Ear Infections: Why They Are So Common and What To Do If They Are A Chronic Problem

By Jessa McClure


Your toddler suddenly wakes in the middle of the night pulling on his ear, telling you he’s in pain. You realize that the days of cold symptoms have probably become an ear infection.
Although the helplessness of dealing with a child suffering from such an infection makes you feel like you’re the only parent who has ever gone through this experience, you are not alone. Five out of six children will experience an ear infection before their third birthday, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). In fact, board-certified pediatrician, Lindsay Irvin, MD, of the Alamo Heights pediatric clinic, said she sees children with ear infections every day. “According to Nelson’s Textbook of Pediatrics, ‘Next to the common cold, ear infections are the most commonly diagnosed and probably the most prevalent illness of children in the United States,’” Irvin said.


Why does is occur?
“Middle ear infections are usually caused by inflammation of the Eustachian tube – a tube that runs from the middle ear to the back of the nose,” she said. “The Eustachian tube is responsible for draining and ventilating, the middle ear.” If the Eustachian tube is compromised, due to inflammation, it cannot function properly. The poorly functioning tube then creates a breeding ground for bacteria and infection.


What are the signs and symptoms of an ear infection?
“Acute Otitis Media – the kind of infection that needs to be treated with antibiotics – almost always occurs in conjunction with an upper respiratory infection (a cold),” the pediatrician said. If your child shows these symptoms within three to seven days of cold (fever, cough and nasal drainage), than they might be showing signs of an ear infection. Signs could include:


  • Ear pain
  • Feeding/eating poorly
  • Sleeping poorly
  • Crying more than usual
  • Fever
  • Pulling at the ears


What are the treatments for an ear infection?
The treatment for a middle ear infection depends on its type. The most common types are Otitis Media with effusion (OME) ad Acute Otitis Media (AOM). “The Academy of Pediatrics does not recommend any treatment – just close follow up and watchful waiting—for a child who has OME,” Irvin said. “For AOM the ear drum is noted to be opaque and bulging on exam and sometimes the examiner can see pus behind the ear drum. That kind of infection does require treatment with an antibiotic.” Children with recurrent ear infections, or infections that fail to clear with antibiotics, will sometimes need to have tympanostomy tubes inserted to ventilate the middle ear when the Eustachian tube becomes too inflamed and isn’t doing its job.
Why are ear infections so common in young children?
“The main reason is that ear infections are almost always associated with colds, and young children catch a lot of colds,” she said. “The other reason is that children’s Eustachian tubes function differently from those of an adult.” A child’s Eustachian tubes are more level than an adult’s, and therefore do not drain as well. When mucus and swelling occur because of a cold or other respiratory illness, it is even more difficult for fluid to drain out of the ear, according to the NIDCD


Can ear infections be prevented?
“Preventing the common cold is the best way to prevent ear infections,” Dr. Irvin said. “Parents can teach their children to cover their cough and wash their hands.” However, the pediatrician said there’s really no way to prevent them completely, especially if the parent had chronic ear infections as a child.


When is an ear infection a serious problem?
“Recurrent ear infections can lead to conductive hearing loss and speech delay,” she said. If your child has chronic ear infections and you believe there’s a problem with their hearing or speech, Dr. Irvin suggests asking your pediatrician to refer your child for a formal hearing evaluation and a pediatric Ear Nose and Throat specialist. “Early identification of hearing impairment is critical for a child’s optimal outcome with regard to expressive language and communication.”


Dr. Irvin said hearing is a gift and every child should have the chance to experience it. “We need to embrace the gift and fill their ears with many loving words and beautiful sounds as we


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