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Childhood ear infections: causes and cures
Infections that spread

5 ways to avoid otitis media
5 ways to avoid otitis media

Although there’s no sure way to prevent otitis media, these defensive measures may help:

  1. Avoid what’s catching. Because the process leading to otitis media often starts with a cold or an infection of the tonsils or adenoids, it makes good sense to try to keep your child out of contact with children who have colds and other respiratory infections. This can be difficult advice to follow, but if your child has already had one or more middle ear infections, it may be well worth the effort.
  2. Don’t smoke. Here’s one more reason to kick the habit: Children who live with smokers are more susceptible to otitis media than those who live in smoke-free homes. Cigarette smoke irritates the linings of the nasal passages and middle ear cavities, which interferes with the normal functioning of the eustachian tubes.
  3. Raise an infant’s head during feedings. This is especially important if the baby has a respiratory infection. It may help prevent fluid from collecting in the middle ear.
  4. Elevate a sleeping infant’s head and/or upper body when he or she has a cold. (Do this by putting a few pillows under the mattress, not under the baby’s head.) This will help fluids drain.
  5. Breastfeed. A mother’s immunities to disease are passed through breast milk, helping to protect babies from colds and respiratory infections, which can lead to otitis media.

Earaches that aren’t
Earaches that aren’t

Sometimes ear pain is unrelated to infection. For example:

  • Gnats and other insects can crawl into a child’s ear. Not being able to turn around and crawl out, they struggle with a motion that can be painful and frightening. Warm water may wash a small insect out; larger insects can be removed by a doctor.
  • Illness in other parts of the head and neck can cause pain in the ear. The most common culprits are “the four T’s”: tongue, teeth, tonsils and throat.
  • Small children sometimes put objects into their ears that get stuck. Beads, buttons, pencil lead, erasers, bits of plastic toys and dried beans are some of the most common choices. Objects stuck in the ear should be removed by a physician.

Few parents are strangers to ear infections: Roughly half of all children suffer one by their first birthday. By age 3, one-third of those youngsters will have two or more ear infections, which account for 30 million visits to doctors each year.

This common ailment, called otitis media (OM for short), is more than merely painful. Without proper treatment, OM can have serious health consequences. Begin by understanding that OM comes in four varieties. The mildest, serous otitis media, occurs when fluid collects in the middle ear. If that fluid becomes infected, the condition is called otitis media with effusion. Left untreated, this form of OM can lead to purulent otitis media, in which pus fills the middle ear and may burst the eardrum. The fourth type of OM, secretory otitis media, occurs when prolonged episodes of OM cause the cells lining the middle ear to produce a thicker fluid in large quantities.

Otitis media often occurs when the eustachian tube (the narrow canal that connects the middle ear to the back of the nose) is blocked. An upper respiratory infection or allergy can cause one or both eustachian tubes to swell shut, preventing drainage. Enlarged adenoids (lymph nodes located in the top of the throat) can also block the eustachian tube opening. In children, the eustachian tubes are shorter and more horizontal than those of adults, making it more difficult for fluid to drain as it should.

Any of the four types of OM can become chronic. Chronic OM is more likely to cause long-term damage to the ear. In addition, parents may not seek medical treatment as soon as they would for an acute case because the symptoms of a chronic condition usually cause a child less discomfort.

Infections that spread

Chronic otitis media with effusion and chronic purulent otitis media are the most serious forms of OM. These infections can spread to the mastoid process (the honeycomb-like bone behind the ear), where they’re difficult to treat, or cause damage to the small bones of the middle ear.

A child showing signs of otitis media should be taken to his or her physician. Possible symptoms include a feeling of fullness in the ear; severe earache; fever and chills; nausea and diarrhea; hearing loss; and periodic seeping of fluid from the ear. Young children who cannot describe an earache may pull at or rub one or both ears. You may also notice that your child is fussy or doesn’t seem to be able to hear you.

If an infection is present, an antibiotic may be prescribed. Note that it must be taken for the full duration of the prescription—usually 10 to 14 days—even if the child’s symptoms disappear before then. Treatment may also include decongestants, antihistamines (if allergies are thought to be causing OM), and medication to relieve pain and reduce fever.

If hearing loss or fluid in the middle ear persists, an operation called a myringotomy may be recommended. In this procedure, which is usually done in a hospital under general anesthesia, a tiny incision is made in the eardrum, and fluid is suctioned out. If enlarged adenoids are thought to be contributing to the problem, they can be surgically removed. For children who suffer from a persistent case of ear infection, physicians may recommend that a small plastic tube be inserted through the eardrum to allow the middle ear to drain.