How Do Ear Infections In Children Occur
Heres an anatomy lesson
The ear is divided into three parts: the outer ear canal, the middle ear space where infections occur, and the inner ear where the nerves and balance center are. A thin, membranous eardrum divides the outer and middle ear. The middle ear space contains the small bones that conduct the vibrations of the eardrum to the brain and is also connected to the back of the nose via the Eustachian tube.
Immature Eustachian tube
In infants and young children, this tube is much shorter and is angled. It is therefore much easier for bacteria to migrate from the nose and throat up into the middle ear space. As the child grows, this tube becomes more vertical, so germs have to travel upward to reach the middle ear. This is one-reason children outgrow ear infections.
When your child has a cold, the nasal passages get swollen and mucus collects in the back of the nose. This environment is a breeding ground for the bacteria that normally live in the nose and throat to begin to overgrow. Mucus is also secreted within the middle ear space just as it is in the sinuses.
Germs migrate up through the Eustachian tube and into the middle ear space where they multiply within the mucus that is stuck there. Pus begins to form and soon the middle ear space is filled with bacteria, pus, and thick mucus.
Who Is At Higher Risk For Ear Infections
- Children less than 5 years old, because they have shorter eustachian tubes.
- Children who attend daycare, because they tend to have more colds.
- Children with allergies.
- Children who are exposed to cigarette smoke. Smoke causes inflammation of the eustachian tube, making ear infections more likely.
- Children who were not breastfed. Breast milk has antibodies that help fight infections.
- Babies who are being bottle fed, especially if they swallow milk while lying too flat. Milk can enter the eustachian tube and cause inflammation, which increases the risk of an ear infection. Children should be held upright while drinking a bottle. When they are old enough to hold their own bottle well, they should be taught to drink from a regular cup and no longer given a bottle.
- Children with cleft palates, as their eustachian tubes are often inflamed.
- Children of First Nations and Inuit descent, though its not clear why.
Can Ear Infections Be Prevented
Currently, the best way to prevent ear infections is to reduce the risk factors associated with them. Here are some things you might want to do to lower your childs risk for ear infections.
- Vaccinate your child against the flu. Make sure your child gets the influenza, or flu, vaccine every year.
- It is recommended that you vaccinate your child with the 13-valent pneumococcal conjugate vaccine . The PCV13 protects against more types of infection-causing bacteria than the previous vaccine, the PCV7. If your child already has begun PCV7 vaccination, consult your physician about how to transition to PCV13. The Centers for Disease Control and Prevention recommends that children under age 2 be vaccinated, starting at 2 months of age. Studies have shown that vaccinated children get far fewer ear infections than children who arent vaccinated. The vaccine is strongly recommended for children in daycare.
- Wash hands frequently. Washing hands prevents the spread of germs and can help keep your child from catching a cold or the flu.
- Avoid exposing your baby to cigarette smoke. Studies have shown that babies who are around smokers have more ear infections.
- Never put your baby down for a nap, or for the night, with a bottle.
- Dont allow sick children to spend time together. As much as possible, limit your childs exposure to other children when your child or your childs playmates are sick.
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Symptoms That Your Child Might Have An Ear Infection
One of the most common reasons for a child to visit a physician is an ear infection. Many parents bring their children to the doctor because the child has been pulling on their ear. Is this because of an ear infection? What are the symptoms of an ear infection? Dr. Cindy Gellner stops by to discuss the possible symptoms of an ear infection and when it’s time to go to the doctor.
There are a lot of nerve endings in the ear and that’s why it’s such a popular place for massage therapists and acupuncturists to work on. So other than pulling, your child has no other symptoms. Ear infection? Maybe not. But say your child also has a fever, has had a cold for a while, isn’t sleeping like they normally do and are just plain cranky, then it’s time to get those ears checked out.
Despite what a lot of people think, going outside in the wind or cold without a hat on won’t cause an ear infection. Ear infections happen behind the eardrum, not in front of it where the cold and the wind would hit. An ear infection is caused by bacteria and it’s a common complication of a viral cold. Nasal congestion and mucus block off the tube that connects to the middle ear to the back of the throat. That’s the Eustachian tube. And then the ears can’t drain properly if that’s blocked. This makes a pool of fluid, which is a great breeding ground for bacteria and, hence, an infection is born.
What Research Is Being Done On Middle Ear Infections
Researchers sponsored by the National Institute on Deafness and Other Communication Disorders are exploring many areas to improve the prevention, diagnosis, and treatment of middle ear infections. For example, finding better ways to predict which children are at higher risk of developing an ear infection could lead to successful prevention tactics.
Another area that needs exploration is why some children have more ear infections than others. For example, Native American and Hispanic children have more infections than do children in other ethnic groups. What kinds of preventive measures could be taken to lower the risks?
Doctors also are beginning to learn more about what happens in the ears of children who have recurring ear infections. They have identified colonies of antibiotic-resistant bacteria, called biofilms, that are present in the middle ears of most children with chronic ear infections. Understanding how to attack and kill these biofilms would be one way to successfully treat chronic ear infections and avoid surgery.
Understanding the impact that ear infections have on a childs speech and language development is another important area of study. Creating more accurate methods to diagnose middle ear infections would help doctors prescribe more targeted treatments. Researchers also are evaluating drugs currently being used to treat ear infections, and developing new, more effective and easier ways to administer medicines.
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How Do You Treat Ear Infections In Babies And Toddlers
If you suspect your baby has an ear infection, take the following steps:
- Your childs pediatrician will check your little ones ears, since you wont be able to see an ear infection from the outside.
- Ask about medication. Some pediatricians will take a wait-and-see approach , but many will prescribe antibiotics usually a 10-day course.
- Offer your child appropriate pain relievers. Whether or not your child gets antibiotics, your doctor will likely recommend acetaminophen or ibuprofen for pain and fever relief.
- Apply heat . You can reduce the pain associated with an ear infection by applying heat or cold to the outer ear.
- Elevate your baby’s head. If your baby is older than 1, you may want to insert a pillow under the crib mattress to reduce pain while he sleeps, but be sure to ask your doctor before you try this . And remember, never place pillows, wedges or other soft objects on top of the mattress in your babys crib, as they may pose a suffocation risk.
Once the ear infection has cleared usually within a week to 10 days its not uncommon for there to still be a bit of fluid left over in the ear, which usually resolves on its own. Your pediatrician should continue to check your childs ears at each visit to make sure theres no infection.
Can Ear Infections Affect Hearing
Fluid buildup in the middle ear also blocks sound, which can lead to temporary hearing problems. Kids having a problem might:
- not respond to soft sounds
- need to turn up the TV or radio
- talk louder
- seem inattentive at school
In kids who have otitis media with effusion, the fluid behind the eardrum can block sound, so mild temporary hearing loss can happen, but might not be obvious.
A child whose eardrum has ruptured might have ringing or buzzing in the ear and not hear as well as usual.
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Can I Do Anything To Prevent Ear Infections In My Child
It is not easy to prevent ear infections, but the following may help reduce the risk:
- making sure your childs environment is smoke-free.
- breastfeeding your baby for at least 3 to 6 months is thought to be protective against the early development of ear infections this may be because breastfeeding boosts the infection-fighting system
- keeping your childs room warm and dry
- making sure your child has all their immunisations on time
What Is An Ear Infection And What Causes It
The ear is made up of three parts: the outer, the middle and the inner ear. The middle ear is the space just behind the eardrum. Sometimes, excess fluid can pool in this space and lead to infection.
Acute middle ear infections are painful infections that last a few days. They are often caused by the same viruses that cause the common cold, or by bacteria. The distinction between viral and bacterial causes is important because only bacterial causes respond to antibiotic treatment and some bacterial infections get better even without antibiotics.
Sometimes with an infection, the eardrum can rupture and have a hole that remains. When fluid from the infection fails to clear, or a hole is present, doctors call this a chronic middle ear infection.
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Still Not Sure Head To The Doc
The only way to be sure that your child has an ear infection is to visit your pediatrician. Take a baby younger than age 2 to the doctor if a cold and apparent discomfort dont go away in two or three days, or if a fever doesnt go away in one or two days.
When your physician peeks in your childs ear to check for signs of an infection, shes looking at the eardrum to see if it is red, thick, or bulging.
Symptoms Of Ear Infections In Babies
There are many symptoms that may indicate an ear infection. Again, just having one of these symptoms doesnt always mean your baby has an ear infection. But if your baby has several of these symptoms togetherand especially if they have recently had a cold or other virus you can suspect that they may have an ear infection.
- Crankiness and fussiness due to discomfort and pain
- Trouble sleeping or lying down flat
- Pulling at the ears from pain
- Clumsiness due to ear balance issues
- Yellow or brownish fluid draining out of your babys ear
- Difficulty hearing or responding to the sound of your voicethis is due to fluid build up in the ear and should resolve after the ear infection is over
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Symptoms That Teething And Ear Infections Share
There are a lot of symptoms of teething and ear infections that are pretty similar, so it can be hard to tell them apart when your child is feeling unwell.
If your little one is waking more frequently in the night, then they might be teething, or have an ear infection. Fussiness during the day or at night can be a sure sign something is wrong with your baby, with many different causes.
Flushed red cheeks are another symptom that could point to either teething or an ear infection.
If your little one is restless, irritable, and has a reduced appetite, then its most likely that something is wrong. Check with the symptoms below to try to identify if this is an ear infection or if your child is teething.
Cheek rubbing is often something your child will do when they have ear pain or sore gums, so this could point to either cause. If your baby is ear pulling or hitting their ears, this could be because of pain in their ears, but it also could actually be caused by teething pains. Often babies cant detect the exact place their pain is coming from, so they think that ear pulling will help. If they havent got a fever or any cold symptoms, then this is probably a symptom of their teething pain.
If your baby is refusing to lie flat on their back, it could be because they have an ear infection or because of teething pains.
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.
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When To Take Your Child To The Doctor For An Ear Infection
If your child has an ear infection, parents should call their childs doctor or pediatrician if:
- Symptoms persist for more than 24 hours
- Infant is 6 months old or younger
- Ear pain is acute or severe
- Infant or toddler cant sleep or is irritable after having a cold or other respiratory infection
- There is a discharge of fluid, pus or blood from the ear
Signs The Ear Infection Has Become Severe
If you catch an ear infection in time and get it treated promptly, it can be easily treated and your toddler will be OK within a few days. Sometimes, though, the infection can become more serious. âAn ear infection is usually considered severe if your child develops a fever higher than 102.2Â° F, their pain has persisted over 48 hours, or there is any sign of bloody discharge from their ears,â Maynard says. Kirkilas notes that seeing blood or pus drain from the ear can be a sign that the ear drum has ruptured. If you suspect your toddler has a severe infection, both doctors recommend calling your pediatrician or going into an urgent care immediately.
Watch out for these symptoms even if your child is on an antibiotic. âAntibiotics, such as amoxicillin, are very effective against middle ear infections, but in rare cases your child may have a resistant infection that requires switching antibiotics,â Maynard says. He recommends calling your doctor if their symptoms do not improve within 48 hours of treatment.
You should also look out for persistent hearing loss. âIf your child suffers from recurrent ear infections for several months, their pediatrician may refer them to a specialist who can place tubes in the eardrum to help prevent fluid from collecting,â Maynard says.
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Infections Inside The Ear
Antibiotics are not usually offered because infections inside the ear often clear up on their own and antibiotics make little difference to symptoms, including pain.
Antibiotics might be prescribed if:
- an ear infection does not start to get better after 3 days
- you or your child has any fluid coming out of the ear
- you or your child has an illness that means there’s a risk of complications, such as cystic fibrosis
They may also be prescribed if your child is less than 2 years old and has an infection in both ears.
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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How We Can Help
If your child has chronic ear infections, they may need special tubes in their ears to help drain the fluid. Other times, surgery to remove the adenoids may help.
Find out how we can help by making an appointment with Dr. Kumra today. Use our online booking tool or call 646-859-6136.
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How To Tell If Your Baby Is Teething Or Has An Ear Infection
Teething can cause drooling, crankiness, and the desire to gnaw on things. Teething does not cause a fever. If your baby has a raised temperature, is less interested in feeding, has a runny nose, or has a rash, theyre most likely sick. When in doubt, visit the doctor its better to be safe.
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