By Natalie Dicou
Perhaps you’ve noticed your favorite toddler tugging at his ears recently or acting grouchy. There’s a chance your little one has a middle ear infection — or otitis media.
We’re in the thick of the cold and flu season, and for children ages 18 months to about 4 years that means an uptick in earaches, which strike pint-sized patients far more frequently than adults and older kids.
Blame it on the eustachian tube, the canal that connects the middle ear to the throat and equalizes pressure between the outer and inner ear.
“In young children, the eustachian tube is not as vertical as it is in adults so it doesn’t drain as easily,” said Marc Error, M.D., an ear, nose and throat specialist — or otolaryngologist — with University of Utah Health Care. “Fluid can build up behind the eardrum, and then it can become infected by bacteria and can cause ear pain and hearing loss.”
The chance of a tot getting an ear infection by age 3 is 80 percent — about the likelihood of a teen getting acne at some point during adolescence. Parents can improve their kids’ odds of staying healthy by teaching them good hygiene and to avoid touching their ears, nose, mouth, and eyes, Error said. Some children have an increased risk of ear infections, such as individuals with a family history of ear infections.
“Bottle-fed children are more likely to get ear infections than breast-fed children because of negative pressure caused by sucking, which can be transferred to the middle ear,” Error said, noting that when bottle-feeding, it’s best to use bottles that prevent nipple collapse and air-bubble formation as these are associated with negative pressure.
Kids are also more likely to get ear infections if they have weak immune systems, spend time around someone who smokes, or if they attend daycare (because of the increased risk of catching a virus in a closed space teeming with children).
When they’re not feeling well, it can sometimes be difficult to understand what youngsters are trying to tell us. Error advises to watch for certain signs and behaviors that may signal an ear infection, including pulling on the ears, irritability, sleep problems, hearing difficulties, fluid draining from the ears, loss of balance, and fever.
He recommends ibuprofen and acetaminophen to reduce pain and inflammation. If a fever persists beyond 3-5 days, Error says it’s a good idea to see a family physician. A health care provider will inspect the outer ears and eardrums using an otoscope, the hand-held tool with a pointy end that health care providers use to examine ears, to determine if treatment is needed.
In the past, antibiotics were viewed as the go-to solution for ear infections, but in 2013 the American Academy of Pediatrics issued new guidelines recommending that antibiotics be prescribed only after patients meet more stringent criteria since the medicine is becoming resistant to such infections. It means parents are more likely to hear “Let’s watch and wait” from pediatricians. The approach is effective: Studies show 80 percent of ear infections clear up within a week by themselves.
In more severe cases, fluid can remain behind the eardrums for an annoyingly long time. If fluid doesn’t drain for more than three months, Error said one option is a surgery called tympanostomy in which small tubes are placed in one or both ears to allow air into the middle ear and to drain the fluid. This improves the child’s ability to hear and reduces the probability of an infection.
It’s more likely, however, that kids will simply outgrow their ear infections once their eustachian tubes (named after Bartolomeo Eustachi, a 16th century Italian scientist) change from a horizontal position to a more vertical one. From there, it’s easy sailing. Well, until the acne hits.