There might be an ear infection in your child's future. Indeed, by the time they turn 3 years old, five out of six kids will have suffered from an ear infection, according to the American Academy of Pediatrics (AAP).
Some factors that make your child more prone to getting ear infections are out of your control. For example, being assigned male at birth (although doctors don't know why), attending daycare (lots of germs), and having a family history of ear infections all raise the probability. Even so, certain choices parents make can help prevent this common ailment.
Keep reading to learn how to prevent ear infections in babies, toddlers, and children. We also break down the causes and treatment options, so you know what to expect when your little one complains of an aching ear.
What to Do About Recurring Illnesses
What Is an Ear Infection?
Any parent who has had a child with an ear infection knows how uncomfortable it can make them. It's characterized by pain and inflammation—usually in the middle ear (otitis media).
Here's how it usually happens: The eustachian tube connects the back of the throat to the middle ear, and it might get plugged for various reasons (like colds or influenza). The blockage promotes fluid build-up, which caters to bacteria or viruses that cause infection.
Note that outer ear infections (called otitis externa or swimmer's ear) can also occur. These usually impact the ear canal, and they're caused by "moisture and local trauma," says Elise Perlman, MD, an emergency medicine doctor at Cohen Children's Medical Center of New York and assistant professor at the Zucker School of Medicine at Hofstra Northwell. Outer ear infections can pop up after swimming, for example, or harsh cleaning with a cotton swab.
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What Causes Ear Infections?
Ear infections occur at all ages, but they're most common between 6 months and 24 months, says Florencia Segura, MD, FAAP, a board-certified pediatrician working at Einstein Pediatrics. “In young children under 24 months, the eustachian tube is shorter, more floppy, and more horizontally positioned than in adults, which permits nasal secretions to enter the middle ear more easily, and therefore causes ear infections more readily,” she says.
Also, a child's immune system is still developing, so they're less able to fight infections (like colds and flu) that can contribute to ear infections.
That said, not all ear infections are caused by a cold or flu-like illness; sometimes, they can happen without warning, explains Dr. Segura. Other risk factors for developing ear infections include:
Age under 2 years oldFamily history of inner ear infectionsAtopy (like eczema, asthma, and allergies)Exposure to tobacco smokeAttending daycareAnatomic abnormalities
Signs of Ear Infections
In babies, kids, and toddlers, common ear infection symptoms include:
Abrupt onset of ear painFeverNew discharge from the earIrritabilityPoor feeding in infantsTugging, grabbing, or pulling at earsDiscomfort when lying flatPlugged-up ears that can make hearing difficult
Can You Prevent Ear Infections?
Keeping your family healthy, especially during cold and flu season, can reduce the risk of ear infections in your kids. Other protective factors that can help prevent inner ear infections include the following.
Shelter them from secondhand smoke.
According to the Centers for Disease Control and Prevention (CDC), exposure to secondhand smoke increases the risk of ear infections in kids. The smoke can irritate the eustachian tube, which connects the inner ear to the sinus passages.Even if you only smoke outdoors, your baby can be exposed to those dust particles from your hair or your clothing.
Avoid the common cold.
"Although ear infections themselves aren't contagious, the upper respiratory illnesses that can lead to ear infections are," says Max M. April, MD, pediatric otolaryngologist and professor at NYU Grossman School of Medicine.
Limit your baby's exposure to large crowds and avoid having them held by people who are sick. Once your child gets older, encourage them to wash their hands often, especially before touching their eyes, nose, or mouth. Also make an effort to keep your child away from sick kids.
If you're making a decision about child care, choose a smaller setting.
"The more children there are in a room, the more germs and colds there will be for your child to catch," says Dr. April.
Breastfeed for at least six months.
“Breastfeeding protects against ear infections during the first two years of life,” says Dr. Segura. Exclusive nursing for the first six months is associated with the most significant protection, but any breastfeeding appears to be beneficial.
Limit pacifiers.
According to research, babies who use pacifiers might be more likely to develop ear infections. “Using pacifiers after six months of age increases the risk of recurrent ear infections due to eustachian tube dysfunction,” says Dr. Segura.
Feed your baby in an upright position.
When a baby drinks from a bottle while they're flat on their back, the liquid tends to pool in their mouth, increasing the chance for it to flow into the middle ear and cause infection. As a rule: When your child is drinking, their head should be higher than their stomach. Try holding them as upright as possible and don't allow them to take a bottle to bed.
Note that breastfeeding is thought to be less risky because the nipple is farther back in a baby's mouth, which prevents milk from pooling, and the flow of milk is more controlled and slower than it is from a bottle.
Take precautions against allergies.
If you think allergy symptoms could be causing your child's ear infections, be proactive by removing as many allergenic items from your home as possible. For instance, ban pets from your child's sleeping area, keep the rooms where they spend the most time as free of dust as possible, and opt for bedding without feathers or down.
Vaccinate, vaccinate, vaccinate
By staying up-to-date on childhood immunizations, including annual influenza vaccines, you can reduce your child's risk of getting sick, which can lead to ear infections.
Don't hesitate to call the pediatrician.
If your child suffers from recurrent ear infections, their pediatrician might want to put them on antibiotics to prevent future infections. Another treatment option for children with chronic ear infections is the insertion of a tympanostomy tube into the ear, which allows fluid to drain from the middle ear. If ear infections seem to be hindering your child's hearing or learning, consider discussing these prevention options with your pediatrician.
Can Chronic Ear Infections Affect Hearing?
Ear infections can cause temporary hearing loss due to fluid accumulation in the middle ear. “This can affect a child's ability to hear and understand speech clearly, [which can] hinder their language and communication development,” says Kjirsten Broughton MS, CCC-SLP, a pediatric speech-language pathologist and founder of Southern Nevada Speech and Language Services.
Of course, not all children with ear infections will experience communication delays, and the impact can vary from person to person, says Broughton. But if you're concerned, you should speak to your child's pediatrician and/or a speech-language pathologist.
Ear Infection Treatment
Your child's pediatrician can diagnose ear infections by looking at the eardrum to asses color, contour, and mobility, says Dr. Perlman. They're treated with pain control and possibly antibiotics, depending on your child's age and symptom severity. (The AAP notes that 80% of ear infections get better on their own, and avoiding antibiotics can defend against antibiotic resistance in the future).
Dr. Perlman explains there are two treatment strategies for ear infections: immediate or delayed antibiotic therapy.
"Immediate antibiotics should be started in all infants less than 6 months with a confirmed inner ear infection and those 6 months to 2 years with signs of infection in both ears," says Dr. Perlman. That's because young children are more prone to complications.For most other healthy kids, a delayed antibiotic therapy approach is standard practice. "It's reasonable to consider the 'watchful waiting' approach with delayed initiation of antibiotics should symptoms worsen or fail to improve with pain control alone," says Dr. Perlman.
Since antibiotics can take 24-48 hours to kick in, parents may want to consider using over-the-counter pain relievers such as ibuprofen and acetaminophen to reduce discomfort in the meantime.
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