Ear infections in children

What is an ear infection?

An ear infection is inflammation of the middle section of the ear which can be caused by a viral or bacterial infection. An ear infection causes fluid to build up behind the ear drum which is what causes the pain. It often occurs after a sore throat, cold or upper respiratory infection as these ailments give way to a perfect breeding ground for bacteria and also make it easy for viral infections to spread to the middle ear. Sore throats, colds, and upper respiratory infections cause inflammation of the passageways between the ear and the throat and as children have smaller eustachian tubes than adults, and less efficient immune systems, it makes them even more susceptible. In fact, 75% of children will experience an ear infection by the time they celebrate their third birthday!

Signs & Symptoms

The symptoms and signs of an ear infection often occur quickly and then resolve quickly. They include:

• Earache
• High temperature
• Nausea or vomiting
• Low energy
• Slight hearing loss
• Diminished balance – falling, clumsiness, or leading against things more than normal
• Child Pulling at their ear(s)
• Irritable
• Difficulty sleeping

Types of Ear Infections

There are three main types of ear infection:

• Acute Otitis Media (AOM)

  This is the most common type of ear infection. It is when the fluid builds up behind the ear drum and causes pain and possible fever. In severe cases the pressure of the fluid can build up so much that a little hole is formed in the ear drum and pus may run our of the ear. This is horrible and frightening to see but this type of perforation usually signals the end of the condition as the release of fluid will relieve the pain which was present due to the pressure. It’s important that the doctor checks over your little one after a perforation to make sure that the infection is gone.

• Otitis Media with Effusion (OME) – known as Glue Ear

  Sometimes after an acute ear infection some fluid may remain trapped behind the eardrum. Often there is no symptoms of OME – but the doctor will see the fluid using a device called an otoscope. This problem can sometimes affect hearing and so difficulty hearing may be the only indication.

• Chronic Otitis Media with Effusion (COME)

• This is when fluid remains trapped behind the ear drum for a prolonged period of time or keeps recurring even when there is no infection. This can leave children susceptible to further infections and cal also affect hearing.

 

See the doctor if :

• There is no improvement after 48 hours
• If your child is inconsolable.
• If you suspect your child has hearing issues
• If your child has a persistent high fever of over 38 degrees celcius.
• If your suspect your child has a balance disturbance
• If there is any swelling around the ear.

Treatment of ear infections:

• Ear infections are often self limiting and require no treatment other than relieving the symptoms. You can use calpol and nurofen when needed in accordance with the manufacturers instructions to relieve earache and fever.
• A cold compress held over the ear may also provide some relief of pain.
• If any of the warning symptoms above are present or the earache does not clear up within two to three days then you should visit your G.P.  The treatment the G.P decides will depend on what they find after examining your child but may include a 7-10 day course of antibiotics if a bacterial infection is present. It is important to finish any course of prescribed antibiotics completely in accordance with your pharmacists instructions. This will help to prevent the infection coming back after a short time period and in a more aggressive manner.
• Sometimes the doctor may just recommend observation and treatment of symptoms as the infection may be viral and antibiotics would be no help in this case.
• The earache may also not actually be due to an infection and could be as a result of an allergy which causes swelling of the eustachian tube which decreases drainage and causes pain. Another possibility is that there is an obstruction in the ear from a foreign object or even just wax. Eczema can also occur in the ear and can cause pain, as can some types of dental pain!

So as you can see its very important to get a persistent earache investigated so that the true cause of the pain can be identified and treated. Its also good to understand that there are many potential causes of earache which don’t include infection and so would not benefit from an antibiotic as I know a lot of parents feel let down if that is not what is recommended by the doctor.

Top Tips:

• Wash your own and your child’s hands frequently to reduce the chances of infection spreading.
• Avoid children playing together when they are sick (not always possible I know!!)
• Avoid your child being around tobacco smoke as this actually can increase the incidence of ear infections as well as posing other health risks.
• Use a steam inhaler or humidifier to keep congestion at bay – you all know by now I’m a huge fan of humidifiers.  You can read more about it or purchase the one I recommend here!
• If there is nasal congestion I usually add a few drops of snufflebabe vapour oil into the humidifier – this helps to loosen nasal secretions which in turn releases pressure from the eustachian tube which relieves pressure in earaches! Its all connected!
• The HSE recommend the use of a cold compress against the ear to help alleviate pain.
• Remember recurrent earaches can be an indicator or fluid retention and should always be highlighted to your doctor to ensure long term hearing difficulties are prevented.

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I hope you have found this article helpful and if you have any questions at all please don’t hesitate to contact me by sending a private message to the WonderCare Insta page or by calling me (Sheena) at Milltown totalhealth Pharmacy in Dublin 6 on 012600262. I’m always happy to help!

 

Article updated 8/11/22