Ear Infections in Children
Children can have infections of the skin of their ear canal or a middle ear infection. Ear canal infections (otitis externa) are common after swimming or if you use cotton buds to clean your child’s ears. Middle ear infections are much more common and are caused by viruses and bacteria that reach the ear via the nose.
Middle ear infections in children (otitis media)
If your child has been pulling on their ear, and crying more than usual, they may have an ear infection. In children this is usually this is a middle ear.
What is a middle ear infection?
Ear infections usually start when your child gets a cold, a sore throat or another common infection. The infection may be caused by either bacteria or viruses. The infection spreads up a tube called the Eustachian tube, which connects your middle ear to the back of your nose. The middle ear is the part of your ear behind your eardrum. When the infection gets into your child’s ears, it makes them swollen, blocked and painful. Fluid called mucous builds up behind the eardrum. This makes it hard for your child to hear and causes pressure or pain. Sometimes the eardrum bursts and you see fluid coming out. The tear in the eardrum will heal after a few days. Ear infections are very common, especially in young children. Anyone can get an ear infection. But children are more likely to get them than adults. Children who go to childcare are most likely to get them, because infections spread easily among groups of children. Often fluid is left behind after a middle ear infection which takes many weeks or months to resolve. This can cause hearing loss and learning delays.
What are the symptoms of a middle ear infection?
The most common symptoms are ear pain and a high temperature. If your child’s eardrum bursts, you may see fluid coming out of the ear. Babies who have an ear infection might cry more then usual and hold or tug their ear. Other signs of an ear infection in children include being irritable, or having trouble sleeping, keeping balance or hearing. Not all children with ear infections need to see a doctor. If your child can talk and tell you their ear is hurting, a painkiller might be all they need. If pain killers do not seem to be working or if you are unsure you should take them to your doctor.
What treatments work?
Often your child will get better in a few days without treatment. Pain killers can be helpful to keep them comfortable while the infection settles down. Antibiotics may help some children, but are not always needed and do have side effects in some children. Medicines Painkillers, such as paracetamol and ibuprofen will help your child feel better and relieve pain. Antibiotics Antibiotics may help your child recover from an ear infection faster. Antibiotics are drugs that kill bacteria. But your child may get better anyway without antibiotics. Also, antibiotics do not work for all ear infections. Most doctors are now careful not to prescribe antibiotics unless they think a child does need them. This is because antibiotics may not work as well in the future if they are used too much. This is called antibiotic resistance. If your child gets several ear infections a year, your doctor may prescribe antibiotics for a few months without a break, to try to prevent more ear infections. It might work. But there is a risk your child may get side effects, or that the antibiotics may not work so well in the future. If your child has more than 3 infections in 6 months or 4 infections per year they are having recurrent acute otitis media. They would benefit from the insertion of grommets and possibly an adenoidectomy at the same time. Things you can do to avoid your child getting more infections
- Do not smoke near your child
- Try to keep your child away from other children who have colds or other infections
- If you are pregnant or a very new mother, consider breastfeeding. This seems to protect children from ear infections.
- Try not to let your child use a bottle lying down.
- Do not give your child a dummy
- Ensure that your child is fully vaccinated for the flu and pneumococcus.
What will happen to my child who has a middle ear infection?
About 8 in 10 children who have an ear infection get better without any treatment after two to three days. But some children get ear infections again and again. Children who have repeated ear infections may have problems with their speech and language. Sometimes this leads to problems at school. Ear infections can cause other problems if they do not clear up properly. After an ear infection, fluid can get trapped behind the ear drum (glue ear). It can stop your child hearing properly, which can make learning difficult. Rarely, an ear infection can spread to the large bone behind your child’s ear or cause meningitis or a brain abscess. An early sign of this is pain, swelling and tenderness behind your child’s ear. If this happens see your doctor urgently. Children with recurrent ear infections may benefit from insertion of grommets and possibly an adenoidectomy.
