Ear Infection

Ear infections are more common in children than in adults because the Eustachian tubes in children are short and horizontal, making its functionof draining the mucus out from the middle ear difficult. In adults these tubes are triple in length and more vertical to be able to drain out the fluid easily. Moreover, children are more susceptible to colds or upper respiratory tract infections because of their weak immune system and ear infections are likely to accompany colds a number of times. Within the first two years, two-thirds of all children will have at least one ear infection. Children below 1 year, who are left at day-care centres are exposed to more viruses and so are easily affected by ear infections than those who are cared for at home. Once your child starts going to school, chances of ear infection decrease, because of the growth of his middle ear structures which reduces chances of fluid blockage and also because body’s defensive mechanism against infection improves with age.

Causes

Ear infection occurs when your child has a cold, or sinus infection or allergies affecting the nasal passages, during her first few years. Human ear is made up of three parts - external ear, middle ear, and inner ear. It is the middle ear that is affected when the child has an ear infection. The middle ear region is the ear drum and the small space behind the ear drum is connected to the back of the nose and throat by a tiny channel called the Eustachian tube. Normally the middle ear space is filled with air and fluid or mucus which is usually drained by the Eustachian tube. But during colds, sinus infections, or allergies, mucus or fluid gets accumulated in this space due to blockage of the Eustachian tube. If this accumulated fluid becomes infected by bacteria or viruses, it causes pain in the ear and inflammation of the ear drum. In some cases of middle ear infections, there may be a perforation caused in the ear drum due to blockage of the Eustachian tube which produces a severe imbalance of pressure between the middle ear and the atmosphere. The pressure of the fluid against the ear drum causes the perforation.

Symptoms

• Ear infections cause severe pain usually (though not always).
• Babies with ear infection pull at their ears and cry more during feeding because sucking and swallowing cause pain in the middle ear.
• Babies have trouble in sleeping because while lying down, there are changes in ear pressure which will cause pain in the ears.
• Rise in temperature from 100 to 104 degree F.
• Pus flows out from the infected ear. This shows that there is a hole formed in the ear drum. (No undue cause to worry, for the hole will heal by itself in about a week without complications.)
• Temporary decrease in hearing ability. (Once the middle ear is free of fluid, normal hearing will be restored.)

Treatment

• Take your child to a paediatrician as early as possible. Your doctor may prescribe liquid paracetomol in dose appropriate to her age, to relieve pain and also to bring down the fever.
• Do not use ear drops before consulting your paediatrician.
• An antibiotic prescribed by your paediatrician is the primary treatment for ear infection. Within 3 days the child will start to recover from her infection.
• Do not discontinue the medication (usually prescribed for a week or 10 days to prevent recurrence of infection) immediately after your child starts feeling better.
• After completing the medication, take your child for another check up to see if any fluid is still present behind the ear drum.
• If an antibiotic prescribed doesn’t work, it is because the bacteria causing infection is resistant to it. So the paediatrician will prescribe a different antibiotic.
• If all the drugs used don’t work, fluid in the ear can be drained surgically.

Prevention

• Occasional ear infections cannot be prevented.
• For ear infections which occur frequently due to seasonal allergies, antihistamines or decongestants will be prescribed by your paediatrician.
• Upto date vaccinations can prevent illnesses that may lead to ear infections.
• Breast feeding for at least 6 months, generally reduces the risk of illnesses in babies, so is the case with ear infections too.
• Let your child stay away from people who smoke because cigarette smoke will affect the effective functioning of the Eustachian tube. Let her be also away from those who have colds.
• Give your child more fruits and vegetables to strengthen her immune system.
• Cleanliness keeps away illnesses, so instruct your child to wash hands regularly before eating to prevent any kind of infection.
• Repeated ear infections are only temporary, which will improve as your child gets older.