In the United States, three out of four children have experienced at least one ear infection before they reach three years of age. Ear infections are the second leading childhood illness, after the common cold. In order for you to understand the development of ear infection, you must first understand the working of the ear.

Let’s Look at the Ear

Have you ever noticed how sound speakers vibrate? Have you ever touched your throat when you were speaking? Yes, you can feel the vocal cords vibrate. Invisible waves of energy that make up sound are what cause the vibration. As sound reaches the ear, all parts of the ear work together to make certain the ear transmits the proper information to our brain.

The ear is not just responsible for sound; it is also responsible for balance. It is made up of three parts: the inner ear, the middle ear and the outer ear. Sound moves through the air to the outer ear, which is also caused the pinna. This is the part of the ear that we see. From there, it moves on to the inner ear. This is where the ear drum is located, as well as three very small bones that are called ossicles. When sound hit the eardrum, it vibrates and the ossicles act as amplifiers to send the vibrations to the inner ear where they are translated to electric signals and are sent to the auditory nerve that is connected to the brain. Once the brain receives the nerve impulses, they’re translated to sound.

Ear Pressure

In order to function correctly, the middle ear has to be at the same pressure as the world outside the body. This is done by the eustachian tube, which connects the ear to the throat directly behind the nose.

When air reaches the middle ear, the eustachian tube works to equalize the air that reaches the middle ear to the air outside of the body. At times, you will hear your ears pop. When you hear that pop, the eustachian tube has just equalized the air in your middle ear. Sometimes both ears will pop at the same time, or only one ear may need to be equalized. Another job that the middle ear is responsible for is to drain mucus from the middle ear to the throat.

How Do Inner Ear Infections Occur?

If your child is suffering from allergies or a cold that blocks his nasal passages, the eustachian tube’s lining can become blocked by congestion or by mucus in the tube. When this happens, the middle ear, which is usually full of air will build up with fluid. Any bacteria or viruses that enter the middle ear by means of the eustachian tube are then trapped. Bacteria and germs take advantage of this and breed in the fluid. This is how a middle ear infection occurs.

Otitis Media

Otitis media is a fancy name for inflammation of the inner ear. However, there are different forms of this infection. When your child’s pediatrician says she has an ear infection, in most cases she is referring to acute otitis media, which is normally fluid or pus in the middle ear that causes redness of the ear drum, pain and, in most cases, fever.

Most other forms of otitis media cause fluid build up in the middle ear for six weeks or more. This is called chronic otitis media. Another type that doesn’t necessarily mean your child’s inner ear is infected, is known as otitis media with effusion.

Your child’s pediatrician must determine which type of otitis media your child has in order to treat it effectively. Antibiotics aren’t necessary for all forms of ear infections and shouldn’t be given.

Why Middle Ear Infections?

Children between the ages of two and four years have frequent bouts of middle ear infection. Here’s why:

• Children’s adenoids are large and can interfere with the eustachian tube’s openings.

• A child’s eustachian tubes are more horizontal and shorter than those of adults. Bacteria and viruses can access the middle ear with ease because of this.

• Your child’s immune system is underdeveloped until he turns seven. He is not able to fight ear infections as well as older children and adults.

Other Factors

Other factors that can cause frequent middle ear infections in children are:

• Bottle feeding.

• Attending preschool or daycare.

• Exposure to cigarette smoke.

Boys or Girls?

Ear infections are more common in boys when there is a family history of otitis media. It is quite common for the middle ear to become infected during the winter months when colds and respiratory infections occur.

Signs and Symptoms

The signs and symptoms of ear infection can be very mild or range in severity to very extreme. Here is a list of signs and symptoms that will indicate that your child likely has an ear infection.

• Your child complains of pain when she lies down, sucks or chews. This is because these activities cause fluctuation of pressure in the middle ear. Your child may refuse to eat or wake up in the middle of the night because she is in pain. This often is accompanied by crying.

• Older children may tell you they have an earache because a build up of fluid is causing pressure on their eardrum. Young children may cry and be extremely irritable or may cry and pull at their ears.

• Fluid buildup in the middle ear can cause your child’s eardrum to rupture if it is very severe. This allows the ear to drain and pain may disappear because draining releases the pressure.

If fluid builds up in your child’s middle ear, she may not hear well because sounds are blocked. This can cause temporary hearing loss, which may include:

• Your child turning up his music or the television.

• Louder talking than normal.

• Inattentiveness at home or school.

Other Symptoms of acute middle ear infection may be:

• Dizziness.

• Fever.

• Vomiting.

• Nausea.

• Staggering or loss of balance.

Otitis Media with Effusion

This type of middle ear infection often has no symptoms whatsoever. On the other hand, your child may complain of frequent ear popping. The fluid behind your child’s eardrum can cause temporary hearing loss that is not obvious to either you or your child.

Contagion

Middle ear infections are not contagious. Your child cannot pass it on to others. He can pass colds and respiratory infections that cause it.

Duration

In most cases a middle ear infection will vanish within three days without the use of antibiotics. If your child’s pediatrician prescribes a round of antibiotics, they are usually taken over the course of ten days. Children who are over the age of six may only be prescribed a seven day round.

Even after a round of a prescribed antibiotic has been given, fluid may remain in the middle ear for a few months. This is especially true if the infection was extremely severe.

Diagnosis and Treatment

If you believe your child has an ear infection, he should be examined by his pediatrician. She will know his medical history and will perform a physical examination in order to make a diagnosis. She will look into your child’s ear with a small tool called an otoscope. It looks very similar to a tiny flashlight and allows her to see the eardrum. After the examination is complete, the pediatrician will use the information she has collected to manage your child’s middle ear infection. The factors include:

• The severity and type of ear infection that your child has.

• Your child’s history of ear infections.

• How long your child has had the ear infection.

• The age of your child.

• If your child’s hearing is being affected.

• All risk factors.

An open communication between you and your child’s pediatrician is very important, as you will have some say in the course of treatment.

Many pediatricians will suggest waiting a few days to see if the infection clears on its own. If this is decided, she will prescribe a medication to relieve pain so your child will find some relief.

Other Reasons to Wait

There are other reasons why it’s best to wait.

Antibiotics

• Will not remove fluid from your child’s middle ear.

• Won’t kill the infection if it is caused by a virus.

• Will not eliminate pain within 24 hours.

• Can cause side effects.

• Can cause antibiotic resistance.

If your child suffers from chronic middle ear infection, her pediatrician may put her on a daily regime of antibiotics. This will prevent middle ear infections from recurring. Infants, toddlers and children under six years, or those who are suffering from severe or terminal illness may need a course of antibiotics as soon as the symptoms occur. This also applies to children who have been diagnosed with Down syndrome or cleft palate.

Check Ups

If your child has middle ear infection with effusion, physical examinations by her pediatrician should be scheduled at least twice a year.

Pain Relief

Whether or not your child’s pediatrician prescribes a round of antibiotics, you can help to relive his pain by giving him acetaminophen or ibuprofen, which can be purchased at any drugstore or pharmacy. Do not give your child aspirin; it has been linked to Reye’s syndrome in children who have experienced viral infections.

Eardrops

Ask your child’s pediatrician if you can use eardrops for pain relief. Never instill eardrops into your child’s ear if the eardrum has ruptured.

Ear Infection Prevention

A family history of ear infection cannot be changed, but lifestyle choices can minimize the chance of your child coming down with one.

• Breastfeed your baby for at least six months.

• Never allow your child to be exposed to cigarette smoke.

• Try to reduce your child’s exposure to large groups of his peers. Colds and respiratory infections are contagious and these lead to middle ear infection.

• Wash your hands and teach your child to wash his hands frequently. This minimizes the transfer of germs and bacteria.

Call the Doctor

• When your child complains of ear pain, especially if he has a fever or a history of ear infections.

• If your child’s ear infection is getting worse, or is prolonged.

If you follow the tips in this article, your child will not experience as many middle ear infections. Take care of your child’s ears. Though not common, frequent and severe middle ear infections can cause permanent hearing loss.