Can A 4 Month Old Have An Ear Infection

Treatments And Tips For Teething

Teething is a natural part of your little one growing up, and unfortunately, all infants experience pain and discomfort while they grow their new teeth. We’ve got some tips to help deal with teething fever and the other symptoms of teething, to help make the process as easy as possible for you and your child.

Earache and ear infections can be commonly mixed up with teething symptoms, but it is not common for teething to cause ear infections for babies. If your baby is suffering from earache that seems to be caused by teething, you might be able to move them onto the side that isn’t as painful, and relieve a little bit of the pain, but most likely the pain is being caused by their teeth and gums and just feels like ear pain.

Keep your child hydrated with lots of little sips of water, as they will be losing a lot of fluid and probably won’t want to drink as often because it may hurt. Little sips as often as you can will make sure they stay hydrated.

Make sure you have a cloth handy to dry your baby’s drool, as it could cause skin irritation which might add an extra level of pain for your baby.

Children’s Paracetamol might be a good option to help with pain, just make sure you read the bottle carefully to get the correct dosage.

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Tests For Middle Ear Infection

The GP will look carefully at the inside of your childs ear using an instrument called an otoscope.

The GP might also do a tympanometry. This test measures how much your childs eardrum can move, and it can help the GP work out whether the ear is normal. Its usually a painless test that takes just a couple of minutes.

If your child has had several ear infections, or if your doctor thinks there might be a chronic infection or glue ear, the doctor might organise a hearing test. Your child can have a formal hearing test at any age.

Living With An Ear Infection

If your child suffers from several ear infections each year, youll want to look out for symptoms every time they have a stuffy nose or congestion.

Never stick anything in your childs ear to relieve the pain of an ear infection, to remove the tubes or remove a foreign object. See your childs doctor to have it removed.

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Signs Of An Ear Infection

Ear infections are common in babies, and it is helpful to know the classic signs to watch out for:

• Crying and irritability: Your babys ear is most likely painful, so expect crying and irritability. You may notice more crying when your baby lies down. This is because the ear pressure increases with lying down, leading to an increase in pain and discomfort during an ear infection.
• Tugging at the ear: Because your baby is too young to tell you that their ear hurts, look for signs such as tugging on the affected ear.
• Difficulty feeding: The act of sucking and swallowing causes changes in ear pressure and is usually uncomfortable during an ear infection. You may notice that your baby is hungry and seems eager to eat, but stops right away.
• Trouble sleeping: Expect a restless night or two when your baby has an ear infection. Because lying down is painful, your little one will probably wake throughout the night.
• Ear drainage: Its possible for your baby to develop ear drainage with an ear infection. The drainage will appear different than normal ear wax, which is orange-yellow or reddish-brown. Infected drainage may appear white, green, yellow, or blood-tinged and have a foul odor.
• Fever: Its estimated that about 50% of babies and children will develop a fever with an ear infection.

When Should I Take My Baby To The Doctor For An Ear Infection

• Fever. While some pediatricians have different standards for what constitutes a fever, if you suspect an ear infection and your child is running any kind of fever, dont worry about bothering your pediatrician with a call to the office. Definitely call the doctor immediately if your infant is under 3 months old and has a temperature of 100.4 degrees Fahrenheit or higher or if your child is between 3 months and 3 years old and the fever reaches 101.5 degrees F or higher .
• A discharge of blood, fluid or pus from the ear . This could mean that the pressure from the buildup of fluid in the ear has caused your childs eardrum to rupture which is not as scary as you might think. The release of pressure usually relieves some pain, and the eardrum usually heals itself within a few weeks. Still, youll want to see the pediatrician within a day or so since your child may need antibiotics to kill any bacteria that may have caused the ear infection.
• No improvement in your childs symptoms. Call if symptoms haven’t diminished after three days with or without antibiotics. Or get in touch if the infection seems to get better and then returns, which could mean that your child has a chronic ear infection.

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Does My Baby Have An Ear Infection

Take this quick quiz to find out just how much you know about ear infections.

Q. Are all children at risk for ear infections?

A. Ear infections are common in kids, especially babies between ages 6 and 18 months. One reason may be simple anatomy. The tube that drains fluid from inside each ear is much shorter in children than in adults.

In children, ear infections often follow a cold virus. One study in Pediatrics found that 30 percent of upper respiratory infections in kids younger than age 3 led to an ear infection. Other factors, such as being around smokers, can raise the risk for ear infection.

Q. How do I know if my baby has an ear infection?

A. Young ones may cry and tug at their ears. Theyll seem irritable and wont feel like eating or sleeping. They also may have a fever.

Q. Does my little one need antibiotics?

A. It depends on your childs age. Most ear infections in older babies and kids go away after a week or two without antibiotics. Taking these medicines when they arent needed can make it harder for your child to fight off future infections.

The American Academy of Pediatrics recommends antibiotics for babies younger than 6 months with ear infections. If your child is between 6 and 24 months and the ear infection isnt serious, antibiotics may offer little benefit. After age 2, an antibiotic is recommended only for a severe ear infection.

Online Medical Reviewer: Desrosiers, Florence MD

Date Last Reviewed: 4/2/2010

Cause Of Ear Infections

• A bacterial infection of the middle ear
• Blocked eustachian tube, usually as part of a common cold. The eustachian tube joins the middle ear to the back of the throat.
• Blockage results in middle ear fluid .
• If the fluid becomes infected , the fluid turns to pus. This causes the eardrum to bulge out and can cause a lot of pain.
• Ear infections peak at age 6 months to 2 years. They are a common problem until age 8.
• The onset of ear infections is often on day 3 of a cold.
• How often do kids get ear infections? 90% of children have at least 1 ear infection. Frequent ear infections occur in 20% of children. Ear infections are the most common bacterial infection of young children.

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Treatment For Middle Ear Infection

Symptoms of middle ear infection usually improve by themselves within 24-48 hours, so antibiotics arent often needed.

You can give your child paracetamol in recommended doses to help with pain. Your GP might suggest some anaesthetic ear drops if your child has severe pain.

If your child still has pain and is unwell after 48 hours, is particularly unwell or is less than 12 months old, your GP might prescribe a short course of antibiotics, usually penicillin.

Most children improve after a few days of antibiotic treatment, but always make sure your child finishes the whole treatment, even if she seems better. Stopping too soon could make the infection come back. Often your GP will want to see your child again when your child has finished the treatment, to make sure the infection has cleared up.

Decongestants, antihistamines and corticosteroids dont work as a treatment for middle ear infections.

Putting cotton wool in your childs ear or cleaning discharge with a cotton bud can damage the ear. It isnt recommended.

Recurrent ear infections Some children with recurrent ear infections or glue ear might need a long course of antibiotics.

Glue ear generally improves within three months. Your GP will need to monitor your child during this time to check that its getting better.

If Your Child Has Chronic Ear Infections See A Specialist

Pediatricians typically refer a child to an otolaryngologist an ear, nose, and throat specialist when he’s had three infections in six months or four within a year, but this isn’t set in stone.

“Kids who have frequent infections spend a lot of time feeling ill, and if fluid in their ears doesn’t clear between infections it can interfere with hearing and language development,” says Nancy Young, M.D., head of otology at Children’s Memorial Hospital, in Chicago.

When an ENT examines your child, she’ll discuss whether it’s a good option to insert a tympanostomy tube to reduce the risk of infections and improve hearing. Although there’s no maximum or minimum age for tubes, children usually get them between 1 and 3 years old.

With about 500,000 kids a year undergoing the procedure, it’s the most common surgery with anesthesia performed on children. The surgeon makes a tiny cut in the eardrum, suctions out the fluid, and then inserts a cylinder the length of an infant’s pinkie nail into the hole to keep it open. Once the tubes are in, you won’t be able to see them, but they allow air to flow into the middle ear and fluid to drain out.

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How To Prevent Childhood Ear Infections

While you cant do much to change your child’s family history, you can take the following steps to prevent ear infections:

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

• What to Expect the First Year, 3rd edition, Heidi Murkoff.
• What to Expect the Second Year, Heidi Murkoff.

Why Are Children More Likely Than Adults To Get Ear Infections

There are several reasons why children are more likely than adults to get ear infections.

Eustachian tubes are smaller and more level in children than they are in adults. This makes it difficult for fluid to drain out of the ear, even under normal conditions. If the eustachian tubes are swollen or blocked with mucus due to a cold or other respiratory illness, fluid may not be able to drain.

A childs immune system isnt as effective as an adults because its still developing. This makes it harder for children to fight infections.

As part of the immune system, the adenoids respond to bacteria passing through the nose and mouth. Sometimes bacteria get trapped in the adenoids, causing a chronic infection that can then pass on to the eustachian tubes and the middle ear.

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Ear Infections Can Still Happen With Ear Tubes

Unfortunately, the nail-biting experience of putting your young child through surgery doesn’t come with guarantees. Many children will still get an occasional ear infection, especially when they have a cold. However, your child should definitely get fewer infections, and they’ll usually cause less fever and pain.

“In fact, painless drainage from the ear is the most common sign of an infection in a child who has tubes,” says Dr. Young. However, you may not have to fight with your kid to swallow spoonfuls of antibiotics: Children with tubes in place are able to use antibiotic ear drops instead because the opening in their eardrum allows the medicine to get right into the middle ear.

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Childhood Ear Infections Explained

Ear infections happen when there is inflammation usually from trapped bacteriain the middle ear, the part of the ear connects to the back of the nose and throat. The most common type of ear infection is otitis media, which results when fluid builds up behind the eardrum and parts of the middle ear become infected and swollen.

If your child has a sore throat, cold, or an upper respiratory infection, bacteria can spread to the middle ear through the eustachian tubes . In response to the infection, fluid builds up behind the eardrum.

Children are more likely to suffer from ear infections than adults for two reasons:

• Their immune systems are underdeveloped and less equipped to fight off infections.
• Their eustachian tubes are smaller and more horizontal, which makes it more difficult for fluid to drain out of the ear.

“In some cases, fluid remains trapped in the middle ear for a long time, or returns repeatedly, even when there’s no infection,” Tunkel explains.

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Can Ear Tubes Help

If your child experiences frequent or chronic ear infections, your pediatrician may discuss ear tubes with you. Ear tubes are tiny tubes that are surgically placed into your childs eardrums to drain fluid and prevent blockages. Ear tubes can provide immediate relief for little ones who regularly experience painful ear infections. Talk with your pediatrician and a pediatric ear, nose, and throat doctor to see whether ear tubes are right for your child.

How To Know If Your Baby Has An Ear Infection Or Just Teething

Did you know that teething can be confused with an ear infection in babies?

While these two things might seem completely different concerns, the signs and symptoms can often overlap. For example, when your baby starts tugging on their ear, you may assume thats a clear sign that they have an ear infection. While this is possible, pulling on the ear could also mean your baby is teething because as the tooth erupts, the perforation can cause inflammation in the gum and subsequent pain that radiates to the adjacent ear.

In addition to pulling on their ears, other shared signs and symptoms include:

• Waking more frequently in the night

• More fussing than usual during the day

• Flushed cheeks

• Reduced appetite or pushing food away

• Rubbing their cheeks

So, how can you tell the difference between teething and an ear infection?

Symptoms that would suggest your baby is teething include:

• A low fever

• Swollen, red gums

• Wanting to chew on hard things

On the other hand, if an ear infection is to blame, your child may have the following symptoms:

• A fever of up to 40 °C

• Cold symptomsear infections are almost always preceded by a cold

• Discharge from the ear

• Complaining of ear pain or hearing loss

• Not reacting to auditory cues

• Loss of balance

What should you do if you suspect your baby is teething?

What should you do if you suspect your baby has an ear infection?

In summary:

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What Are Ear Infections

Ear infections, which can affect the ear canal or the middle ear, are common in babies. According to a study in Pediatrics, 23 percent of babies in the United States will experience at least one ear infection by the time they are 12 months old. That figure rises to more than half by the age of 3 years.

Ear infections tend to start either with an unhealthful bacterial growth or a viral infection, such as a common cold.

There most common types of ear infections in babies are:

• Acute otitis externa . Also known as swimmers ear, AOE refers to an infection in the ear canal.
• Otitis media. An infection in the middle ear can cause inflammation, leading to a fluid buildup behind the eardrum. Sometimes, the narrow passageways that connect the middle ear to the back of the nose, called the Eustachian tubes, can swell.
• Otitis media with effusion . This infection occurs when fluid builds up in the middle ear but does not usually cause pain or fever.
• Acute otitis media . This refers to a fluid buildup in the ear, which typically results from a bacterial infection.

Babies and children are more prone to ear infections as their Eustachian passages are shorter and narrower that than those of adults. This not only makes it easier for bacteria to reach the middle ear, but it means fluid is more easily trapped.

Other symptoms to look out for include:

It is not always possible to prevent ear infections in babies, but there are some steps caregivers can take to make them less likely:

Where Is The Middle Ear

The middle ear is behind the eardrum and is also home to the delicate bones that aid in hearing. These bones are the hammer , anvil and stirrup . To provide the bigger picture, lets look at the whole structure and function of the ear:

The ear structure and function

There are three main parts of the ear: outer, middle and inner.

• The outer ear is the outside external ear flap and the ear canal .
• The middle ear is the air-filled space between the eardrum and the inner ear. The middle ear houses the delicate bones that transmit sound vibrations from the eardrum to the inner ear. This is where ear infections occur.
• The inner ear contains the snail-shaped labyrinth that converts sound vibrations received from the middle ear to electrical signals. The auditory nerve carries these signals to the brain.

Other nearby parts

• The eustachian tube regulates air pressure within the middle ear, connecting it to the upper part of the throat.
• Adenoids are small pads of tissue above the throat and behind the nose and near the eustachian tubes. Adenoids help fight infection caused by bacteria that enters through the mouth.

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