Everything you need to know about ear infections in children

It’s that time of the year when everyone else’s child seems to be sick. Parents are exhausted and your Facebook news feed is filled with rants about sleepless nights, long waits at the paediatricians and so on. While we commonly hear of the dreaded cold and infamous viral fevers, ear infections in childrenare another reason for those ridiculously high temperatures that your child might be running.

Remember mums, if your child has a high fever that goes on for over 5 days, there’s definitely more to it.  A fever is often a sign that something out of the ordinary is going on and your body is trying to fight it off. 

Firstly, what are ear infections in childrenall about? Ear infections usually occur in the middle ear, and are caused by bacteria occurring from the fluid that builds up behind the eardrum. In medical terms, ear infections are referred to as Otitis Media (OM).

There are three types of ear infections in children.

1. Acute otitis media

This is the most common of ear infections in children. It is when parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum. Children get earaches and fever as a result.

2. Otitis media with effusion

This is sometimes an after effect of a regular ear infection. It happens when fluid continues to be trapped behind the eardrum after an ear infection. This is tricky because it doesn’t typically cause symptoms and can only be diagnosed by a doctor inspecting your child’s ear using a specific instrument.

3. Chronic otitis media with effusion

This happens when fluid remains in the middle ear for an extended period or returns again and again even without an infection. This condition makes it difficult for children to fight new infections and can damage their hearing. 

Image Source: kids-ent.com Children are more likely than adults to get ear infections because their Eustachian tubes are smaller.

As always, bacteria and viruses are the culprit. Often after your child has a sore throat, cold, or any other upper respiratory infection, the bacteria may spread to the middle ear. 

Also, fluid that enters the area usually drains quickly through the eustachian tubes which connect the middle ear to the back of the nose and throat. But when colds, sinus infections and allergies occur, these tubes get blocked and fluid ends up trapped in the middle ear. 

Wet, warm places are breeding grounds for germs so a fluid-filled middle ear naturally paves the way for an infection to occur. 

Ear infections in children are also more common than in adults because their eustachian tubes are smaller and more level than adults. This makes it harder for fluid to drain out of the ear (even in normal conditions).

On another note, a child’s immune system is not as developed and effective as an adult’s and this makes it harder for him to fight an infection. 

There are primary and secondary risk factors for ear infections in children.

Primary risk factors 

• Age (children below three years old are most susceptible)
• Children with weak immune systems
• Family history of ear infections
• Sleeping or lying down with milk bottle in the mouth 

Secondary risk factors 

• Recurrent colds and upper respiratory infections
• Exposure to cigarette smoke 
• Being in a childcare centre with other children 

• Pain in the ear
• Fever 
• Yellow or whitish fluid draining from the ear
• Trouble sleeping (lying down makes an ear infection more painful)
• Reduced appetite (painful to chew and swallow)
• Unpleasant smell or foul odour from the ear
• Trouble hearing sounds
• Difficulty with balance 
• Fussiness and crying
• Tugging or pulling of the ears

Ear infections in children causes them to fuss more.

If it’s just a case of an outer ear infection, or there is no infection, doctors may treat it with ear drops. However, for middle ear infections, it’s likely he will prescribe your child a dose of antibiotics that will last for seven to ten days. This is usually given with other medication such as Ibuprofen to treat your child’s fever. While other medication do not have to be completed, it’s extremely important that you complete the course of antibiotics. 

In the case of frequently recurring ear infections in children, doctors might recommend a surgical procedure that places a small ventilation tube in the ear drum to improve air flow and prevent the building up of fluid.

Don’t be alarmed if the doctor performs a hearing test on your child. The fluid in the ear can cause temporary mild loss of hearing that should get better once the infection resolves.

• As far as possible, keep your child away from other children who are sick
• Get the appropriate vaccines such as pneumococcal and Haemophilus vaccines to prevent pneumonia and meningitis 
• Frequent washing of hands
• Keep your child away from tobacco and second hand smoke 
• Don’t put your baby down for a nap or to bed, with a bottle

Yes, they can become a serious problem. If left untreated or if the infection is severe, it can rupture your child’s ear drum. 

Repeated ear infections in childrencan lead to hearing loss and scarring. In very rare cases, untreated ear infections can lead to mastoiditis (a skull infection) or meningitis.

So mums, remember, if your child has a persistent fever, try to get to the root of the problem. If you find yourself pumping him with dose after dose of paracetamol only to have the fever returning with a vengeance, it’s best that you get medical attention.

Sources: Singhealth, National Institute of Deafness and Other Communication Disorders