Ear infections in children

Unfortunately, ear infections happen to most children at some point. This useful guide will help you recognise the symptoms and causes, and know your treatment options.

Ear infections are one of the most common childhood ailments, affecting kids of all ages, from toddlers to school-aged children. Most parents have faced the distress of seeing their little ones in pain, tugging at their ears, or struggling with sleepless nights due to ear discomfort. While ear infections can be worrying, understanding what they are, how to manage them and when to seek help will give you the reassurance that you know how to handle the next one.

What are ear infections?

An ear infection, medically known as otitis media, occurs when the middle ear (the space behind the eardrum) becomes inflamed and infected. This can happen due to a build-up of fluid caused by bacteria or viruses, leading to pain and sometimes temporary hearing loss. Kids are more susceptible to ear infections than adults because their Eustachian tubes (the narrow passages connecting the middle ear to the back of the throat) are shorter, more horizontal and are more easily blocked. This makes it harder for fluid to drain out, creating an ideal environment for germs to multiply.

Common symptoms

Ear infections can be tricky to spot, especially in younger children who may not yet have the words to describe how they feel. However, there are some tell-tale signs that parents can look out for:

• Pulling at their ears: If your child is constantly tugging at their ears, it could be a sign of discomfort or pain caused by an infection.
• Crying and irritability: Children often become unusually fussy or irritable when they have an ear infection, especially when lying down, as this position can increase ear pressure.
• Difficulty sleeping: The pain and pressure in the ear can make it hard for little ones to settle, leading to restless nights.
• Reduced appetite: Swallowing can be painful with an ear infection, so children may show a lack of interest in eating or drinking.
• Fluid drainage: In some cases, yellow or clear fluid may drain from the ear. This can indicate a ruptured eardrum, which should be examined by a healthcare professional.
• Hearing issues: Your child might seem unresponsive or less alert to sounds around them if fluid in the ear is affecting their hearing.

If you notice any of these symptoms, especially if your child is in pain or the symptoms persist, it’s best to seek medical advice.

Causes?

Ear infections often follow a cold, sore throat or other respiratory infections. When a child has a cold, the bacteria or viruses causing it can spread to the middle ear, leading to a build-up of fluid. This is an ideal breeding ground for germs, sometimes resulting in an infection. Other factors that can increase the likelihood of ear infections include:

• Age
• Allergies
• Exposure to smoke
• Bottle feeding

Diagnosing infections

If you suspect your child has an ear infection, it’s best to visit a doctor. They will examine your child’s ear using an otoscope – a small instrument with a light and magnifying lens. This allows them to see the eardrum and check for signs of infection, such as redness, swelling or fluid build-up.

In some cases, the doctor may perform a tympanometry test, which measures the movement of the eardrum to determine if there’s fluid in the middle ear. These tests help confirm whether there is an infection, as well as how best to treat it.

Treatment options

The treatment for an ear infection depends on your child’s age, the severity of the symptoms and whether it’s a first-time infection or a recurring issue. Let’s look at some common treatment options.

Watchful waiting

In many cases, especially for older children with mild symptoms, doctors may recommend a period of watchful waiting. This approach allows the body’s immune system to fight off the infection without using antibiotics.

Antibiotics

If the ear infection is severe, persistent or your child is very young (under two years), your doctor may prescribe antibiotics. It’s important to complete the full course of antibiotics, even if your little one’s symptoms improve, to be sure the infection is entirely cleared.

Pain relief

Over-the-counter pain medications like paracetamol or ibuprofen can help reduce fever and ease any pain. For babies and younger children, consult your doctor for the appropriate dosage.

Ear drops

If your child has a build-up of earwax or fluid, your doctor may recommend ear drops to alleviate their symptoms and try to get the ear to drain.

Prevention

While it’s impossible to prevent every ear infection, there are steps parents can take to reduce the risk.

Hand washing

Teaching your child to wash their hands regularly can reduce the spread of germs that cause colds and respiratory infections.

Avoid smoke exposure

Keep your child away from cigarette smoke, as it can irritate their respiratory tract and increase the likelihood of ear infections.

Vaccinate

Stay up-to-date with vaccinations. Immunisations, particularly the flu vaccine and pneumococcal vaccine, can help protect against infections that lead to ear issues.

Breastfeed if possible

Breastfeeding for at least the first six months can boost your child’s immune system and lower the risk of ear infections.

Quick bottle feeds

Avoid prolonged bottle feeding if you can. Try not to let your child fall asleep with a bottle particularly, as lying down while drinking can cause fluid to accumulate in the middle ear.

When to see a doctor

Most ear infections clear up on their own or with minimal treatment, but there are times when medical intervention is necessary. Seek medical advice if:

• Your child’s symptoms last longer than two days.
• There is severe pain or a high fever.
• You notice fluid, pus, or blood draining from the ear.
• Your child has trouble hearing or seems unusually lethargic.

It’s always better to err on the side of caution and consult a healthcare professional if you’re unsure.

Ear infections are an uncomfortable part of childhood, but with the right care and knowledge, you can help your little ones recover quickly and comfortably. Understanding the signs, getting timely treatment and trying to prevent infections in the first place can make all the difference. While no parent wants to see their child in pain, remember that ear infections are common and will pass, either by themselves or with the help of a visit to the doctor.

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