by Michael Cicero

Ear infections are common among young children — and if not properly treated, can have long-term effects ranging from hearing loss to delayed speech development. In fact, three of four children in America will have an ear infection before age three, according to the National Institute on Deafness and Other Communication Disorders (NIDCD).

An ear infection— clinically known as otitis media — often follows an illness, such as a cold, sore throat or upper respiratory infection, and bacteria or a virus can cause it.

Children are at a higher risk for ear infections than adults because their ear passages are smaller, narrower and angled differently, making it easier for germs to reach the middle ear and for fluid to accumulate. And, once the infection has settled in, it’s harder for a child’s younger and still-developing immune system to fight it. Studies have also found that children who have frequent ear infections have a greater incidence of antibiotic-resistant bacteria in their middle ears, according to the NIDCD.

Symptoms of an ear infection

Sometimes an ear infection has no symptoms. If your child isn’t old enough to talk and cannot tell you his or her ear is hurting, common signs include:

• Tugging or pulling at the ear(s)

• Fussiness and crying

• Trouble sleeping

• Fever

• Fluid draining from the ear

• Clumsiness or problems with balance

• Trouble hearing quiet sounds

Certain factors may make your child more prone to ear infections, including exposure to secondhand smoke; putting a baby down to nap or bed with a bottle; being around sick children in close environments such as school or daycare; and being of Native American or Hispanic descent.

Treatment Guidelines

In February 2013, the American Academy of Pediatrics (AAP) issued new guidelines for pediatricians and parents regarding the care and treatment of ear infections. The guidelines recommend several treatment options based on the child’s age and severity of symptoms. For children with ear infections that can’t be definitively diagnosed, particularly children between the ages of six months to two years, treatment guidelines include antibiotics and pain relievers, or observation and close follow-up for 48 to 72 hours before beginning antibiotics. The guidelines also call for more stringent criteria for diagnosing an ear infection, which will allow pediatricians to prescribe antibiotics more effectively. It’s important to note that some ear infections will clear up on their own without antibiotics. Using antibiotics conservatively to treat symptoms helps prevent the development of antibiotic-resistant bacteria in the ear. If your child’s pediatrician prescribes a 7- to 10-day round of antibiotics for the ear infection, it’s important to finish all the prescribed medication. Some fluid in the ear may remain after the infection clears, but usually will disappear within three to six weeks.

If your child experiences any symptoms of an ear infection, don’t delay in seeing a pediatrician. Your doctor will check for fluid behind the eardrum, redness or swelling in the eardrum, or perform a test known as tympanometry. For this test, a small device is inserted into the ear and sound tones and air pressure are used to measure the flexibility of the eardrum (a normal eardrum is more flexible and moves back and forth more easily than an eardrum with fluid build-up).

Multiple ear infections within a year may require your child have tubes placed in the ears to prevent fluid buildup and decrease pain. The simple and painless procedure is performed on an outpatient basis. These tiny ventilation tubes help improve air flow and prevent fluid from accumulating. Most tubes remain in your child’s ears for six to nine months and are checked at follow-up doctor’s visits until they fall out on their own.

Dr. Michael Cicero is a pediatrician and an active member of medical staff at Southampton Memorial Hospital