Common-sense medicine for one of childhood’s most common ailments

Special to the Bulletin

Earaches are a common occurrence for small children. According to the American Academy of Pediatricians (AAP), ear infections are the most common bacterial illness for children in which antibacterial agents are prescribed in the United States; in fact, 90 percent of children have an ear infection usually between ages 6 months and 4 years. If tube placement has been recommended, Dr. Kimi Dart of Brownwood ENT and Allergy reminds parents that Spring Break may be the best time to have those tubes placed while many have time off and will not be missing school.

Children are more prone to earaches and ear infections because their ear passages are smaller, narrower and angled differently than adults’ – making it easier for germs to reach the middle ear and for fluid to accumulate. And, once the infection has settled in, it’s more difficult for a child’s body to fight it than an adult’s.

A middle ear infection in a child begins with a viral infection, such as the common cold. Sometimes fluid accumulates behind the eardrum; in other cases, the Eustachian tubes – the narrow passageways between the middle ear and the back of the nose – become swollen, blocked or infected. While ear infections often follow a cold, the ear infection itself cannot be spread from person to person.

• Symptoms of an ear infection include:

• Pulling or tugging at the ear

• Sleep interruptions

• Fever/headache

• Excess fluid

• Irritability/crying

• Cough/nasal discharge

• Skin rash

• Vomiting/diarrhea

• Fullness, buzzing or ringing in the ears

• Ear drainage

Ear infections generally do not require any intervention or medication, and usually clear up on their own within one to two weeks. Studies show that children who receive medical treatment and those who don’t recover at about the same rate. Treatment with prescription medicine is usually reserved for severe infections or ear infections in very young infants. In fact, taking antibiotics may have the opposite effect – not only by having minimal effect in speeding recovery, but also in helping to develop bacteria that are resistant to drugs. For this reason, when it comes to treating potential ear infections, less is more.

Many doctors recommend a wait-and-see period of 48 to 72 hours as the first step to treating ear infections. If it’s determined that the child has an ear infection, your pediatrician or family physician can provide medication to relieve symptoms, such as over-the-counter pain relievers or ear drops. Parents can also use a warm washcloth or a heating pad on the ear to relieve discomfort. Appropriate doses of ibuprofen or acetaminophen help with pain relief. Avoid aspirin, which is dangerous for young children.

During the waiting period, make sure your child is eating regularly and drinking plenty of liquids, and check your child’s temperature often. If your child’s pain increases with no improvement within 48 to 72 hours, their fever rises above 102 degrees, or your child experiences swelling around the ear, pain or stiffness in the neck area or becomes lethargic, your child should be seen by a doctor and may need antibiotics.

Just as important as knowing the right things to do is knowing what not to do in treating a child’s ear pain or fluid in the ear. The AAP does not recommend treatment for young children with decongestants, antihistamines, steroid nasal sprays or prolonged, frequent or low-dose courses of antibiotics.

In some cases – generally after multiple ear infections – your physician may recommend that small tubes be surgically inserted in your child’s ear(s), to drain fluid and relieve symptoms. The tube is usually a last resort and a method not generally employed unless the child is suffering from recurrent hearing problems and pain due to repetitive ear infections. Many doctors are using tube placement less and less due to the risk of damage to the eardrum and the effectiveness of non-invasive treatment techniques.

While many ear infections are unavoidable, there are things that parents can do to create a healthy environment for your child: avoid smoking, which contributes to childhood illness; and exercise good hygiene, including frequent hand-washing.