A frequent kind of ear infection in children is called otitis media. This is an infection in the middle ear, behind the eardrum. It usually starts with a cold. Ear infections can hurt a lot. Children with ear infections often fuss and cry, pull at their ears, and sleep poorly. Older children will often tell you that their ear hurts.
Most children will have at least one ear infection. Fortunately, children usually outgrow them, often about the time they enter grade school.
Your doctor may prescribe antibiotics to treat ear infections. Antibiotics aren't always needed, especially in older children who aren't very sick. Your doctor will discuss treatment with you based on your child and the symptoms. Regular doses of pain medicine are the best way to reduce fever and help your child feel better.
Ear infection symptoms usually involve discomfort inside the ear or ear canal or on the skin of the ear. Someone with an ear infection may also have a fever or feel dizzy.
Symptoms of an ear infection include:
Middle ear infections usually occur with upper respiratory infections, such as colds. Fluid builds up behind the eardrum, where bacteria or viruses can grow into an infection. Pain and sometimes hearing loss happen as the fluid collects. Usually there is a fever. Sometimes the eardrum ruptures, the fluid drains, and the infection clears.
The main symptom is an earache. It can be mild, or it can hurt a lot. A fever may be present. Babies and young children may be fussy. They may pull at their ears and cry. They may have trouble sleeping.
Symptoms of a middle ear infection often start a few days after the start of a cold or other upper respiratory infection. Some people don't have any symptoms.
If the eardrum ruptures, you may see thick, yellow fluid coming from the ears. This usually makes the pain go away. The eardrum usually heals on its own.
When fluid builds up but doesn't get infected, the ears may just feel plugged. This can affect hearing, but hearing usually goes back to normal after the fluid is gone. It may take weeks for the fluid to drain away.
Most ear infections go away on their own. But antibiotics are recommended for children under the age of 6 months and for children at high risk for complications.
You can treat your child at home with an over-the-counter pain reliever like acetaminophen (such as Tylenol), a warm washcloth on the ear, and rest. Your doctor may give you eardrops that can help your child's pain.
Your doctor can give your child antibiotics, but ear infections often get better without them. Talk about this with your doctor. Whether you use antibiotics will depend on how old your child is and how bad the infection is.
If your child has cochlear implants, your doctor will probably prescribe antibiotics. That's because serious complications of ear infections, including bacterial meningitis, are more common in children who have cochlear implants than in children who don't have these implants.
Follow-up exams with a doctor are important if your child isn't getting better. The doctor will check for persistent infection, fluid behind the eardrum (otitis media with effusion), or repeat infections.
Doctors may consider surgery for children who have repeat ear infections or who keep getting fluid behind the eardrum. Procedures include inserting ear tubes or removing adenoids and, in rare cases, the tonsils.
Fluid behind the eardrum after an ear infection is normal. And, in most children, the fluid clears up within 3 months without treatment. If your child has fluid buildup without infection, you may try watchful waiting.
Have your child's hearing tested if the fluid lasts longer than 3 months. If hearing is normal, you may choose to keep watching your child without treatment.
If a child has fluid behind the eardrum for more than 3 months and has significant hearing problems, then treatment is needed. Sometimes short-term hearing loss occurs. This is especially a concern in children ages 2 and younger. Normal hearing is very important when young children are learning to talk.
If your child is younger than 2, your doctor may not wait 3 months to start treatment. Hearing problems at this age could affect how well your child can speak. This is also why children in this age group are closely watched when they have ear infections.
If a child has repeat ear infections (three or more ear infections in a 6-month period or four in 1 year), you may want to think about treatment to prevent future infections.
Ear tube surgery may be an option if your child has repeat ear infections. Ear tubes are plastic and are shaped like a hollow spool. They help to clear fluid from your child's middle ear. Allowing the fluid to drain prevents the growth of bacteria that cause ear infections. Your doctor can help you decide if ear tubes are the right choice for your child.
These are some things that may help prevent ear infections.
Ear infections are more common in children who are around cigarette smoke in the home. Even fumes from tobacco smoke on your hair and clothes can affect the child.
There is some evidence that breastfeeding helps reduce the risk of ear infections, especially if they run in your family. If you bottle-feed, don't let your baby drink a bottle while your baby is lying down.
Hand-washing stops infection from spreading by killing germs.
Fewer children means less contact with bacteria and viruses. Try to limit the use of any group child care, where germs can easily spread.
Try to wean your child from their pacifier before about 6 months of age. Babies who use pacifiers after 12 months of age are more likely to get ear infections.
A doctor will diagnose a middle ear infection by doing a physical exam and an ear exam and by asking questions about past health.
The doctor uses a tool called a pneumatic otoscope to look at the eardrum for signs of an ear infection or fluid buildup. For example, the doctor can see if the eardrum moves freely when the otoscope pushes air into the ear.
Other tests may include:
Antibiotics can treat ear infections caused by bacteria. But most children with ear infections get better without them.
Your doctor will likely give antibiotics if:
Other medicines that can treat symptoms of an ear infection include:
Most studies find that decongestants, antihistamines, and other nonprescription cold remedies usually don't help prevent or treat ear infections or fluid behind the eardrum.
Some things that increase your child's risk of a middle ear infection are out of your control. These include:
Other things can increase your child's risk of ear infection. They include:
Things that increase the risk of repeated ear infections include:
Complications from ear infections are rare. But some problems that can occur include:
Another complication is ongoing inflammation of the middle ear. The major symptom is repeat or ongoing drainage of pus from the ear through a small hole in the eardrum. Many children with this problem have some hearing loss.
Other complications may develop if there are repeat ear infections:
Rare complications include mastoiditis and meningitis.
Middle ear infections are caused by bacteria and viruses. A small tube (eustachian tube) connects your ear to your throat. A cold can cause this tube to swell, blocking it and trapping fluid inside your ear. This makes it a perfect place for germs to grow and cause an infection.
Call your doctor now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor if:
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