Check If Its An Ear Infection
If you notice any of the following signs in your baby, it is essential to take her to the doctor as soon as possible:
-Rubbing or pulling at the ear
-Fluid drainage from the ear
These are the most common signs that your baby has an ear infection. A diagnosis can be made through a physical examination by a doctor and sometimes requires further testing, such as a hearing test, to confirm. Treatment usually consists of antibiotics but may require additional medical intervention if left untreated. Early diagnosis and treatment are key to preventing complications from ear infections.
Recurrent Ear Infections: Whats Normal And What Needs Specialized Care
Recurrent ear infections are ear infections that dont go away after treatment or that keep coming back after treatment.
Some children may experience multiple ear infections in one year. Many times, its OK for them to continue seeing their pediatrician or family care provider for treatment, says Dr. Watts. But in some cases, a child may need to be referred to an Ear, Nose & Throat specialist for evaluation for ear tube surgery.
Ear tubes help to drain fluid from the middle ear. This may help prevent ear infections. Doctors only consider ear tubes as a treatment for recurrent ear infection if:
- Your child is over 6 months old
- Your child has three or more ear infections in six months
- Your child has four ear infections in 12 months
Even then, there are many things to consider before resorting to ear tube surgery. ENT specialists have received special training in caring for conditions of the ear, nose and throat. If youre referred to an ENT doctor for your babys ear infections, theyll recommend the best course of action based on your childs individual case and needs.
How Ear Infections Resolve
There are two components of ear infections that need to resolve:
- Infection the antibiotics usually take care of the bacteria, which in turn resolves the fever and pain within a few days.
- Middle ear fluid it takes much longer for this to resolve, anywhere from a few days up to 3 months! The fluid slowly drains out through the Eustachian tube down into the nose. Taking repeated courses of antibiotics does not speed up this process, since the fluid is usually no longer infected with bacteria. Chronic nasal congestion or allergies can block the Eustachian tube and therefore prevent the ears from draining. Your childs hearing may be muffled until the fluid drains out. This is not permanent. See below how to prevent ear infections with tips on how to improve ear drainage.
Remember, since the runny nose and cough are usually caused by a cold virus and not bacteria, it may be 3 14 days before these symptoms resolve.
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How Do You Prevent Bacterial Infection In Babies
Most bacterial infections are contagious. While not all bacterial infections can be prevented, taking some precautions may lower the risk of contracting the infection .
- Maintain good hygiene around the baby. Wash their hands after returning from outdoors. If you or some family member has a cold or other infection, then wash hands before holding the baby and their belongings. It is good to wear a mask while handling the baby to prevent the transmission of bacteria through cough or sneezes.
- Always dispose of soiled diapers into a dustbin or diaper pail to prevent bacteria from transferring to the surroundings.
- Promptly clean any open wounds with baby-safe disinfectant and see the doctor for the further dressing of the wound and medication.
- Vaccinate your child against common childhood diseases. The American Academy of Family Physicians recommends immunizing all babies unless contraindicated. Some types of pneumonia can be prevented with vaccines .
- Prevent exposure to tobacco smoke. Exposure to second-hand smoke increases a babys risk of developing pneumonia.
- Only serve cooked food or sealed ready-to-eat infant food . Never feed the baby anything raw since it can expose the little one to bacteria. Store uncooked food away from cooked and ready-to-eat food meant for the baby .
- For the prevention of neonatal conjunctivitis, the state law requires most hospitals to administer antibiotic eye drops that contain erythromycin to the baby after birth .
Signs Your Child Has An Ear Infection
Ear infections are very common in infants and younger children. These infections, usually caused by bacteria from a sore throat, cold, or other upper respiratory infection spreading to the childs ear, can cause much pain for your child. But, when your children cant talk just yet or they cant verbalize whats going on with their bodies, how can you tell if they have an ear infection? First, we have to start by explaining the three different types of ear infections.
An acute otitis media ear infection is the most common type. When your child has an AOM infection, parts of the ear are infected and swollen and fluid is trapped behind the eardrum. This causes pain in your childs ear and they could also have a fever. An otitis media with effusion ear infection comes after an ear infection has come and gone, but there is still fluid behind the eardrum. The OME infection could be present without any symptoms at all. The third type of ear infection, chronic otitis media with effusion, occurs when fluid stays behind the middle ear for long periods of time. This can make it harder for your child to fight new infections, and it can also affect their hearing.
Although you wont be able to properly diagnose your child with a specific type of ear infection without taking them to their pediatrician, you can look for some signs of an ear infection in general. Here are four signs that your child may be dealing with an ear infection:
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Recovering From An Ear Infection
If the healthcare provider prescribes an antibiotic for your child, be sure to follow the dosage instructions carefully.
If youâre following the providerâs guidelines regarding the antibiotic dosage, your child may start feeling better in one to two days, with the fever and ear pain disappearing. During this time your child may also feel fullness or popping in the ear, which is a good sign that the recovery is under way.
The provider may very likely ask to see your child again to monitor the recovery. The provider will once again check to see if thereâs fluid in the middle ear. Fifty percent of children may still have fluid in the ear three weeks after treatment with medicine. But in 90 percent of those children, the fluid in the middle ear disappears within 3 months. If the fluid doesnât go away, the provider may refer your child to an ENT.
Oftentimes, in these instances, the ear infection may not be responding to the specific type of antibiotic that was first prescribed. The ENT may decide to have your child do another round of antibiotics, but this time prescribing a stronger one.
How Do You Treat An Ear Infection In Children
In some instances, an ear infection in children might go away on its own. Many doctors will prescribe an antibiotic to treat an ear infection, which usually needs to be taken for 7 to 10 days. To help with ear pain or fever, a doctor might also recommend over-the-counter pain relievers or ear drops.
Ear infections are often caused by bacteria. However, some ear infections are caused by viruses, which cannot be treated with antibiotics.
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What Is An Otoscope
The otoscope comes with several pointed tips, called specula. Choose one thatâs slightly smaller than the opening of your child’s ear. If the ear hole is too small for the smallest tip, donât try to check for an infection at home.
Clean the speculum, unless youâre using disposable ones, and fit it to the viewing end of the otoscope. Turn on the instrument’s light.
If your child is older than 12 months, pull the outer ear gently up and back. This will straighten the ear canal and make it easier to see inside.
Hold the otoscope at the handle with your pinky finger outstretched. When the instrument is in the ear canal, your pinky should rest on your child’s cheek. This will keep it from going too far inside their ear canal and possibly hurting them.
Next, slowly put the speculum into your child’s ear while looking into the viewing end of the otoscope. The ear canal is sensitive, so donât put pressure on the instrument or push it too far.
Move the otoscope and the ear very gently until you can see the eardrum. Angle the viewing piece slightly toward your child’s nose, so it follows the normal angle of the ear canal.
Two important things to keep in mind:
Here are some things to look for:
- A red, bulging eardrum
- Earwax buildup
- A hole in the eardrum
To Identify An Ear Infection Look For Clues In Your Childs Cues
Otitis media commonly known as a middle ear infection is practically a rite of passage for infants and toddlers. The primary reason for little ones vulnerability: Their developing ears are more prone to fluid buildup and conducive to invasion by germs than those of adults. The eustachian tube, the ear-to-nose drainage passage for fluid from the middle ear, is shorter in children. If bacteria or viruses infect the tube due to a cold or allergies, it can become inflamed, as can the nearby adenoid glands. Fluid may become trapped in the swollen middle ear, causing pain.
Know Your Childs Risk
If your child reaches age 3 without having had an ear infection, hes an exception to the rule most children have had at least one ear infection by this age. If hes had an infection, hes more likely to have another one. Many other factors can increase his risk, including allergies, bottle-feeding, exposure to cigarette smoke and history of respiratory illness.
Fall and winter are the times of year to be especially vigilant against ear infections. As we enter cold and flu season, these illnesses can be precursors to an ear infection. Be alert if your child attends day care or playgroups, where she is vulnerable to catching a respiratory infection.
Keep Your Eyes and Ears Open
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What Causes An Ear Infection
An ear infection usually is caused by bacteria and often begins after a child has a sore throat, cold, or other upper respiratory infection. If the upper respiratory infection is bacterial, these same bacteria may spread to the middle ear if the upper respiratory infection is caused by a virus, such as a cold, bacteria may be drawn to the microbe-friendly environment and move into the middle ear as a secondary infection. Because of the infection, fluid builds up behind the eardrum.
The ear has three major parts: the outer ear, the middle ear, and the inner ear. The outer ear, also called the pinna, includes everything we see on the outsidethe curved flap of the ear leading down to the earlobebut it also includes the ear canal, which begins at the opening to the ear and extends to the eardrum. The eardrum is a membrane that separates the outer ear from the middle ear.
The middle earwhich is where ear infections occuris located between the eardrum and the inner ear. Within the middle ear are three tiny bones called the malleus, incus, and stapes that transmit sound vibrations from the eardrum to the inner ear. The bones of the middle ear are surrounded by air.
The inner ear contains the labyrinth, which help us keep our balance. The cochlea, a part of the labyrinth, is a snail-shaped organ that converts sound vibrations from the middle ear into electrical signals. The auditory nerve carries these signals from the cochlea to the brain.
How Can You Prevent Ear Infections In Children
- Observing good hygiene, including washing your and your babys hands regularly and sanitizing your home
- Keeping your child away from other kids who have a cold
- Protecting your child against secondhand smoking
- Breastfeeding your baby during his/her first year
- Practicing proper bottle positioning to keep the milk from flowing into the eustachian tubes
- Getting vaccinations for meningitis, influenza and pneumonia
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If You Think Its An Ear Infection
If you think your little one has an ear infection, if they have other symptoms, and if symptoms dont seem to resolve in a day or two, see a doctor. At home, you can:
- Give a weight-appropriate dose of a baby painkiller but check with your doctor before the first time you use it .
- Offer foods and fluids frequently to avoid dehydration.
- Dont fret about routine. If you have the luxury of being home with your baby, let them sleep when they like.
- A warm compress against the ear can soothe the pain.
- A pillow or two under your babys mattress can elevate the head and help them sleep. However, do not put a pillow directly under your babys head.
How Do I Tell The Difference Between Teething And Ear Infection
The best way to tell the difference between teething and ear infection is to have a medical practitioner examine the baby or toddlers ears. There are some other signs suggestive of one or the other condition, but sometimes babies can have both. An infection indicates the presence of bacteria, and without treatment this could cause damage. It always makes sense to see a doctor, if in doubt. Still, parents can look for other signs that differentiate between teething and ear infection such as drooling, response to pressure on the gums, type of nasal mucus, worsening illness, and greater discomfort in a prone position.
One of the difficulties with trying to tell teething and an ear infection apart is that both conditions may be accompanied by a slight fever. Usually, fever with teething doesnt exceed 100 degrees F , but sometimes an ear infection presents without fever or a low grade fever. Alone, this symptom is unreliable in telling the difference between the two.
Teething and ear infection can share in common the following symptoms:
- Pulling on the ears
- Positive response to pain medicine
- Mouth pain
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Can Ear Tubes Help With Recurrent Ear Infections In Babies
Babies who get recurrent ear infections or have one ear infection that doesnt clear up for months even with antibiotic treatment may be good candidates for ear tubes. 670,000 children in the US have this procedure each year.
An otolaryngologist makes a tiny incision in the childs eardrum and inserts a small tube into the slit. The tube releases pressure and acts as a vent. This lets air in and allows fluid out, so bacteria dont flourish. Its an artificial eustachian tube that lets the ear breathe.
Your childs doctor may suggest this solution because a baby that has persistent fluid in its ears is a prime candidate for repeated ear infections and hearing loss.
Ear Infections in babies can be very serious. A severe or untreated infection can rupture the babys eardrum. Ruptures dont happen very often but its important to follow up with the doctor to make sure the ear infection has cleared up and the eardrum is healing. Repeated infections of the ear can sometimes cause hearing loss and scaring.
All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered a specific diagnosis or treatment plan for any individual situation. This information does not create a doctor-patient relationship. Always seek the advice of your own doctor in connection with any questions or concerns you may have regarding your health or the health of your children.
The Ear Tube Controversy
While ear tubes do have their place in treating recurrent ear infections, there does exist some controversy over their use. The advantages are listed above, but some common concerns about tubes are:
- Some doctors may be too quick to recommend ear tubes before exhausting all other preventative measures or before allowing enough time to allow the ears to clear up without surgery.
- As with any surgery, there are risks to general anesthesia.
- The tubes often leave a little scar covering approximately one-sixth of the eardrum. This scar is often permanent. There does not seem to be any long-term consequence of this scarring, but were not completely sure. Please note that recurrent ear infections with or without eardrum rupture can also lead to scarring.
- Please note that ear tubes dont always prevent ear infections. Some children will still get as many infections even with the tubes in, but the fluid drains out right away.
- Many children benefit from ear tubes, parents declaring their child is a new person The ear infections are gone, hearing has improved, no more sleepless nights with a crying child, no more endless courses of antibiotics.
- A general indication for tubes are chronic ear fluid for more than four to six months, more than three ear infections in six months, or more than five in one year. You and your doctor should decide together when it is the right time for ear tubes for your child.
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Johns Hopkins Pediatric Otolaryngology
Our pediatric otolaryngologists are committed to providing compassionate and comprehensive care for children with ear, nose, and throat conditions. As part of the Johns Hopkins Children’s Center, you have access to all the specialized resources of a children’s hospital. Your child will also benefit from experts who use advanced techniques to treat both common and rare conditions.