedure called a myringotomy, which involves an incision in the ear drum, most often done under a surgical microscope with a small scalpel. The tubes relieve the pressure and allow the fluid to drain. Some children naturally have small Eustachian tubes, so this helps correct that problem. As the child’s ears grow and develop, the tubes fall out automatically and the ear infections are no longer a problem. Sometimes, the tubes fall out too soon and have to be replaced. For some children, they never fall out and eventually have to be surgically removed.

Get vaccinated

 

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To keep an ear infection from coming back, it helps to limit some of the factors that might put your child at risk, such as not being exposed to cigarette smoke and not going to bed with a bottle. In spite of these precautions, some children may continue to have ear infections, sometimes as many as five or six a year. To lower your child’s risk for ear infections, make sure they are vaccinated every year with a pneumococcal conjugate vaccine to protect against several types of pneumococcal bacteria. This type of bacteria is the most common cause of ear infections. The flu vaccine is strongly recommended for children in daycare. Washing your hands frequently can also help. Washing hands prevents the spread of germs and can help keep your child from catching a cold or the flu. And as much as possible, try to limit your child’s exposure to other children who may be sick and be sure they that don’t share any food or drinks.

Trusted by thousands of listeners every week, T. Glenn Pait, M.D., began offering expert advice as the host of UAMS’ “Here’s to Your Health” program in 1996. Dr. Pait began working at UAMS in 1994 and has been practicing medicine for over 20 years.