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Ear infections in children (Otitis media)

Posted Jun 14 2009 12:00am

Otitis (o-TI-tis) media is an infection (in-FECK-shun) of the middle ear (the space behind the eardrum). Children are most likely to get ear infections when they are between three months to three years old. Ear infections are most common during cold and flu season, usually in the winter and early spring months.

Nontypeable Haemophilus influenzae (NTHi) is one of the three main bacterial causes of otitis media (OM), an infection or inflammation of the middle ear. OM is one of the most significant health problems for children. It is estimated that 83% of all children will experience at least one ear infection prior to 3 years of age

Otitis Media is the most frequent diagnosis recorded for children who visit physicians for illness. Two out of three children under the age of 3 experience at least one episode of acute otitis media. An inner ear infection is the most common cause of hearing loss in children.

Children with ear infections have a build-up of fluid and pressure in the middle ear. The middle ear may become infected by germs, which grow easily in the fluid trapped behind the eardrum.

Children are prone to ear infections because they have trouble draining the substances present in their ear. The substances may promote the growth of bacteria. Because children have trouble draining their ears it is important that if you bottle-feed your child to sit them in an upright position during feeding. This prevents fluid from accumulating around the ear area. Never allow your child to fall asleep with the bottle. Not only does this promote ear infections, but also responsible for nursing bottle decay. This causes your child’s teeth to rot. Breastfed infants do not have to be fed upright.

If you are currently breastfeeding, you are already providing great protection for child against ear infections. Breastfed infants are less like to obtain ear infections.

Your breastfed child will not only have fewer ear infections, but protection against other infections. Breastfeeding provides protection against diarrhea, gastrointestinal and respiratory infections; in fact, infections of every kind.

Ear infection is most often cause by bacteria, although is some cases, it is viral. Breastfeeding has been shown to prevent otitis media in children. Some researchers suggest this is because when a mother breastfeeds her child, she passes immunities to her baby that help prevent otitis media.

What is a middle ear infection?

The middle ear is the small part of your ear just inside your eardrum. It can get infected when germs from the nose and throat are trapped there.

Acute otitis media is the presence of fluid, typically pus, in the middle ear with symptoms of pain, redness of the eardrum, and possible fever. Other forms of otitis media are either more chronic (fluid is in the middle ear for 6 or more weeks) or the fluid in the middle ear is temporary and not necessarily infected (called otitis media with effusion).

Doctors try to distinguish between the different forms of otitis because this affects treatment options. Not all forms of otitis need to be treated with antibiotics.

Middle ear infections account for up to 30 percent of pediatric office visits in America, and are second in prevalence only to the common cold. A child’s risk of getting ear infections decreases with age, as the structures of the ears enlarge and the immune system becomes stronger.

Causes of Ear infections

Ear infections are more likely associated with bacteria than viruses. In addition, there are several conditions that can cause the nasal passages to become inflamed, which leads to ear infections. These conditions include allergies, upper respiratory infections such as colds or influenza viruses.

An ear infection results when fluid and bacteria build up in the area around your baby’s eardrum. Normally any fluid that enters this area leaves pretty quickly through the Eustachian tube (which connects the middle ear to the back of the nose and throat) when your baby yawns or swallows. But if the Eustachian tube is blocked common during colds, sinus infections, even allergy season it traps the fluid in the middle ear. Bacteria like to grow in dark, warm, wet places, so a fluid-filled ear becomes the perfect breeding ground. As the infection worsens, so does the swelling in and around the eardrum, and, as a result, the pain. Fever develops as your baby’s body attempts to fight the infection.

Pacifier use may increase the risk of middle ear infections in babies and young children. In one study, the incidence of ear infections was 33 percent lower in babies who didn’t use pacifiers.

Babies are particularly susceptible to ear infections because their Eustachian tubes are short (about 1/2 inch) and horizontal. As they grow to adulthood, the tube triples in length to 1 1/2 inches and become more vertical, so fluid can drain more easily. Ear infections are one of the most common childhood illnesses. Although there are no statistics on how many babies get them, the American Academy of Pediatrics expects that most children will have gotten at least one ear infection by the time they turn 3.

How can I tell if my baby has an ear infection?

The easiest way to tell if your baby has an ear infection or any other illness is a change in his mood. If he turns fussy, or starts crying more than usual, you should be on the lookout for a problem. If he develops a fever (whether slight or high) you have another big clue. Ear infections tend to strike after a common cold or sinus infection, so keep that in mind too.

You may also notice that your child may be struggling to hear you. If they are old enough, they must complain to you about the pain or ringing in their ears. All of these are indications that they have contracted an ear infection. You may also notice that a discharge may be accumulating his or her ear.

Signs and Symptoms of Ear infections

Otitis media with effusion often has no symptoms. In some kids, the fluid that’s in the middle ear may create a sensation of ear fullness or “popping.” As with acute otitis media, the fluid behind the eardrum can block sound, so mild temporary hearing loss can happen, but might not be obvious.

The signs and symptoms of acute otitis media may range from very mild to severe:

* The fluid in the middle ear may push on the eardrum, causing ear pain. An older child may complain of an earache, but a younger child may tug at the ear or simply act irritable and cry more than usual.

* Lying down, chewing, and sucking can also cause painful pressure changes in the middle ear, so a child may eat less than normal or have trouble sleeping.

* If the pressure from the fluid buildup is high enough, it can cause the eardrum to rupture, resulting in drainage of fluid from the ear. This releases the pressure behind the eardrum, usually bringing relief from the pain.

Fluid buildup in the middle ear also blocks sound, which can lead to temporary hearing difficulties. A child may:

* Not respond to soft sounds

* turn up the television or radio

* talk louder

* appear to be inattentive at school

Other symptoms of acute otitis media can include:

* Fever

* Nausea

* Vomiting

* Dizziness

How to prevent ear infections in children

· Breast-feed your baby for at least four months. Your baby may be less likely to get an ear infection if he is breast fed.

· Do not give your child a bottle while he is lying down. This may cause liquid to leak into your child’s eustachian (u-STAY-shun) tube.

· Keep your child away from people who smoke. Children who breathe secondhand smoke are far more likely to develop ear infections.

· Keep your child away from crowds. Germs are easily and quickly spread in daycare centers. Keep your child away from sick playmates. Try to keep him home if there is a cold or other infection going around the daycare.

· Wash your and your child’s hands often. Washing with warm water and soap will help keep germs from spreading through your household.

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