Why is my baby getting so many ear infections?

TENDING to a cranky, crying baby with an ear infection is one of those things that new parents will never escape. And while paediatric research has shown a reduction in the number of babies that present with more than one case of ear infections in a year, many babies suffer through several episodes yearly.

But how many and in what time span is too often, and what are the associated risk factors for these infections?

“Parents should be concerned when children present frequent occurrences of acute otitis media — defined as three or more episodes within six months or four in a year. The causes vary depending on the child and pre-existing conditions such as genes, allergies or even Down Syndrome, for example, which is known to increase the possibility of babies suffering with ear infections,” said Dr Francis Barnett, consultant otolaryngologist (ENT) at Facial and Oral Surgery Associates and associate lecturer at the University of the West Indies, Mona.

He noted that while the list of possible causes is extensive, a key enabler to these infections identified is the structure of the middle ear.

“The ear is divided into three sections — outer, middle and inner ear. In childhood, infection of the middle ear is most common. The middle ear is connected to the back of the nose with a tube called the Eustachian tube. This tube serves several functions but most importantly, it allows for ventilation and pressure equalisation in the middle ear cavity. In the child this tube is shorter and wider. This allows the infection to travel easier into the middle ear,” Dr Barnett explained.

These infections, which affect 80 per cent of children by the age of three, are a result of viruses and bacteria. Below, Dr Barnett shares a few of the most common sources of ear infection in babies:

1. Exposure to second-hand smoke

Children who are exposed to an environment where there are smokers are up to 50 per cent more likely to suffer from multiple ear infections. A few studies have shown that tobacco may worsen Eustachian tube function.

2. Preschool, day care, and nurseries

These institutions or facilities have many children and many with varying health issues. This is a very interactive environment that facilitates the spread of germs.

3. No breastfeeding

Breastfeeding improves the immune system of the baby. Studies have shown that babies who are breastfed longer are less likely to suffer from ear infections than their formula-fed peers.

4. Allergies

Whenever children are under attack from allergies (food, pollen, etc) the risk of ear infections also increases because the upper airways and Eustachian tube become inflamed or irritated.

5. Age

Until about age eight, the Eustachian tube in children remains underdeveloped, a feature which shows a close association with acute otitis media (a painful type of ear infection) in children. Sixty-five per cent of children are diagnosed with acute otitis media by age two and up to a further 15 per cent more by age three.

6. Use of pacifiers

Some experts have suggested that the constant sucking motion may cause fluid from the nose to be pulled to the throat and into the middle ear, thereby increasing the likelihood of a middle ear infection, particularly in children two years and older.

7. Hereditary

Some families may be at more risk

Dr Barnett noted that there is a wide array of antibiotics available to treat these ear infections that generally clear up without the need for any further treatment. However, for recurrent cases, another solution could be explored.

“The Myringotomy and Grommet insertion is the placement of a small tube into the eardrum. This allows for ventilation and pressure equalisation in the middle ear bypassing the Eustachian tube,” Dr Barnett said.

He said this surgical procedure has been shown to decrease the risk of repeated middle ear infections. The adenoids are lymphatic tissue situated close to the Eustachian tube opening at the back of the nose. An adenoidectomy or removal of the adenoids also helps to decrease the risk of recurrent infections.