Ear Infections 101

If your child hasn't had an ear infection already, then it's likely on the horizon. After the common cold, ear infections are the most commonly diagnosed illness among children in the US. According to the American Academy of Pediatrics (AAP) 90% of children have an ear infection some time before they are school age, most often between ages of six months and four years.

In children, the Eustachian tubes in the ear are shorter and more horizontal than in an adult making it easier for bacteria to enter and thrive in the middle ear. The Eustachian tubes are also narrower and stiffer, which can make them more susceptible to blockage. Plus, children's immune systems aren't fully developed until the age of seven, making it more difficult for children to fight off infections.

How do I know if my child has an ear infection?

Ear infection symptoms can range from mild to severe. Children who can talk often complain of ear pain. Babies may just tug on their ears or cry more than usual. Lying down, sucking or chewing can all cause painful pressure changes in the middle ear, which can result in loss of appetite or difficulty in sleeping. Your child may also have a fever, and in some cases nausea, vomiting or dizziness.

Call your child's doctor if you suspect an ear infection. You'll likely need to visit the doctor's office where he can diagnose the condition by questioning you about your child's symptoms and by checking his ear with an otoscope.

Treating Ear Infections

Theirs is no single approach for treating ear infections. To determine the best course of treatment your doctor will consider how often your child has had ear infections, the type and severity of the infection, your child's age, and how long the symptoms have persisted. Some ear infections are caused by a virus and many ear infections will resolve on their own, so your doctor may recommend a "wait and see" approach. This is partly because so many bacteria are becoming resistant to antibiotics. For most children the AAP is now encouraging doctors to proscribe antibiotics for ear infections after this "wait and see" observation period. However, there are some cases in which the AAP recommends treating ear infections at the onset of symptoms. Their goal is to decrease the number of overall antibiotic courses proscribed for this very common condition. If your doctor does proscribe an antibiotic for an ear infection, make sure to take the entire course. If you don't, your child could become sick again. And if the illness returns, it is more likely to be resistant to antibiotics.

Here are some ways to prevent ear infection:

• Breastfeed.
  Studies have shown that infants that are breastfed for at least six months have a lower incidence of ear infections. If you bottle-feed your child, make sure that he is at an incline, not lying flat, during feedings.
  
• Minimize exposure to second hand smoke.
  Exposure to tobacco smoke can increase both the frequency and severity of ear infections.
  
• Reduce exposure to other kids.
  If it's possible, limit your child's contact with large groups of children. If you need to use childcare, choose the smallest setting feasible. This will limit your child's overall illness exposure, including ear infections.
  
• Wash hands.
  Both your hands and your baby's hands can introduce viruses and bacteria into baby's body. Good, old-fashioned hand washing is one meaningful step you can take toward preventing infection.

Although it's rare, ear infections that don't go away or severe repeated infections can lead to complications. So it's important to have your child evaluated if you suspect an ear infection, especially if his symptoms are combined with a high fever.