Middle-ear infection (known medically as otitis media) is the most common illness in babies and young children. Researchers estimate that at least 75 percent (and possibly more than 90 percent) of children experience at least one such infection during the first three years of life, and close to 50 percent get three or more ear infections during those early years.
Of course, children aren't the only ones who get ear infections. But they are, by far, the most common victims. Adults are more likely to get an infection of the outer ear, which is aptly referred to as "swimmer's ear" because it usually gets its start when water containing bacteria or fungi seeps into the ear and gets trapped in the ear canal.
In order to understand how middle-ear infections develop, it helps to know how healthy ears function. The outer ear is connected to an air-containing space called the middle ear. The eardrum, a thin membrane, is stretched across the entrance to the space, and three tiny sound-conducting bones are suspended within it. The pressure within the middle-ear space is equalized with the atmosphere through a narrow tube called the eustachian tube. The eustachian tube opens into a space behind the nose where air or fluid may enter or escape. The air pressure in the middle ear is equalized more than one thousand times a day -- every time you swallow -- usually without you noticing it. The eustachian tube also carries fluid away from the middle ear.
When a cold or an allergy is present, the eustachian tube swells and air is absorbed by the lining of the middle ear, creating a partial vacuum. The eardrum then gets pulled inward, and fluid weeps from the lining of the middle ear. Bacteria or viruses from the nose and throat can travel up the eustachian tube and infect the stagnant, warm fluid in the middle ear, which provides a perfect environment for them to live and multiply. When this happens, an infection is underway.
Children may be more prone to middle-ear infections for a variety of reasons. For example, their eustachian tubes are shorter and straighter than those in adults, which may make it easier for bacteria and viruses to penetrate. Children get colds and sore throats more often than adults. And the immune system is not as fully developed during childhood as it is in adulthood.
Preventing Ear Infections
Steer your child clear. Since middle-ear infections generally start with a cold or other upper respiratory infection, you'll help protect your child from ear infections by keeping him or her away from other kids who have infections. Making sure that any nasal allergies that your child has are well controlled can also be beneficial. And if you are in the process of choosing a day-care facility for your child, check into the center's policy for dealing with children who are ill.
Teach proper nose-blowing technique. Once your child is old enough, teach him or her to blow his or her nose softly rather than with excessive force, so as not to drive infection into the ears. And teach your child not to stifle a sneeze by pinching the nostrils, since this, too, may force the infection up into the ears.
Don't smoke. Here's another reason not to smoke: Children who live with smokers seem to be more susceptible to middle-ear infections than are those who live in smokefree homes. Cigarette smoke irritates the linings of the nasal passages and middle-ear cavity, which in turn interferes with the normal functioning of the eustachian tube. If you cannot quit, at least take your habit outside.
Be careful with bottle-feeding. Avoid giving a bottle of milk or formula to a baby who is lying on his or her back, because the nutrient-rich liquid can flow into the eustachian tube during swallowing and pool there, creating a luxurious breeding ground for infectious organisms.
Stay alert to the signs. It is essential to get your child to the doctor as soon as you suspect an ear infection, but to do that, you need to be aware of the symptoms that can signal an ear infection. An older child who has an ear infection may complain of ear pain or aching or a stuffiness in the ear. In a younger child who cannot yet describe an earache, you need to be alert to other signs that may signal an imminent ear infection, such as pulling on or rubbing the ear, any trouble with hearing or balance, crying more than usual, or fluid draining from the ear. (Signs that an infection has taken hold include fever, crying, rubbing the ear, nausea, and vomiting.)
Treating an Ear Infection
If you suspect your child has an ear infection, you should take the child to the doctor at once. If a middle-ear infection is treated promptly, it is not serious. If not treated right away, your child might suffer hearing loss and, as a result, a delay in learning and speech development. Once your child has seen the doctor, however, there are some things you can do to help make your little one more comfortable.
Follow through on the doctor's instructions. Your job doesn't end with a visit to the doctor. You will need to be sure that your child receives any medication prescribed by the doctor. Be sure, too, that you understand and follow the directions for administering the medicine (call your doctor or pharmacist with any questions). If an antibiotic has been prescribed, it's especially important that your child take the medication for the full time prescribed.
Keep your child's chin up. If your child is lying down, prop his or her head up on pillows. Elevating the head will help keep the eustachian tubes draining into the back of the throat.
Try mild heat. Applying a heating pad set on warm -- not hot -- to the affected ear may make your child more comfortable.
Give acetaminophen. Try giving your child acetaminophen to help relieve pain and fever. Do not, however, give your child aspirin. Aspirin use in children with a viral illness has been associated with Reye's syndrome, an often fatal condition characterized by severe, sudden deterioration of liver and brain function. For a list of precautions to take when using over-the-counter analgesics, click here.
We've covered most of the ear difficulties you will encounter, but there are more serious problems, such as deafness or tinnitus. Turn to the next section for an examination of other ear disorders.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.