Medical Monday-Ear Infection Fact Sheet

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It's 2:00 am and you've been up all night with a screaming child who's trying to do back flips out of your arms.  You've been pacing the floors and your conversation with your loved one goes something like this:

Mom:  Take this kid for a second or I'm going to loose my mind.
Dad:  What do you want me to do with him?
Mom:  I don't know.  I'm not the doctor
Dad:  Well, then take him to emerg to see one
Mom:  Tonight?  Maybe it can wait until tommorow
Dad:  Whatever you think!
Mom:  I'm not sure either, what do you think?
{this conversation plays out for another 2 hours until finally someone packs the bags and off  you go to the local emergency room}

Ear infections are the #1 diagnosed childhood illness.  Affecting 90% of children before they ever hit school age.  As parents, we somehow become super detectives when our children are sick.  Looking for clues and trying to diagnose their illness.
The only thing most moms have to go by when reporting to a doctor is that their typically happy baby or child has suddenly become slightly "demon possessed"and they are seemingly no longer comforted by traditional means.  We've all had that same middle of the night experience when you ask yourself, is this teething or ears?
Unfortunately,  my kids have had countless ear infections which seems to be a somewhat inherited trait.  My husband has hearing loss as does his sister.  In fact, his sister has to wear hearing aids because of repeat ear infections as a kid. Opal has had 3 sets of tubes and Sapphire has had one. 

Today I put together a quick fact sheet to help everyone understand what Ear Infections are all about and what the possible treatment options are. 


What is Otis Media?
Otis Media is the medical term for a ear infection.
What are the two types of Ear Infections?
AOM(acute otitis media) This means that a part of the ear is infected and swollen.  Also known as a middle ear infection.
OEM(otitis media with effusion) This refers to the mucous or fluid that remains trapped in the ear after the infection has resolved.  Fluid and mucous can also accumulate because of the structure of the inner ear and because the eustachian tube does not drain the fluid properly.  Many children experience mild to moderate hearing loss as a result of fluid in the ear. Not only can it effect hearing but it also effects speech and language. 
What causes ear infections?
Ear infections are a direct result of viruses and/or bacterial entering the ear.  Ear infections also arise secondary to a previous cold or illness.
What is the eustchian tube and how does it contribute to ear infections?
When the ears are infected the eustachian tubes become inflamed and swollen. The adenoids can also become infected. The eustachian tubes are inside the ear. They keep air pressure stable in the ear. These tubes also help supply the ears with fresh air. The adenoids are located near the eustachian tubes. Adenoids are clumps of cells that fight infections.
Why do kids get so many ear infections and adults don't?
These tubes are smaller and straighter in children than they are in adults making it more difficult for fluid to drain out of the ear.
Most importantly, how do I know my child has AOM or OEM?
•Does she tug or pull at her ears?
•Does he cry more than usual?
•Do you see fluid draining out of her ears?
•Does he have trouble sleeping?
•Can she keep her balance?
•Does he have trouble hearing?
•Does she seem not to respond to quiet sounds?
Signs that fluid may be present in older children include delayed or difficulty with speech. 

Treatment Options

1. Initially it is important to treat the pain associated with an ear infection.  OTC pain relievers such as Tylenol or Motril are recommended.  I tend to alternate between the two.   Tylenol is excellent in reducing a fever while Motrin has anti-inflammatory properties to reduce swelling within the ear.
2. To treat with Antibiotics or not has always been the  unanswered question when discussing ear infections.  After discussing this with many family physicans the consensus is that the majority of children
3. Surgery-Sometimes a surgery for the placement of small tubes ,lso known as a called a myringotomy is necessary to treat repeat or ongoing ear infections.  It has been performed since 1954 and is extremely safe. The tubes look like this][ and inserted through a very minute incision in the tympanic membrane(ear drum).  My two older kids have both had several sets of tubes.  The procedure took approximately 12 minutes start to finish and within 2 hours they were feeling mostly back to normal.  Expect the tubes to fall out within 6 months to a year as the ear canal grows.  Some children need a repeat myringotomy.  Another kind of surgery removes the adenoids. This is called an adenoidectomy. Removing the adenoids has been shown to help some children with otitis media who are between the ages of 4 and 8  Opal had his adenoids out with great results. If your child has 3 diagnosed ear infections in 6 months or 4 in 12 months then it may be time to consult a ENT(ears, nose and throat doctor).  Most refers are made through family physicians or nurse practitioners.

I also want to note that it is important children see a otiologist at least once to check their hearing prior to starting shool.  Undeteced hearing impariment can result in learning problems.

One final note on this topic of ears and ear infections.
Have you ever heard of the saying, "never put anything in a ear that's smaller than your elbow"?
Many parents feel the need to clear a child's ear canal of  the ear wax (aka cerumen).  Cerumen in the ear canal is actually a protective mechanism of the body.  It only becomes a problem when it prevents fluid in the ear from draining or if it prevents a health professional from visualizing the middle and inner ear components.  Most often ear wax falls out without any intervention.  Therefore, cue tips are best reserved for crafts and not for cleaning the ears.  By using cue tips you run the risk of pushing wax further into the ear canal which may result in ear wax impaction or even worse damage to the damage to the tympanic membrane the .  Ear wax impaction may require intervention.  To treat cerumen impaction you can place several drops of baby oil or olive oil in the affected ear to soften the wax so that it will be expelled by the body.  If this doesn't help than your Doctor may have to irrigate the ear or use a special instrument to remove the wax. To properly clean you child's ear you can wrap your finger around a warm wet cloth and wipe the outer ear.

I hope this helps with your questions and concerns in regards to ear infections.  Most importantly, trust your gut!  You know your child best!  Sometimes Doctors need to be reminded of this!

Do you have any other pediatric health questions that you would like me to answer or find the answers to?
Here are a few topics up for discussion.  Please let me know if you would like information on any of the following topics

• infant and toddler constipation
• allergies
• rashes
• vaccines

No health topic is off limits.  I will do my very best to provide you with the most accurate and up to date information on any health concern.