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An ear infection is a bacterial infection of the middle ear (the space behind
the eardrum). It usually is a complication of a cold, occurring after the cold blocks off
the eustachian tube (the passage connecting the middle ear to the back of the throat).
Your child's ear is painful because trapped, infected fluid puts pressure on the eardrum,
causing it to bulge. Other symptoms are irritability and poor sleep.
Most children will have at least one ear infection, and over one fourth of these
children will have repeated ear infections. In 5 to 10 percent of children, the pressure in the
middle ear causes the eardrum to rupture and drain yellow or cloudy fluid. This small hole
usually heals over the next week. Children are most likely to have ear infections between
the ages of 6 months and 2 years, but they continue to be a common childhood illness until
the age of 8 years.
Permanent damage
to the ear or to the hearing is very rare. See your family doctor or
pediatrician to confirm a diagnosis of an ear infection.
Care Plan for Children with Ear Infections
Antibiotics
Your child needs the antibiotic prescribed by your physician. This medicine will
kill the bacteria that are causing the ear infection.
Try not to forget any of the doses. If your child goes to school or a baby sitter,
arrange for someone to give the afternoon dose. If the medicine is a liquid, store the
antibiotic in the refrigerator and use a measuring spoon to be sure you give the
right amount. Give medicine until the bottle is empty or all the pills are gone. (Do not
save the antibiotic for the next illness because it loses its strength.) Even though your
child will feel better in a few days, give the antibiotic until it is completely gone.
Finishing the medicine will keep the ear infection from flaring up again.
Pain relief
Acetaminophen or ibuprofen can be used to help with earache or fever over 102 degrees
Fahrenheit (39 degrees Celsius). These
medications usually control the pain within 1 to 2 hours and can be taken for a
few days until the antibiotic takes effect. Earaches tend to hurt more at
bedtime.
Restrictions
Your child can go outside and does not need to cover his or her ears. Swimming is permitted as
long as there is no perforation (tear) in the eardrum or drainage from the ear. Air travel
or a trip to the mountains is safe; just have your child swallow fluids, suck on a
pacifier, or chew gum during descent. Your child can return to school or day care when he
or she is feeling better and is fever free. Ear infections are not contagious.
Ear recheck
Your physician will schedule a return appointment for your child
in 3 to 4 weeks. At
that visit, the eardrum will be looked at to be certain that the infection is cleared up
and more treatment isn't needed. Your physician may also want to test your child's
hearing. Follow-up exams are very important, particularly if the infection has caused a
hole in the eardrum.
Prevention of ear infections
If your child has recurrent ear infections, follow these tips to help prevent
recurrence.
- Protect your child from second-hand tobacco smoke. Passive smoking increases the
frequency and severity of infections. Be sure no one smokes in your home or at day care.
- Reduce your child's exposure to colds during the first year of life. Most ear infections
start with a cold. Try to delay the use of large day care centers during the first year by
using a sitter in your home or a small home-based day care.
- Breast-feed your baby during the first 6 to 12 months of life. Antibodies in breast milk
reduce that rate of ear infections.
- Avoid bottle propping. If you bottle-feed, hold your baby at a 45-degree angle. Feeding
in the horizontal position can cause formula and other fluids to flow back into the eustachian tube. Allowing an infant to hold his own bottle also can cause milk to drain
into the middle ear. Weaning your baby from a bottle between 9 and 12 months of age will
help stop this problem.
- Control allergies. If your infant has continuous watery nasal drainage, consider an
allergy as a contributing factor to the ear infections, especially if your child has other
allergies such as eczema.
- Check the adenoids. If your toddler constantly snores or breathes through his mouth, he
or she may have large adenoids. Large adenoids contribute to ear infections. Talk to your
physician about this.
Call your child's physician immediately if:
- Your child develops a stiff neck.
- Your child acts very sick.
Call your child's physician during office hours if:
- The fever or pain is not gone after your child has taken the antibiotic for 48 hours.
- You have other questions or concerns.
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