Ear Infections


“Rebecca would get at least one ear infection a month,” says Dana Erikson. “At first I didn’t know what was wrong. She would pull at her ears and cry.” Rebecca is not alone. “Roughly half of all toddlers in Canada will have at least one bout of otitis media,” says Dr. Dominique Dorion, president of the Canadian Society of Otolaryngology. The most the common type of ear infection in children is acute otitis media. Pus builds up behind the eardrum – this is not unlike a pimple. Pain comes from the pressure in the
middle ear. Hearing is affected because the eardrum cannot move normally. The factors needed for developing an ear infection are bacteria or a virus or an eustachian tube problem (when the self-cleaning mechanism of the middle ear is not working properly).

SIGNS AND SYMPTOMS OF EAR INFECTIONS

OTITIS EXTERNA

– (aka, “swimmer’s ear”) pain, discharge, possible hearing loss and very specifically pain on manipulation of the ear. Fever is very unusual.

OTITIS MEDIA

– pain, mild loss of hearing, fever is common and systemic symptoms associated with an upper respiratory tract infection are often present.

 RISK FACTORS:

● Daycare
● Winter
● Other upper airway infection
● Weakness of the immune system
● Small size of eustachian tube
● Cleft lips and palate
● Bottle-feeding, especially in the crib
● Use of pacifier
● Smoke in the immediate environment
● Allergies (Although often difficult to evaluate, parents report that switching their child’s diet to avoid potential allergens, like eggs, cow’s milk or gluten will sometimes make a big difference.)
● Reflux of stomach acid

TREATMENT
As a general rule, otitis media that is treated well will not cause many problems. “At this time there is a very strong movement toward not giving antibiotics to treat ear infections,” says Dorion. “We teach family physicians and paediatricians to consider not giving antibiotics unless the child is very ill – especially in older kids (over two years).” A four-year-old, therefore, who is otherwise healthy, but who complains and cries a bit because of ear pain does not necessarily need antibiotics. TLC and Tylenol should do the trick in most of these cases. If problems persist for more than three days, antibiotics are necessary to prevent complications.

TIME FOR TUBES?
1 Experiencing repeated bouts of otitis media (five to seven per year).
2 Having an otitis media that does not heal completely on its own and affects hearing significantly for more than three months. Most tubes will come out eventually on their own. Depending on the type of tubes, some may need to be taken out when the child is ready, which does not require a general anaesthetic. As a general rule, the longer the tubes are in the higher the risk of the ear drum being accustomed to having a hole in it and not healing afterward.

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