Inflammation of the middle ear in children (otitis) can develop after exposure to cold, and as a result of overheating due to improper feeding or weakened immunity. Even a common cold leads to otitis, if the middle ear is imbued with microbes, causing a runny nose or sore throat.
An ear infection is an inflammation of the middle ear, usually caused by bacteria, that occurs when fluid builds up behind the eardrum. Anyone can get an ear infection, but children get them more often than adults. Five out of six children will have at least one ear infection by their third birthday. In fact, ear infections are the most common reason parents bring their child to a doctor. The scientific name for an ear infection is otitis media (OM).
Ear Infections in Children (Otitis) in Children
Ear infections, also called otitis media, are a common problem in children. About 50 percent of infants have at least one ear infection by their first birthday. Ear infections can cause pain in the ear, fever, and temporary hearing loss and general signs such as loss of appetite and irritability. Some children get better without specific antibiotic treatment but most young infants benefit from use of an antimicrobial agent.
Symptoms of otitis in children:
Otitis media in young children usually begins abruptly: healthy baby falls asleep and wakes up in the night from severe pain. He cries, his sick, and the temperature can rise up to 40C. Baby disturbs sick eyelet hand, but no one else gives to touch him.
In addition, it is hard for him to breathe, his head hurts and starts diarrhea. Sometimes with a sore hand can drop the corner of his mouth.
Symptoms of an ear infection in adolescents and older children may include ear aching or pain and temporary hearing loss. These symptoms usually come on suddenly.
In infants and young children, symptoms of an ear infection can include:
- Fever (temperature higher than 100.4ºF or 38ºC, see the table for how to measure a child’s temperature)
- Pulling on the ear
- Fussiness or irritability
- Decreased activity
- Lack of appetite or difficulty eating
- Vomiting or diarrhea
- Draining fluid from the outer ear (called otorrhea)
Treatment of otitis in children:
Immediately contact your doctor. Using the special tools he will examine the eardrum and will determine whether the child has otitis media. Let the child paracetamol to bring the temperature down and reduce the pain. Make the ear a warm compress. Perhaps the doctor will prescribe special eye drops that contain pain relievers components.
If on the fourth day, the pain is not, again, call a doctor. It is not excluded that the baby will need antibiotics. If a fever, and ear filled with pus, the doctor may offer a small operation – paracentesis. It is necessary to remove the pus that has accumulated over the tympanic membrane. After that, the child will recover.
Treatment of an ear infection may include:
- Medicines to treat pain and fever
- A combination of the above
The “best” treatment depends on the child’s age, history of previous infections, degree of illness, and any underlying medical problems.
Antibiotics — Antibiotics are routinely given to infants who are younger than 24 months or who have high fever or infection in both ears. Children who are older than 24 months and have mild symptoms may be treated with an antibiotic or often are observed to see if they improve without antibiotics.
Antibiotics can have side effects such as diarrhea and rash, and overusing antibiotics can lead to more difficult to treat (resistant) bacteria. Resistance means that a particular antibiotic no longer works or that higher doses are needed next time.
Observation — In some cases, your child’s doctor or nurse will recommend that you watch your child at home before starting antibiotics; this is called observation. Observation can help to determine whether antibiotics are needed.
Observation may be recommended in these situations:
- If the child is older than 24 months
- If ear pain and fever are not severe
- If the child is otherwise healthy
You can give pain-relieving medicines during observation to ease pain.
If your child is being observed rather than treated with antibiotics, you will need to call or go back to the doctor or nurse’s office after 24 hours for follow-up. If your child’s pain or fever continues or worsens, antibiotics are usually recommended; observation may continue if the child is improving.
Pain management — Pain-relieving medicines, including ibuprofen (sample brand name: Motrin) and acetaminophen (sample brand name: Tylenol), may be used to reduce discomfort.
Complementary and alternative medical treatments — There are a wide variety of complementary and alternative medical (CAM) treatments advertised to treat ear infections. These may include homeopathic, naturopathic, chiropractic, and acupuncture treatments.
There are few scientific studies of CAM treatments for ear infection, and even fewer studies that show CAM treatments to be effective. As a result, these treatments are not recommended for ear infections in children.
Decongestants and antihistamines — Cough and cold medicines (which usually include a decongestant or antihistamine) have not been proven to speed healing or reduce complications of ear infections in children. In addition, these treatments have side effects that can be dangerous. Neither decongestants nor antihistamines are recommended for children with ear infections.
Follow-up — Your child’s symptoms should improve within 24 to 48 hours whether or not antibiotics were prescribed. If your child does not improve after 48 hours or gets worse, call your doctor or nurse for advice. Although fever and discomfort may continue even after starting antibiotics, the child should get a little better every day. If your child appears more ill than when seen by his or her health care provider, contact the provider as soon as possible.
Children who are younger than two years and those who have language or learning problems should have a follow-up ear exam two to three months after being treated for an ear infection. These children are at risk for delays in learning to speak. This follow-up helps to ensure that the fluid collection (which can affect hearing) has resolved.