Pediatric Ear Infection
Pediatric Ear Infection Overview
Ear infections are very common among children—especially babies and toddlers—with only the common cold being diagnosed more frequently by pediatricians. There are two main types of ear infections: the outer ear infection, also called otitis externa or “swimmer’s ear,” which occurs when your child gets water in their ear, leading to inflammation; and middle ear infection, called acute otitis media. Outer ear infections are marked by pain when the outer earlobes are touched or massaged, and sometimes by discharge coming from the ear. Middle ear infections, which occur behind the eardrum, are marked by pain, fever and irritability—caused by an infection in the Eustachian (eu-sta-chian) tube, that connects the middle ear to the nose.
Even though ear infections are common among children, pediatricians need to examine them to make sure what looks like an infection actually is an infection. Symptoms of middle ear infections include:
- Pulling and tugging on the ear (typically among babies and toddlers)
- Decreased hearing
- Irritability or difficulty sleeping especially when lying down
- Discharge from the ear
- Accompanying upper respiratory infection symptoms
There are numerous risk factors associated with middle ear infections, typically tied to either the unique health profile of your child or environmental factors. Health risk factors include:
- History of seasonal allergies
- Frequency of upper respiratory illness
- Presence of enlarged adenoids—a clump of tissue in the back of the nose
- Pacifier use
Environmental risk factors include:
- Smoking in the household
- Daycare attendance
Pediatric Ear Infection Prevention
Although researchers are not sure why some children have chronic ear infections and others don’t, there are some clear environmental and biological factors that have been found to reduce ear infections. From breastfeeding to not smoking, parents can make a difference in reducing or eliminating their children’s chances of contracting ear infections.
Children with fewer ear infections include:
- Those who have been breastfed
- Those in smoke-free homes
- Those who are older than two years old
- Those who have been immunized against the flu
- Those in smaller daycare or home settings
- Those who have been weaned off a pacifier
Pediatric Ear Infection Diagnosis
Ear infections cannot be diagnosed over the phone, no matter how frequently your child has experienced this illness. Your Wellstar pediatrician will want to carefully examine the ear, concentrating on the appearance and movement of the eardrum. With an ear infection, the eardrum will look red and will usually bulge because of the discharge—or pus—building up behind it. Often the eardrum will also be immobile, meaning your pediatrician will not see it move when they use their otoscope, a medical tool used to look inside the ear.
Pediatric Ear Infection Treatment
Until recently, all children with ear infections were routinely treated with antibiotics. But new research shows that most children will get better without those prescriptions, with no ill effects. This discovery has two benefits: it limits children’s exposure to antibiotics' side effects and it reduces the development of antibiotic-resistant infections. Your Wellstar pediatrician might recommend this "observation option" if your child is more than two years old and does not have discharge from the ear.
If an antibiotic is offered, take the medicine completely as directed by your pediatrician. He or she may also suggest a non-aspirin pain reliever, such as acetaminophen or ibuprofen, to control your child's pain.
Ear Tube Surgery
Although most ear infections are easy to treat, some children will struggle with multiple ear infections that do not get better easily. These children might be candidates for ear tube surgery.
During this surgery, small drainage tubes are placed in one or both eardrums to keep the area behind the eardrum clear and keep the pressure equalized to the pressure in the middle ear.
This is one of the most common childhood operations. While the child is under general anesthesia, the surgeon cuts a small hole in the eardrum and inserts a small plastic tube in the opening.
Most tubing stays in place for six to 12 months and then typically falls out on its own. The hole then closes naturally within three to four weeks. In rare cases, a child might need the tubing put back in.
This has been found to help some children who have repeat ear infections or fluid behind the eardrum. But doctors tend to suggest these surgeries only after tubes have failed to prevent repeat ear infections. Children younger than 4 don't usually have their adenoids taken out unless they have severe nasal blockage.
Ongoing Care for Pediatric Ear Infection
Wellstar offers long-standing, community-based pediatricians who are to home and trained to:
- Help you determine healthy lifestyles for your child and useful ways to role model your choices.
- Offer advice to prevent illness and injuries.
- Provide early and appropriate care of acute illness to prevent its progression.
- Treat life-threatening childhood conditions requiring intensive care.
- Guide you in anticipating your child’s needs from newborn to adulthood.
Pediatric Emergency and Immediate Care Center
Certified nurses with pediatric advanced life support certification work with Wellstar’s board-certified emergency services physicians in the Pediatric EDs at Wellstar Cobb and Kennestone hospitals. The Pediatric Emergency Department at Wellstar Kennestone Hospital is open seven days a week, from 11 AM to 11 PM. The Pediatric ED at Wellstar Cobb Hospital is open seven days a week, 24 hours a day.