EAR infections are one of the most common illnesses children experience. In fact, some 25 per cent of all children will have repeated ear infections between the ages three months to three years. Three to four ear infections a year is quite normal.

There are different types of ear infections. Otitis externa (infection of the outer ear and/or ear canal), otitis media (infection of the middle ear), and otitis media with effusion (infection with fluid build-up in the middle ear) are the most common types.

Usually, when you hear the term “ear infection”, we are typically referring to a middle ear infection, or otitis media, which is the most common type. That is, an infection of the part of the ear behind the eardrum. The eardrum is the part of the ear that protects the tiny, delicate structures of the middle ear from the outside environment. Children are more likely to get middle ear infections because their immune systems aren’t as developed as adults, and the (Eustachian) tube inside the ear are shorter and straighter, making it easier for infections to develop.

Otitis externa is an infection of the outer ear. The pinna (which is the part of the ear we seen) and the ear canal, which is the tube leading to the eardrum. (You know, that part of the ear you use the Q-tip to clean and scratch when you know you aren’t supposed to).

Many times, an ear infection starts off as a cold. The virus or bacteria causing the cold travels from the respiratory tract through the Eustachian tube (which connects the middle ear to the throat) and causes inflammation. The Eustachian tube may become swollen and blocked, which leads to an ear infection developing. If your doctor believes the ear infection is caused from a virus (which is more common culprit), we give medications to relieve the symptoms of the ear infection such as pain and cough/cold. If your doctor suspects a bacterial cause, your child will be prescribed antibiotics. Do not give your child antibiotics unless prescribed by a doctor.

To diagnose an ear infection, doctors will ask if your child is experiencing certain symptoms, then examine the child’s ear with an otoscope.

Some of the symptoms of ear infections in infants and children include:

• Ear pain

• Fever

• Fussiness or irritability

• Rubbing or tugging at an ear

• Difficulty sleeping, poor sleeping

• Loss of appetite

• Drainage from the ear

• Not hearing well

• Vomiting

The otoscope is a fancy flashlight that allows us to view the ear canal and eardrum. We look to see if the eardrum is red or inflamed, if it is bulging, if there is fluid behind the eardrum, and if the eardrum is ruptured. Examination of the ear can be uncomfortable, and children usually squirm and try to avoid having something put in their ear. If the child does have an ear infection, the examination may even be painful, unfortunately.

So, how can you prevent ear infections? The same way you can prevent a cold. Do your best to stay healthy and keep others healthy. Wash your hands often, eat healthy foods, stay away from persons who are sick, make sure your child is up to date with immunisations, breastfeed exclusively for six months and continue for at least 1 year, don’t smoke around children and avoid second hand smoke.

Factors that may increase the risk for ear infections include:

– Age. Children ages three months to three years are at greater risk of developing ear infections

– Adenoidal Hypertrophy. Adenoids are tissues inside the nose and throat area that are very close to the Eustachian tube. If they are swollen, inflamed or infected, it can affect the Eustachian tube leading to increased risk of ear infections

– Allergies. Allergies can cause irritation and inflammation of the respiratory tract which can lead to inflammation of the Eustachian tube, possibly leading to ear infections

– Colds. Having frequent colds increases the chances of developing an ear infection

– Family history. Sometimes the tendency to get ear infections run in the family.

– Chronic illnesses. Persons with long term (chronic) illnesses like respiratory diseases and weakened immune systems are more likely to develop ear infections.

It is important that ear infections are diagnosed and treated properly. Repeated ear infections, or fluid behind the eardrum, may lead to some level of hearing loss. If there is permanent damage to the structures of the middle ear, it may possibly lead to permanent hearing loss. Also, untreated ear infections can spread to the surrounding areas in and around the ear like the skull and bones of inside the head possibly leading to meningitis, abscess formation and infected bones in the head.

Piercing your child’s ear will not cause a middle ear infection. But a piercing does break the skin, so there is a risk of the hole from the piercing becoming infected. To prevent this, clean the area with a cotton swab with rubbing alcohol or apply an antibiotic ointment around the ear lobe, front and back, twice a day, and gently twist the earrings at least once a day while cleaning. Don’t press on your baby’s ear when doing so, as that can be painful. After each bath, gently pat the area dry to remove any dampness.

Dr Tal’s Tidbit

Ear infections are common and frequent throughout most children’s lives. You can help to prevent ear infections by doing your best to keep yourself and your child healthy. If you suspect your child has an ear infection, have your child assessed by a doctor to ensure proper diagnosis and treatment to alleviate pain and discomfort, and to avoid possible long-term complications like recurrent ear infections and hearing loss.

Dr Taleya Girvan has over a decade’s experience treating children at the Bustamante Hospital for Children, working in the Accident and Emergency Department and Paediatric Cardiology Department. Her goal is to use the knowledge she has gained to improve the lives of patients by increasing knowledge about the health-care system in Jamaica. Dr Tal’s Tidbits is a series in which she speaks to patients and caregivers providing practical advice that will improve health care for the general population. Email: dr.talstidbits@gmail.com IG @dr.tals_tidbits