Ear Infections

Middle Ear Infections (Otitis Media)
Middle ear infections are one of the most common illnesses of early childhood.  They follow obstruction of the Eustachian tube.  Under normal conditions the middle ear cavity is filled with air which passes through the Eustachian tube from the nose and throat.

Children have Eustachian tubes that are easily obstructed by the congestion of colds and allergies.  When obstruction occurs, the middle ear cavity fills with fluid.  Bacteria grow in the middle ear fluid resulting in an ear infection.


How Can You Tell If Your Child Has An Ear Infection?
The diagnosis is easy in older children who complain of an earache, that their ear feels stopped up, or that they cannot hear normally.  Infants may have a fever, rub or pull at their ears and cry with pain.  However, they frequently do not demonstrate these specific signs and will only be fussy.  This makes it difficult to tell sometimes if young children have more than just a cold.  We recommend observing your child at home unless you feel there are symptoms indicating something worse than a typical cold.


How Are Ear Infections Treated?
Antibiotics are used to kill the bacteria that cause ear infections.  Although the ear infection is eliminated, the middle ear fluid may persist.  Therefore, it is important that we recheck your child at the end of the course of antibiotic treatment.  If fluid persists, continued treatment may be necessary to avoid another infection.


What Can Be Done to Prevent Ear Infections?
Viral colds, which usually precede ear infections, are very contagious, but unfortunately, they cannot be prevented.  During the winter when children are crowded together, colds are easily passed from one child to another.

Tobacco smoke in the environment has been shown to increase the number of ear infections and duration of fluid in the middle ear cavity.  If care givers must smoke, it should be outside of the home or daycare environment.

Wearing a hat to prevent cold air in the ears and avoiding water in the ears will not prevent middle ear infections.  Use of antihistamines/decongestants (“cold preparations”) may be of benefit.

If a baby has recurrent ear infections it may help reduce the number of infections if the baby is upright when feeding.  Never prop the bottle and allow the baby to feed.


What Are Tubes And When Are They Needed?
Ventilation tubes are small plastic tubes inserted through the ear drum by an ear surgeon. It is a minor surgical procedure, but requires general anesthesia.  The indications for tubes vary with the individual child's situation.  In general, if children have middle ear fluids that persist for more than three months, or, if they are having one ear infection after another that cannot be prevented with medication, then we may recommend tubes.