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What is otitis media?
Otitis media is a bacterial or viral infection of the middle ear (the space
behind the eardrum). Middle ear infections usually occur as a complication of a
cold, allergies, nose and throat infection, or enlarged adenoids (glands at the
top of the throat). Middle ear infections usually clear up without complication
or long-term effects.
Middle ear infections are more common in children than adults and are the
most prevalent childhood illness next to the cold. They occur most frequently
between age 3 months and 3 years, but are still common until age 8. Almost 25%
of children will have repeated ear infection, and 5% to 10% will develop a small
hole on the eardrum as a result of fluid pressure. Children are affected more by
ear infections than adults for two reasons: (1) they usually get more colds and
respiratory infections than adults (2) the eustachian tube is shorter and has
less of a slope in children than in adults.
How can I tell if my child has otitis media?
Ear infections can be painful. Trapped fluid puts pressure on the eardrum,
causing it to bulge. Symptoms of middle ear infections in children are:
- Drainage from ears that is yellow, brown, white or, green but
is not earwax
- Fever between 100 and 104 degrees Fahrenheit
- Cold-like symptoms
- Fussiness
- Vomiting
- Diarrhea
- Rubbing the ears
- Cannot sleep through the night or take naps
- Refusing a bottle or food (because doing so is painful)
- Complaints of nausea or dizziness
- Doesn’t respond when called (due to temporary hearing loss
from fluid buildup)
How are ear infections diagnosed?
The doctor will examine the child’s eardrum with an otoscope (a special
light helps see into the ears) but may also check the fluid in the middle ear
using a pneumatic otoscope, which blows a small puff of air at the eardrum.
Another useful diagnostic tool is tympanometry, which uses sound and air
pressure to check for fluids in the middle ear.
How are ear infections treated?
Antibiotics and prescription eardrops are used to treat middle ear
infections. Over-the-counter antihisthimines and decongestants will not keep
children from getting ear infections, but they can help relieve symptoms.
Acetaminophen or ibuprofen can help relieve earache or fever.
How can I help my child get better?
- Give your child all of the medication as instructed by the
doctor, even if he or she is feeling better.
- Notify the doctor if you child’s symptoms do not improve within
1 to 3 days.
- Schedule and keep a follow-up appointment two to four weeks after
the initial visit, just to make sure your child’s ears are improving and no
further treatment is needed.
- Acetaminophen or ibuprofen, given as instructed, will help
relieve pain.
- A warm compress for older children may help relieve pain at
bedtime. This is not recommended for infants.
Call the doctor immediately if:
- Your child develops a stiff neck
- Your child seems very ill
- Call the doctor during office hours if fever or pain has not gone
away after taking the antibiotic for 48 hours.
What can I do to help prevent my child from getting an ear infection?
- Breastfeed your baby during the first 6 to 12 months of life.
Antibodies in breast milk reduce the rate of ear infections.
- Hold your child during feedings instead of propping up bottles.
- Make sure your child’s vaccinations are current.
- Reduce your child’s exposure to colds during the first year of
life.
- Keep your child away from tobacco smoke.
- Teach and encourage your child to blow the nose gently. This will
prevent the forcing of fluid into the middle ear.
- Keep your child away from things that may trigger an allergy
attack. Continuous nasal drainage from allergies contributes to ear
infections.
Questions to ask your child’s doctor
-
For how long and at what times of the day should I give my child medication,
if any?
- How should I store the medication? In the refrigerator?
- When will my child start to feel better?
- Will I need to bring my child back for a follow-up visit?
- Should I keep my child home from school or day care?
- From which activities should I limit my child?
- Are certain foods or liquids more helpful?
- Which over-the-counter pain relievers do you recommend?
- Which over-the-counter medications/preparations are NOT recommended?
- Which symptoms should I report to the doctor?
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