Ear-itated

An ear infection is a common childhood condition, and probably one of the most miserable for everyone in the household. As any parent who has had a child suffer from the ailment knows, there can be a lot of crying and discomfort involved.

According to Steven Andreoli, MD, pediatric otolaryngologist (ENT) at Wolfson Children's Hospital and Nemours Children's Health, Jacksonville, babies as young as 4 to 6 months can experience an ear infection. In general, they occur in the first couple of years of life, then improve until it's time for school.

"As kids graduate into school age, they start to have more respiratory illnesses and sinus problems, which again can lead to ear infections," Dr. Andreoli said. "Fortunately, it's rare for ear infections to persist into adolescence or the teen years."

Built that way

Ear infections often result from another illness – cold, flu or allergies – that causes congestion and swelling of the nasal passages, throat and eustachian tubes, which are responsible for draining fluid produced by the ears to the back of the nose.

"Young children's eustachian tubes are shorter, and the muscle is still developing. In addition, babies spend much of their time laying flat, so gravity is not helping flush the fluid. As a result, some children's ears don't 'breathe' as well, raising the risk of infection," explained Dr. Andreoli. "For school-age children, it's a result of being near more sources of respiratory infections."

Do you hear what I hear?

How do you know if your child might have an ear infection?

Dr. Andreoli said, "Telltale signs may include fever, tugging at the ears, nausea, vomiting, crying, irritability, lethargy and ear drainage. Older children may describe pain, a sense of fullness inside the ear or muffled hearing."

The sound of silence

In most cases, ear infections are easy to treat in one of three ways:

• Antibiotics typically resolve the infection within 5-10 days. The medicine is most commonly taken by mouth. Drops may be used if there is drainage or the child already has ear tubes.

• Pain medications alleviate some of the discomfort that causes fussiness, difficulty sleeping or crying. Caregivers can give weight-appropriate doses of acetaminophen or ibuprofen after consulting with their pediatrician.

• Ear tubes are reserved for children who have had three or more ear infections in six months, four or more in a year, persistent fluid in the ear or hearing loss. "Placing ear tubes is the most common procedure in the United States, with about 670,000 performed annually," said Dr. Andreoli. "It's a 5- to 10-minute outpatient procedure. A typical set will stay in place about 10-18 months and will pop out on its own."

Dr. Andreoli said, "Almost every child will have an ear infection before the age of 2. Most are managed well with antibiotics from the pediatrician's office. Children with recurring infections, persistent fluid in the ears or speech issues related to hearing loss are often referred to a specialist."

Prevention is possible

There are some unavoidable risk factors for ear infections including family history, frequent illness, and immune deficiency and chronic respiratory diseases.

Don't despair. Dr. Andreoli said there are things you can do to help prevent ear infections:

• Avoid second-hand smoke. "Make sure your child is breathing healthy air," he said.

• Breastfeed. "Studies have shown breast milk affords some protection against ear infections."

• Feed baby at an upright angle. When bottle-feeding, hold the baby's head higher than his or her stomach to keep the formula and other fluids from flowing back into the eustachian tubes. Dr. Andreoli added, "Keep the baby upright for a few minutes after eating to reduce reflux, which could also cause fluid build up in the middle ear."

• Take a break from daycare. "If your child is in daycare for social reasons versus work necessity, a short break can reset the system and get the child's ears back on track."

Wolfson Children's Hospital provides pediatric otolaryngology (ear, nose and throat) services in partnership with Nemours Children's Health, Jacksonville. Click here to learn more.