Should My Child See Her Pediatrician For An Ear Infection
In some cases with older babies and toddlers, mild symptoms may go away on their own. But if your child is under 6 months old, has a high fever, severe pain, drainage or swelling in the ear, its time to call your pediatrician. However, your doctor wont necessarily prescribe antibiotics right away. Ear infections are caused by both bacteria and viruses, so antibiotics arent always the solution. According to the American Academy of Family Physicians, there are several reasons why doctors dont prescribe antibiotics for every ear infection:
- Antibiotics dont work for ear infections caused by viruses.
- Antibiotics dont help the pain associated with ear infections
- Infections from both viruses and bacteria often disappear without antibiotics in a few days, especially in children over two years old.
- Physicians are keenly aware that the overprescription of antibiotics makes vital medicines less effective, so we work hard to use them only when truly necessary. In many cases, your doctor will watch the infection for a few days to see if it goes away on its own.
What Should I Expect If I Or My Child Has An Ear Infection
Ear infections are common in children. Adults can get them too. Most ear infections are not serious. Your healthcare provider will recommend over-the-counter medications to relieve pain and fever. Pain relief may begin as soon as a few hours after taking the drug.
Your healthcare provider may wait a few days before prescribing an antibiotic. Many infections go away on their own without the need for antibiotics. If you or your child receives an antibiotic, you should start to see improvement within two to three days.
If you or your child has ongoing or frequent infections, or if fluid remains in the middle ear and puts hearing at risk, ear tubes may be surgically implanted in the eardrum to keep fluid draining from the eustachian tube as it normally should.
Never hesitate to contact your healthcare provider if you have any concerns or questions.
Why Do Kids Get Ear Infections
Kids get ear infections more than adults do for several reasons:
- Their shorter, more horizontal eustachian tubes let bacteria and viruses find their way into the middle ear more easily. The tubes are also narrower, so more likely to get blocked.
- Their adenoids, gland-like structures at the back of the throat, are larger and can interfere with the opening of the eustachian tubes.
Other things that can put kids at risk include secondhand smoke, bottle-feeding, and being around other kids in childcare. Ear infections are more common in boys than girls.
Ear infections are not contagious, but the colds that sometimes cause them can be. Infections are common during winter weather, when many people get upper respiratory tract infections or colds .
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Articles On Ear Infection Treatments
If you care for children, you likely know already how often they come down with earaches. Adults get them, too, but youngsters have them much more often. Thatâs because they donât fight off viruses and bacteria as well, and their little ears arenât good at draining fluids yet.
Key Points About Middle Ear Infections
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How Is An Ear Infection Treated
Treatment of ear infections depends on age, severity of the infection, the nature of the infection and if fluid remains in the middle ear for a long period of time.
Your healthcare provider will recommend medications to relieve you or your childs pain and fever. If the ear infection is mild, depending on the age of the child, your healthcare provider may choose to wait a few days to see if the infection goes away on its own before prescribing an antibiotic.
Antibiotics may be prescribed if bacteria are thought to be the cause of the ear infection. Your healthcare provider may want to wait up to three days before prescribing antibiotics to see if a mild infection clears up on its own when the child is older. If your or your childs ear infection is severe, antibiotics might be started right away.
The American Academy of Pediatrics has recommended when to prescribe antibiotics and when to consider waiting before prescribing based on your childs age, severity of their infection, and your childs temperature. Their recommendations are shown in the table below.
American Academy of Pediatrics Treatment Guide for Acute Otitis Media
|in one or both ears||Mild for < 48 hours and temp < 102.2° F||Treat with antibiotic OR observe. If observe, start antibiotics if child worsens or doesnt improve within 48 to 72 hours of start of symptoms|
Longer Term Effects Of Inner Ear Infections
Generally, the symptoms will clear up as soon as the infection is gone. However, the effects can sometimes last longer.
You might still feel dizzy and off-balance even when the other symptoms caused by the infection have gone. This can be a sign that the balance organs were damaged. Your brain can usually learn to work with these changes, so your sense of balance should usually come back by itself. However, if youre struggling to cope or the problem persists, you should see an ENT specialist. The doctor can check for any underlying causes and may refer you for vestibular rehabilitation therapy to help you to recover your balance.
Inner ear infections can also have a longer term effect on your hearing. This is more likely if you had bacterial infection, so your doctor might recommend a hearing test to check on your ears after the infection.
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Why Do Children Get Many More Ear Infections Than Adults Will My Child Always Get Ear Infections
Children are more likely than adults to get ear infections for these reasons:
- The eustachian tubes in young children are shorter and more horizontal. This shape encourages fluid to gather behind the eardrum.
- The immune system of children, which in the bodys infection-fighting system, is still developing.
- The adenoids in children are relatively larger than they are in adults. The adenoids are the small pads of tissue above the throat and behind the nose and near the eustachian tubes. As they swell to fight infection, they may block the normal ear drainage from the eustachian tube into the throat. This blockage of fluid can lead to a middle ear infection.
Most children stop getting ear infections by age 8.
When Should I Take My Baby To The Doctor For An Ear Infection
Watch closely for changes in your childs health, and be sure to contact your doctor or nurse call line if: Your child has new or worse discharge from the ear. Your child is not getting better after 2 days . Your child has any new symptoms, such as hearing problems, after the ear infection has cleared.
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What Causes Inner Ear Infections
Infections can happen in any part of the ear, including the inner section. When the inner ear is infected, the problem is sometimes known as labyrinthitis.
The infection can be caused by a virus or bacteria, which usually reach the inner ear after affecting another part of your body.
- Viral Infections: Lots of different viruses can affect the inner ear, including the common cold and flu. The infection usually spread to the inner ear from other parts of the body , so you may start to develop symptoms related to your inner ear after noticing cold-like symptoms. Antibiotics cant help with this type of infection.
- Bacterial Infections: Bacterial infections are less common, especially in adults, but they can happen. Bacteria are more likely to get into the inner ear if the membranes separating it from the inner ear are broken, which might happen if you have a middle ear infection. If the infection is caused by bacteria then taking antibiotics might help.
In some cases, the problem that we call an inner ear infection isnt actually an infection at all. Labyrinthitis can happen when the inner ear becomes inflamed for other reasons, for example if you have an autoimmune condition that causes your immune system to mistakenly attack the tissue. You might need to get treatment for this underlying condition in order to prevent the inner ear problems from returning.
Diagnosis Of Ear Infections
Your physician will look into your ear with an otoscope, a medical instrument with a light on one end designed to get a better view inside the ear. Your doctor will look for the visual signs of ear infection, such as redness and inflammation.
To check for fluid buildup, a pneumatic otoscope, which blows air at the eardrum, will be used. If there is excessive fluid behind the eardrum, it will not move as it should when the air hits it.
In some cases, hearing tests may also be performed to assess any damage to the ear from the infection.
Different types of ear infections present with different symptoms, which can include:
- Inner ear infections: Hearing loss, ringing in the ears , dizziness, loss of balance, nausea and vomiting, and ear pain
- Middle ear infections: Fluid in the ear, ear pain, fever, a feeling of general illness, pressure in the ears, and hearing loss
- Outer ear infections: Inflammation of the ear canal, itching in the ear, ear pain, swelling of the ear canal, redness, and fluid draining from the ear
Ear Infection Doctor Discussion Guide
Children with ear infections, especially toddlers or infants, may not be able to describe their symptoms, but an ear infection will often present with the following signs:
- Tugging or pulling at their ears
- Fussing or crying
- Being clumsy and having balance issues
- Trouble hearing or responding to quiet noises
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Symptoms Of Ear Infection
Babies and small children might:
- pull or rub their ear
- have a high temperature
- have redness around the ear
- be restless or irritable
- not respond to noises that would normally attract their attention
See your doctor if:
- your child is in pain
- there is discharge from the child’s ear
- your child is unwell or vomiting
- your child can’t hear properly
- there is swelling behind the ear and the ear is being pushed forward
- your child keeps getting ear infections
When You Need Antibiotics
Children with ear infection with high temperature and vomiting are more likely to benefit from immediate treatment with antibiotics. Children who don’t have high fever and vomiting are unlikely to have complications and unlikely to benefit from immediate antibiotics4.
There are situations when antibiotics should be given promptly:
- Moderate or severe ear pain .
- High fever .
- Dehydration .
- Chronic conditions, such as heart disease or cystic fibrosis, which could put a person at risk for complications from an ear infection.
- Child younger than 2 years of age, because the risk of complications is higher for very young children.
- The condition worsens or fails to improve within 48 to 72 hours of onset of illness.
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Ear Infection Home Treatments And Remedies
Ear infections can occur in the outer ear , middle ear , and inner ear . Natural and home remedies to treat pain include:
- Over-the-counter pain relievers like ibuprofen and acetaminophen
- Applying a warm compress on the infected ear.
- Applying naturopathic ear drops with ginger, tea tree, or olive oil may help with pain and inflammation.
Talk with your doctor or pediatrician before using any herbal or naturopathic medicine for ear infections.
What Causes An Ear Infection
Ear infections are caused by bacteria and viruses. Many times, an ear infection begins after a cold or other respiratory infection. The bacteria or virus travel into the middle ear through the eustachian tube . This tube connects the middle ear to the back of the throat. The bacteria or virus can also cause the eustachian tube to swell. This swelling can cause the tube to become blocked, which keeps normally produced fluids to build up in the middle ear instead of being able to be drained away.
Adding to the problem is that the eustachian tube is shorter and has less of a slope in children than in adults. This physical difference makes these tubes easier to become clogged and more difficult to drain. The trapped fluid can become infected by a virus or bacteria, causing pain.
Medical terminology and related conditions
Because your healthcare provider may use these terms, its important to have a basic understanding of them:
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Theres A Serious Rash Growing
One of the most feared infections in children is meningitis. There are all these horror stories of otherwise healthy children suddenly coming down with the bacterial infections and being unable to fight off the infection. Their immune systems struggle.
A rash is one of the first signs of the bacterial infection. Before you worry about every rash, this is one of those that doesnt disappear with the tumbler test . After all, rashes can also be signs of viral infections, irritations, and allergic reactions.
Its still important to keep an eye on the rash. If it gets bigger, grows redder and also sees some discharge, theres a sign that its more serious than viral infections. You should also watch out for inflammation and other signs of illnesses. A bacterial rash will usually be linked to high fevers, floppiness, and extreme fatigue, especially in children.
Your doctor will likely refer you to the hospital if there is a fear of a serious bacterial infection from the rash. This isnt something thats taken lightly. At the hospital, tests can be carried out to make sure its bacterial, the type of bacteria and the best type of treatment.
Youre Blowing Green Or Yellow Snot
When your body is fighting an infection, some of the snot from your nose will change color. One of the signs of bacteria is having green or yellow snot. You can also have green or yellow phlegm when you a cough.
Viral infections usually lead to thin, clear secretions. You also wont usually have any phlegm come up. Youll want to discuss this symptom with your doctor.
However, there are times that green or yellow secretions can be a sign of a tough viral infection. Your doctor will still have to look at other symptoms, but the color is a good indication.
One of the ways to tell if the discolored snot and phlegm is bacterial is to look at the thickness. The viral discoloration will still usually be relatively thin. With a bacterial infection, the phlegm usually becomes much thicker and tougher. There may also be some blood when coughing, as the infection gets worse.
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Million Ear Infection Prescriptions
Ear infections are the most common reason for antibiotic use among U.S. children, with 15 million prescriptions written annually.
Antibiotic resistance is a growing worldwide public health concern that has been spurred by the widespread overuse of the drugs.
“In this country, 96% to 98% of physicians treat ear infections immediately with antibiotics, even though most cases will resolve on their own without treatment,” David M. Spiro, MD, MPH, tells WebMD.
Spiro and colleagues from Yale and Vanderbilt University conducted their study to determine if parents would accept a “wait-and-see prescription” approach to antibiotic treatment when their children had ear infections, and whether the approach would reduce antibiotic use.
The study included 283 children between the ages of 6 months and 12 years with ear infections treated at an urban hospital emergency department.
Children were not included in the study if they had another infection such as pneumoniapneumonia, were severely ill from the ear infection, were hospitalized, had ear tubes or a ruptured ear drum, or had received antibiotics within the prior week.
Roughly half the studied children received prescriptions for antibiotics with no special instructions.
The other half also received prescriptions, but parents were asked not to fill them unless the child was either “not better, or worse” after 48 hours.
How Do I Know If My Baby Has An Ear Infection Or Teething
When your toddler starts tugging on his ear, you may assume thats a telltale sign of an ear infection. He might do the same thing, though, if hes cutting teeth nerves in the back teeth branch out to the middle ear, so it can feel like his pain is coming from his ear.
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What Are Ototopical Antibiotics
Ototopical antibiotics are medications administered topically in the ear for treating middle ear infections. Ototopical antibiotics are usually the first-line treatment for recurrent bacterial ear infections, in the absence of systemic infection.
Ear infections are more common in children, and often clear up on their own. Most ear infections can be managed with warm compresses and pain management. Antibiotics are usually administered only for severe and persistent ear infections.