It’s practically a parental rite of passage: Your child gets fussy with an earache, and you think it might be an ear infection. But how do you know for sure, and how do you know when it’s time to call your pediatrician?
An ear infection often happens after your child has a cold, sore throat or other respiratory infection, says Dr. Sneha Subbarayan, Pediatrician at ThedaCare Physicians Pediatrics-Neenah.
The middle ear will become inflamed, and that can happen when bacteria from a respiratory infection spreads to the middle ear or when a secondary infection occurs following a viral illness such as a cold. If the symptoms continue for more than 48 hours, you should bring your child in for evaluation, Dr. Subbarayan says.
“An untreated ear infection can leave your child in pain, lead to speech and learning issues, and even lead to permanent hearing loss,” she says.
While adults can get ear infections, they’re far more common in children. A child’s eustachian tubes, which connect the middle ear to the throat, are smaller and more level, making it harder for fluid to drain from the ear. When those tubes become blocked or swollen, draining becomes harder or impossible.
“Additionally, the immune system of a child is still developing, making it harder for kids to fight infections,” Dr. Subbarayan says.
Know What to Look for
Most ear infections will happen when children are very young, with five out of six children experiencing an ear infection before age 3, according to the National Institutes of Health.
During the ear infection, fluid builds up behind the eardrum, causing pain and other symptoms.
If your child is too young to tell you what’s wrong, here’s what to look for:
- Crying and fussiness
- Tugging at the ear or ears
- Trouble hearing
- Trouble sleeping
- Fever, particularly in babies and toddlers
- Fluid draining from the ear
- Balance problems
During your clinic visit, your provider will ask about your child’s symptoms and check your child’s ear with a small lighted scope or other instruments. If the eardrum is red and bulging, that’s an indication an infection is present. The most common type of ear infection is acute otitis media, which brings an earache and oftentimes a fever, Dr. Subbarayan says.
Ear infections are usually treated with antibiotics and over-the-counter pain medications. On occasion, a child’s ear pain may not be caused by infection and can improve without antibiotics.
“Seeing your medical provider is the only way to determine whether your child needs antibiotics for an infection or if the pain has another potential cause,” Dr. Subbarayan says.
Don’t give your child aspirin if they are experiencing fever or flu-like symptoms. Doing so can put them at risk for Reye syndrome, a rare condition that can cause liver damage and swelling in the brain. Your provider can recommend an appropriate dose of infant’s or children’s acetaminophen or ibuprofen.
Keeping Infections from Returning
Parents can help prevent recurrent ear infections by ensuring their children are vaccinated against the flu each year, as well as with the 13-valent pneumococcal conjugate vaccine (PCV13). Children can receive the flu vaccine beginning at 6 months old. Infants receive the first dose of PCV13 at 2 months old. The next two shots should be given at 4 months and 6 months, with a final booster that should be given at 12 to 15 months.
“Vaccinated children develop far fewer ear infections,” Dr. Subbarayan says. “PCV13 is recommended strongly if your child goes to day care.”
You should also encourage frequent hand-washing and keep your child away from other sick children and from people who are smoking, she says.
Additionally, don’t put babies and children to bed with a bottle of formula, milk or juice, which can enter eustachian tubes and cause irritation. These liquids also contain sugars that can encourage germ growth. Bottles filled with water are OK.
If your child continues to suffer from ear infections, your provider may recommend a surgical procedure to insert a small, temporary ventilation tube in the eardrum to help prevent fluid from backing up. If this treatment fails, your doctor might recommend removal of the adenoids to keep infection from spreading.
“Seeing your provider is the best plan for taking care of ear infections before they become more problematic,” Dr. Subbarayan says.