Dr. Deena Blanchard, pediatrician and font of knowledge, gives us the tools we need to stay calm and carry on.
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Ear infections are a common problem for young children and a common cause of sleepless nights for parents. It is estimated that 50 percent of children will have at least one ear infection in the first year of life.
What is an ear infection?
The medical term for an ear infection is Acute Otitis Media. This is an infection of the middle ear, the space behind the ear drum. It is not uncommon for children to have ear infections following an upper respiratory infection. This is because fluid builds up behind the inner ear and the fluid can get infected. You can also get fluid build up behind the ear from environmental allergies.
Why are children more likely than adults to get an ear infection?
Children’s ears are not just miniature versions of the adult ear. The Eustachian tube is a narrow tube that runs from the back of the ear into the throat allowing for fluid drainage from the ear. Children’s Eustachian tubes are more narrow and more horizontal then adults. As children get older, the Eustachian tube lies more on a diagonal which helps to promote fluid drainage. Since children’s Eustachian tubes are more horizontal, they tend to clog easier and do not drain fluid as well. Therefore, children are more prone to ear infections.
What are the symptoms of an ear infection?
The most common symptom is ear pain. The pressure of the fluid and the infection behind the ear drum cause pain as it pushes on the ear drum. The ear pain is often worse when lying flat which can lead to difficulty sleeping. Preverbal children may pull or tug at the ear. They may also seem fussier or cry more than usual. Many children with ear infections will have fevers, but your child does not need to have a fever to have an ear infection. Some children will complain of dizziness or loss of balance.
How is an ear infection treated?
There are two strategies for managing ear infections in children. The first is treatment with antibiotics and the second is watchful waiting. Watchful waiting refers to the idea of observing a child for 48-72 hours before initiating antibiotics. If the child is failing to improve in 48-72 hours the doctor would then start antibiotics. There are some cases in which watchful waiting is not appropriate. Children under 2 years of age with ear infections should be treated with antibiotics. Older children who have had ear pain for greater than 48 hours, a temperature above 102.2, have ear infections in both ears, have drainage from the ear or appear unwell to a physician should be treated with antibiotics as well. Any child who has an underlying problem with their immune system or is on medications that suppress the immune system should be treated as well. If you are unsure if your child meets these criteria you should always check with your child’s pediatrician.
It is important to manage your child’s pain with pain relievers such as acetaminophen or ibuprofen. It is not recommended to use cough or cold medications or decongestant in children.
What are ear tubes and when might a child need them?
Ear tubes are tiny tubes that a doctor puts in your child’s ear drums to create an opening. This procedure is done surgically by an Ear, Nose and Throat specialist. Children may need ear tubes if they are having repeated ear infections (typically greater than 3 infections in a 6 month period). Another situation in which tubes might be used is in children with chronic fluid build up behind the ears. Chronic fluid build up can lead to hearing loss and speech delays. If this is the case for your child your doctor will discuss these options with you. If you are not sure or have questions you should reach out to your pediatrician.
My child pulls at her ears all the time, how can I tell when it is an ear infection?
There is no way to know for sure without having a doctor look in your child’s ear. However, if you child seems happy and playful and is eating and sleeping well it is unlikely that your child has an ear infection. There are other reasons that children can pull on their ears. The most common reasons are teething or pulling on the ear when tired or as a self soothing behavior.
Hopefully this clears things up for you. Ear infections are a common childhood illness and something most parents will encounter at some point. With the proper knowledge and medical care these are usually easy to take care of.
Featured Photo by Kelly Sikkema
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Deena Blanchard MD, MPH is a board certified pediatrician working at Premier Pediatrics. Dr. Blanchard has been with Premier since 2009. She completed her residency training at the Morgan Stanley Children’s Hospital of Columbia Presbyterian; where she was awarded Physician of the Year in 2007. There she served as a family advocate as part of the family advisory comity. Prior to attending medical school, she completed her Masters of Public Health at Temple University with a focus on health education. Dr. Blanchard attended Medical School at Albert Einstein College of Medicine where she was awarded Alpha Omega Alpha and The American Women’s Association Glascow Rubin Achievement Award. She currently guest blogs for many child-parent sites.
Premier Pediatrics is an established pediatric practice with locations in both Brooklyn and Manhattan. We have been tending to children for over 30 years with a strong focus on state of the art medical care and family wellness. We offer prenatal visits free of charge which can be scheduled by either calling the office 212-598-0331, 718-369-0817 or via our Prenatal Guide. You can LIKE us on Facebook.