Sunday, December 21, 2008

Ear Infections in Children

It’s cold and flu season, the time of year when children are especially vulnerable to painful ear infections. In fact, ear infections are the most commonly diagnosed childhood illness in the United States, second only to the common cold. More than 75 percent of children will have at least one ear infection by the age of three.

Unfortunately, babies are more prone to ear infections than older children or adults because their Eustachian tubes are short (about a half-inch) and horizontal. (Their immune systems are also less well-developed.) Inside your baby’s head, the Eustachian tubes connect her middle ear to the back of her throat, making a passage for fluids when your baby yawns or swallows. The tubes also protect the middle ear from germs that may enter into it via the throat, and they equalize air pressure, which will play a big part in your child’s ability to balance later on. As babies grow, the Eustachian tubes will triple in length and become more vertical, which helps prevent ear infections as the fluid can drain more easily. But until that happens, your baby may be particularly vulnerable to infections.

The most common type of ear infection is formally referred to as otitis media, caused by fluid and bacterial buildup behind your baby’s eardrum. If the Eustachian tubes are swollen due to a cold, allergy or sinus infection, the fluid can become trapped in the middle ear. In this warm, wet environment, bacteria will thrive and produce pus, putting pressure on the eardrum. This pressure causes it to bulge and results in a very painful ear infection.

But colds and allergies aren’t the only cause of fluid buildup in the ear. Fluid can also be prevented from draining if you hold your baby in a horizontal position during feeding. Although it seems instinctive to completely recline your baby in your arms while nursing, this position actually brings more fluid into your baby’s Eustachian tubes. So, be sure that your baby’s head is higher than her feet when she’s being fed.

Most children will have at least one ear infection before their first birthday. Between 10–20 percent will have three or more infections. Fluid in the ear may last an average of a month per occurrence. Repeated infections can cause mild hearing loss, which is of greatest concern when children are developing language skills. Signs of hearing loss in a baby may include failure to startle at loud sounds, not cooing or babbling, not responding to the sound of your voice, not enjoying games like peek-a-boo, and not making 1- or 2-word sounds (“bye-bye,” “dada”) by the first birthday. Because the signs of hearing loss are much more subtle in a baby’s first year, parents should be especially conscientious about having their baby’s hearing checked if he has repeated ear infections.

Signs of an ear infection include:

• Tugging on the ear
• Increased irritability or crying
• Trouble eating or sleeping
• Fluid drainage from the ear (this may be a result of the eardrum rupturing; seek medical attention right away)
• Lack of response to soft sounds
• Cold/flu symptoms, such as fever or vomiting

If you suspect that your baby has an ear infection, be sure to take her to the doctor, who may prescribe antibiotics or just monitor your baby’s condition to see if it clears up on its own. If your child has had repeated ear infections, or fluid behind both eardrums for longer than three months, resulting in significant hearing loss, she may be a candidate for ear tubes. These plastic tubes are placed through a small surgical opening in your baby’s eardrum to drain the fluid, keep infections from recurring, and restore hearing. They usually stay in for 6–12 months before falling out (or being surgically removed).

©2008. Adapted from Boosting Your Baby’s Brain Power, by Holly Engel-Smothers and Susan M. Heim.

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  1. Hi. What a helpful post. My son gets ear infections from time to time, and it's always so upsetting because I know how painful they are--last year, I got one for the first time since childhood. I just found your blog, I'm also featured on The Ultimate Role Mommy
    Blogroll, and wanted to reach out. I put up a post today about two kids vs. three, and was hoping you could join the discussion over at

  2. My twins who are 4 years old never had an ear infection, but my 8 month old baby has had an ear infection since Oct 31st! She has been on antibiotics 3 times now. Every time she goes off it comes back again. Hopefully it is gone this time. Thanks for the article!!

  3. Thanks for the helpful article!
    Will take note of this.Luckily my kids has not experience any ear infection.:-)

    Happy Holidays to you and you family!


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