Fever | Ear Infections | Strep Throat | Antibiotics | Vaccines EAR INFECTIONS The medical name for middle ear infections is otitis media. By the time kids reach 3 years of age, most have had at least one, and many kids have had more than one, middle ear infection. The middle ear space is protected from outside bacteria and viruses by the ear drum – but it is not protected from germs that move up through the Eustachian tube. The Eustachian tube is the depressurizing canal that connects our mouth and nose cavities to our middle ear space allowing us, for example, to “pop” our ears by yawning. The Eustachian tube is shorter, straighter, and more prone to blockage in younger children than in older kids, explaining the tendency of the youngest for ear infections. Bacteria and viruses that live in our kids’ noses and mouths creep along the Eustachian tube and, if conditions in the middle ear are favorable, cause infection and inflammation. Favorable conditions for middle ear infection include fluid build-up and congestion from concomitant viral infection or allergy (e.g. hayfever), or residual fluid from past ear infections; household cigarette smoke also promotes ear infections. Bottle fed babies are more likely to get otitis media than those who are breast fed for two reasons: the anatomic differences in sucking and swallowing with the two approaches; and, the immunologic benefits of breast milk. Middle ear infections are painful for babies and kids, and are often associated with fever and nausea or vomiting. Although most middle ear infections are benign and resolve with oral antibiotics (and, sometimes, with no therapy at all), some children develop complications of these episodes. Rare complications include more serious infections such as spread to the blood stream (bacteremia) or the brain (meningitis). There has been concern for many years that hearing and speech impairment may result from recurrent middle ear infections and persistent fluid behind the ear drum. It is for the latter concern that certain kids have traditionally been referred to ear, nose, and throat specialists for insertion of drainage tubes in the eardrum. A 2007 study, however, followed children who had received drainage tubes and compared them to kids who had not and found no long term differences in speech and language development, calling into question one of the most common reasons for “tube” placement. Drainage tubes may also be recommended for some young kids who have many (6 or more) painful middle ear infections per year – tubes may reduce the number and make those infections that do occur less painful. Most children can avoid the need for placement of tubes, which can be quite expensive, by treatment of each new ear infection as needed and, in some instances, prophylactic (preventive) antibiotics given daily for several months during the cold and flu season when ear infections are also much more common. Certain bacteria that cause otitis media are prevented by current immunizations. How contagious is it?
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Copyright 2007, Dr. Harley A. Rotbart. Guidelines for Parents from the new book, Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections (ASM Press, 2008). Read Dr. Rotbart’s GERMBlog for frequent updates on important germ issues for your kids |
