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Symptoms

Middle ear infections often develop a few days after a cold or flu. Symptoms usually develop suddenly and can include ear pain, nasal congestion, coughing, fever, discharge from the ear, vomiting, loss of appetite and irritability. If the infection is severe, pus may drain from the ear. Young children may tug at the ear, which can indicate pain.

Ear infections are more likely associated with bacteria than viruses. In addition, there are several conditions that can cause the nasal passages to become inflamed, which leads to ear infections. These conditions include allergies, upper respiratory infections such as colds or influenza viruses.

Age.  The incidence of ear infections peaks in children between seven and nine months old. By 16 months old, their risk decreases.

Respiratory conditions.  Children with respiratory conditions such as allergies, asthma and sinusitis are at increased risk of developing ear infections.

Other medical conditions.  Medical conditions such as Down’s syndrome, cleft palate and any disorder that weakens the immune system increases a child’s risk.

Day care centers.  Some experts believe that children in day care centers are at higher risk of developing ear infections. Ear infections themselves are not contagious; however, the respiratory infections that cause them are contagious. Children who are exposed to other children with these conditions are at higher risk.

Bottle-feeding.  Some experts believe that children who are bottle-fed rather than breastfed are at increased risk for ear infections. This is because breastfeeding helps boost the baby’s immune system to help protect against infections. If you bottle feed, it is better for the infant to sit upright rather than lying flat during feeding.

Smoking.  If the child lives with a parent or family member who smokes, there is an increased risk of getting an ear infection.

Alcohol.  Women who drink alcohol when they are pregnant put their baby at increased risk for a number of problems, including hearing loss and ear infections.

If your child has any of these symptoms, it is important to call your child’s doctor for an accurate diagnosis. The physician will ask you if the child has had any recent colds, is teething, or has experienced any other factors that may be causing the ear pain.

The physician will then remove any earwax in order to get a clear view of the middle ear. Then a flashlight-like instrument (called an otoscope) will be used to look in the ear for signs of an ear infection. These signs include red or yellow color, blisters, or a bulging eardrum. The physician will also check to see if the eardrum is moving.  Decreased movement of the eardrum can be an indication of an ear infection.

Antibiotics.  Many ear infections will resolve without antibiotics. Because using too many antibiotics make bacteria better at defending themselves, doctors use them only when necessary.  If your child is over two years old and does not appear terribly ill, a trial of observation for one to two days may be appropriate. See if the infection improves on its own, especially if it is a first time ear infection.

In other cases, your child’s doctor may prescribe an antibiotic such as amoxicillin, a form of penicillin. Physicians usually recommend that children over two years old take the antibiotic for five to seven days. Younger children are usually required to take the antibiotic for 10 days. If your child does not feel better within two days of taking the last dose, he or she should be re-examined by the physician.

Over-the-counter medicines.  Some over-the-counter medicines such as Tylenol or ibuprofen can help reduce the pain. Cold remedies and decongestants are not routinely recommended, as there is little evidence that the benefits outweigh the side effects.

Surgery.  Many children who have recurrent ear infections or who do not respond to antibiotic treatment often undergo surgery. In an outpatient procedure, a pediatric ear, nose and throat surgeon drains the eardrum and implants tubes to help drain the ear.

You can help avoid ear infections in your child by preventing colds and flu, and treating them effectively when they do occur.

• Wash hands frequently.
• Get enough rest.
• Avoid smoking in the house where the child lives, and change clothes after smoking.

Although ear infections in children are quite common, they should not be taken lightly. Severe or recurrent infections can lead to hearing loss. If you notice your child is experiencing any of the symptoms of an ear infection, call your physician immediately. Also, be sure your child receives regular check-ups and the appropriate immunizations when needed. This can help offer you peace of mind and a speedy recovery for your child.

Dr. Huang is an internal medicine/pediatrics specialist with Alliance Primary Care at 10475 Reading Road in Evendale.  Dr. Huang is currently accepting new patients. Please call 513-563-6896 for an appointment.

Alliance Primary Care is Greater Cincinnati’s largest primary care physician group, with more than 120 practitioners in more than 25 locations.  If you are searching for a physician, click here or call 1-888-749-DrDr.