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Overview

Otitis media is a common infection of the middle ear. Most children have at least one ear infection by the age of three years. Many will have three or more. Otitis media can also affect adults although much less frequently.

Causes

Otitis media usually begins when viruses or bacteria that cause sore throats colds or other respiratory problems spread to the middle ear and cause an infection or inflammation. The resulting swelling blocks a tube which normally allows air to enter behind the eardrum. As a result white cells can't travel from the bloodstream to help fight the infection so they accumulate. A thick yellowish-fluid forms and the eardrum and middle ear bones are unable to move as freely as they should. As this happens the child may have trouble hearing and experience severe pain.

Symptoms

A middle ear infection often occurs on the heels of a cold or other illness. Along with the usual symptoms of a cold including fever sore throat lack of energy and loss of appetite children with ear infections often:

• have earaches
• are irritable
• have trouble sleeping
• tug or pull at their ears
• don't response to quiet sounds

Treatment

The treatment of middle ear infections has changed in the last few years as medical literature shows that most of the infections are viral and don't respond well to antibiotics but tend to get better by themselves. Pain medications such as acetaminophen (Tempra) or ibuprofen (Advil Motrin) treat the two major symptoms of infection; pain and fever. For children under the age of two doctors tend to be more aggressive and may prescribe an antibiotic. If the child is otherwise well many doctors may let the infection take care of itself especially for kids over two. If the infection doesn't show signs of draining on its own an antibiotic may then be necessary. It is important to take all of the medication even after the child begins to feel better.

Complications

Fluid can sometimes be retained in the middle ear. This may or may not be responsive to more antibiotics. Fluid that doesn't drain properly can result in temporary hearing loss. For most children this of no consequence but sustained hearing loss has the potential to lead to delays in speech and language development. In some cases a simple operation may be required. A tube is inserted through the ear drum and into the middle ear to drain the fluid. This is usually an out-patient procedure.

If your child is taking antibiotics for an ear infection call your doctor if your child:

• still has an earache even after two to three days of treatment
• has a fever over 39°C (102°F) or a fever that lasts more than three days
• is very sleepy
• is still fussy or cranky
• is breathing quickly or has trouble breathing
• isn't hearing well.

Prevention

As long as there is the common cold there will be ear infections in children. However you may be able to lessen their occurrence by ensuring that they are not exposed to second-hand cigarette smoke. Other factors that can cause more frequent ear infections include using a pacifier too often bottle feeding while lying down and allergies. Some children who are very susceptible to ear infections may benefit from continuous low dose antibiotics for a time.