The Blessed Event

Did you ever notice the first thing that people do when they see a baby is try to figure out which parent or relative the child resembles? How many times have you heard: "He's got his father's nose" or "He's got his mother's chin"? Now the one thing about having a baby is not only do people tell you they look like someone else in your family they also feel the need to pass on a whole lot of information that you may or may not use.

The thing of it is you've just returned from the hospital and your small overnight case is bursting with information that the nurse gave you when you were discharged. Being sleep deprived you haven't really read a lot of the information because you're waiting until you get home. Every part of your body is sore and you're tired. Did I mention that you're tired? You are waiting until you get your baby into the "routine" that everyone has told you about. This is when you'll catch up on your reading and become a more knowledgeable parent. You know what they say about good intentions...

Three Months Later...

You're feeling a lot better. You have achieved the "routine" that your mom has told you about. It involves sleep for everyone else except you. It also involves you cooking and cleaning while the baby naps. You have chosen to skip the "pearl" of wisdom about resting when your baby does. I mean how else will you get anything done?

You are just going to sit down to have a nice hot cup of uninterrupted coffee when your well-meaning neighbor rings the doorbell. It seemed like a good idea at the time to install a specialty doorbell that played, "Welcome To My World" every time you press it but now you brace yourself to hear your baby's cry. Nothing happens. The neighbor rings the bell again. Nothing happens. You race to the door and tell the neighbor you're busy and you'll call later.

You go to the baby's carrier and look down expecting the worse. The baby is sleeping peacefully. You ask yourself what just happened? Why didn't the baby wake up? You call your mother and tell her what happened. She tells you to check for diaper pins and to see if the baby needs to be burped or fed. You tell her you'll call her back. Why can't she understand diaper pins are not a problem anymore in the world of self adhering diapers? Why would you wake your baby to feed and burp it if he's sleeping? Maybe her advice has been wrong. Quickly you consult your "baby book" that you keep for emergencies under your couch. Your finger quickly finds hearing loss. You begin to read forgetting all about your coffee.

Types of Hearing Loss

1. A conductive hearing loss occurs when the conduction of sound to the actual organ of hearing (cochlea) is affected. In children common causes of conductive hearing loss are: otitis externa (infection in the ear canal), wax in the ear canal, fluid in the middle ear cavity (serous otitis), an ear infection in the middle ear (otitis media), a perforation in the eardrum or a collapsed canal. A cholesteotoma is a cyst in the middle ear. It will also cause a conductive hearing loss. Otosclerosis which is a disease that results in calcification of the stapes bone (stirrup) will result in a conductive hearing loss. The latter two are not common in children. A conductive hearing loss affects the loudness of sound.
2. A sensorineural hearing loss occurs when there is damage to the actual organ of hearing (cochlea). It is also called nerve deafness. A sensorineural hearing loss will affect both loudness and clarity of speech. The damage to the ear/s is permanent. It can occur in one or both ears. A sensorineural hearing loss can vary in degree. It can be: mild, moderate, severe or profound in nature. If a child has a sensorineural hearing loss they will u be wearing hearing aids once they are identified.
3. A mixed hearing loss contains both conductive and sensorineural components. For instance, a child who has a mild sensorineural hearing loss and an ear infection is considered to have a mixed hearing loss. Once the ear infection is cleared up the child will still have a sensorineural hearing loss.

Identifying a Hearing Problem

Children with a conductive hearing problem are easier to spot the older they get. In toddlers and infants be on the lookout for behavioral changes. They include: increase in crying, poking or pulling at the ear during or after they have had a cold, fever, vomiting, diarrhea, red ears, change in sleep patterns and behavior changes which seems odd for the child.

For instance, if you ask the child if he would like an apple and he doesn't respond and an apple will usually bring him running consider there may be a problem. All symptoms do not appear in children. In fact many children are reported by parents to be symptom free.

A positive indicator of a bad middle ear infection is any drainage from the ear. Since it may occur at night check pillows in the morning if you think their may be a problem.

The rule to follow is if you are unsure if a problem exists get your physician to check the child's ears.

A change in sleep pattern may be the biggest tip that a problem is brewing. Child with serous or otitis media problems do not like to lay with their head flat to the mattress. This is because the pressure behind the middle ear presses down on the eardrum and causes discomfort.

In an older child if the head is elevated and they seem to improve take them to their physician for a checkup. In an infant if the baby cries when he is lying down (flat) but improves when you pick him up (note the head position change) get him checked.

How Does a Conductive Hearing Loss Occur?

In infants and toddlers the Eustachian tubes (the tubes that connect the middle ear cavity and the throat and are responsible for keeping pressure on both sides of the eardrum equal) are shorter than those found in adults. As a result there is a shorter amount of distance for bacteria to travel from the throat to the ears. What starts out as a sore throat many times may end up as an ear infection.

Fluid begins to build up behind the eardrum and becomes infected by bacteria. Increasing fluid build up causes pressure which results in an earache. If left untreated the eardrum can rupture relieving the pressure. The earache goes away and baby seems back to normal. Perforations generally heal quickly if proper medical treatment is given. However, too many perforations may cause scar tissue which can eventually affect hearing.

Are Certain Children More At Risk For Ear Infections?

Yes. Children with multiple allergies, facial anomalies such as those found in the cleft palate population, children with Down's Syndrome and those children with chronic nasal congestion are at higher risk for conductive hearing loss. However, once the problem is correctly identified these children can be medically managed so that the ear infections are little more than an inconvenience.

Treatment for Ear Infections

Once a child is identified as having a middle ear infection the physician will usually prescribe a seven to ten day treatment of antibiotics to alleviate the child's pain and kill the bacterial infection. Within 48 to 72 hours a noticeable improvement should occur. All medication should be given and ingested as prescribed by your physician. It is important for the child to be re-checked to make sure all residual fluid is gone. It is possible for bacteria to leave but for fluid to remain. This needs to be monitored as too much fluid for too long a period can impact a child's language learning both expressively and receptively.

Welcome to My World

The phone rings and it's your mother. She has given some thought to what you've told her about her grandchild. Her good friend Mrs. Sendicki has a grandson with ear problems. Mrs. Sendicki swears that these can be cured easily by blowing cigarette smoke in the child's ear. You do something you never thought you would. You hang up on your mother and make an appointment with your doctor.