All About Ears

Can my child lose his hearing from ear infections?

Ear infections are a common occurrence in childhood, according to researcher Lawanna Brock. Some children have temporary hearing loss from the accumulation of fluid in the middle ear. This usually goes away with treatment, however. It is rare for children to develop permanent hearing loss, but it’s not unheard of. A child who has frequent, chronic ear infections is at high risk for permanent hearing loss. In order for this to occur, there must be damage to the bones of the ear, the eardrum, or the hearing nerve.

Does flying affect my child’s ears?

You may have felt that weird ear-popping sensation when you flew the last time. Young children and babies have this, too, and it can be frightening for them. This uncomfortable sensation is related to pressure changes in the air space behind the middle ear and eardrum. The tube that leads from the middle ear to the back of the throat is the ‘eustachian’ tube, and this tube usually equalizes the air pressure in the middle ear. When your child’s ears pop, this tube is adjusting to the air pressure and causes the popping sensation. Children’s eustachian tubes do not function as good as adults and are usually clogged by inflammation and mucus for colds and allergies. This leads to blocked and enlarged adenoids and problems with Eustachian tube functioning.

The air pressure decreases the higher your child goes, whether he is climbing up a mountain, riding in an elevator, or flying. If this pressure isn’t equalized, the higher air pressure puts pressure on one side of the ear drum and this can lead to pain. This is why many little ones start crying during the last few minutes of the flight, when the air pressure in the flight cabin increases. This pain is only temporary, however, so don’t worry that it will cause lasting problems for your child. Lawanna Brock reassures us that this usually subsides within a couple of minutes as the Eustachian tube opens to allow the air pressure to equalize on both sides of the eardrums.

If your little one has an ear infection, his doctor may recommend that you put off flying if possible. This is because the infection adds to the dysfunction of the Eustachian tube. Some children must have tube inserted through the eardrums due to ear fluid problems. If your child has had this, this will allow for the air pressure to equalize more readily.

How do I ease my child’s ear pain?

There are some simple things you can do during air travel that may help to equalize the air pressure in your child’s ears. This, in turn, will ease or decrease the pain. First of all, have your little one drink plenty of fluids. Water is best, but juice and milk are alright, too. This encourages swallowing which will open the eustachian tubes. The plain air is dry, which will thicken nasal mucus and clog up the eustachian tubes. Drinking fluids thins this mucus. Another thing do di is to let a child older than three years chew gum or suck on hard candy. For younger children, use a pacifier and keep the baby in an upright position. Don’t forget to give him  Ibuprofen or Tylenol a half hour before the plane takes off or lands, too. Many parents find that using a nasal decongestant spray before takeoff will help prepare the ear and nasal passages. Try to keep the baby awake if the flight is short because he doesn’t swallow as often during sleep and this will make it harder to keep the air pressure equalized in the middle ear.

What are middle ear infections?

Middle ear infections are referred to as ‘otitis media’ by doctors. This means inflammation of the middle ear. This is the presence of fluid and pus in the middle ear. The symptoms include pain, redness of the eardrum, irritability, and fever. When otitis media becomes chronic, this means that fluid has accumulated in the middle ear and an ‘effusion’ has developed. These types of infections occur during the first 2 to 4 years of a child’s life for many reasons. A child’s Eustachian tube is short and dysfunctional during the first years. The reason doctors distinguish the different types of otitis is because the treatment is different. Not all forms of otitis require antibiotics.

Children develop ear infections more frequently during the first couple of years of life because the Eustachian tubes are shorter and more horizontal than adults’. This lets the bacteria and viruses in more easily. The tubes are more prone to blockage, too, because they are less stiff and narrower. The adenoids are gland-like structures of the upper throat. They are large in children which cause them to interfere with the eustachian tubes. This leads to more ear infections. Also, bottle-feeding, day-care attendance, and exposure to cigarette smoke can all affect the ears of a child. They are also more common in boys than in girls and occur more in families where there is a history of this problem.

What are the signs and symptoms of acute otitis media?

The signs and symptoms of an ear infection range from very mild to severe. These include:

Ear Pain  - The fluid in the middle ear may push on the eardrum, causing the child to have ear pain. An older child may complain of an earache, but a younger child may simply pull at the ear or act irritable by crying more than usual.

Decrease in Appetite - Lying down, sucking, and chewing can cause painful pressure changes in the middle ear. This may make the child eat less than normal.

 Irritability and Trouble Sleeping – Due to the pain and the inability to eat, many children with ear infections have trouble sleeping and are quite irritable.

Drainage from the Ear - If the pressure from the fluid buildup is high enough, it can cause the eardrum (known as the tympanic membrane) to rupture. This results in drainage of fluid from the ear. This, in turn, releases pressure behind the eardrum, bringing relief from the pain to the child.

What are the signs of hearing difficulties due to otitis media? 

With an ear infection, fluid often builds up in the middle ear and also blocks out sound, reports Lawanna Brock. This leads to temporary hearing problems for the child. Be aware that otitis media with effusion often has no symptoms and the hearing could be normal.  With acute otitis media, the eardrum can block sound so there may be temporary hearing difficulties for the child. Other signs include:

• The child does not respond to soft sounds.
• The child turns up the television or radio really loud.
• The child talks really loud.
• The child appears to be inattentive at school.

Are ear infections contagious and how long do they last?

Ear infections are NOT contagious, although the child may have had a cold and this is contagious. Some ear infections are preceded by the presence of a rhinovirus (cold) or sinus infection (bacteria). These conditions are infectious, however. The duration of middle ear infections are around two or three days, usually. Sometimes a doctor will prescribe a 10-day course of antibiotics to be sure to eliminate the causative organism. It is important to note that even with a course of antibiotics, the fluid may remain in the middle ear for several months.

How do I prevent my child from getting an ear infection?

Some factors associated with the development of ear infections cannot be changed. These include a family history and a dysfunctional Eustachian tube. There are certain lifestyle choices that can be changed, however. These include:

• Avoidance of bottle-feeding. Breastfed infants have fewer or no ear infections. If you must bottle feed, hold the infant up at an angle rather than lying him down with the bottle in his mouth.
• Prevent exposure to secondhand smoke as much as possible. Smoking around the infant increases the frequency and severity of ear infections.
• Reduce your child’s exposure to large groups of children in areas such as child care centers. Multiple upper respiratory infections can lead to frequent ear infections for your child. By limiting this exposure, there will be less frequency of colds and fewer ear infections.
• Practice good hand washing, as this is one of the best ways to decrease person-to-person transmission of organisms that lead to ear infections.
• Keep your child’s immunizations up-to-date. Certain vaccines prevent ear infections, so it is important to keep these current.

What is ‘swimmer’s ear’?

Swimmer’s ear is called otitis externa by doctors. This is an infection of the ear canal, not the middle ear. It can be caused by bacteria or fungi and commonly occurs in children who spend a lot of time in the water. What happens with otitis externa is that too much moisture irritates and breaks down the skin in the ear canal, allowing for the fungi or bacteria to penetrate. Children do not have to swim to get swimmer’s ear either. Anything that causes the skin to break down can result in this infection. Some things that lead to this infection include dry skin, eczema, vigorous rubbing, the use of bobby pins in the ear canal, or the use of a cotton-tipped applicator. All of these things can lead to breakdown in the lining of the ear canal.

The primary symptom of otitis externa is ear pain. This tends to be severe and gets worse when the outer part of the ear is pulled or pressed on. It also may be painful for a child with otitis externa to chew, too. Sometimes the ear canal itches before the pain begins. Swelling of the ear canal causes an uncomfortable feeling in the ear. The inflammation leads to swelling of the lymph nodes around the ears, too. Many kids have smelly discharge from an infected ear. The pus can be cloudy or yellowish. Fever is common in some cases, too.

Can you prevent swimmer’s ear?

There are some over-the-counter drops that you can instill in the ear before and after swimming. These are used in the prevention of swimmer’s ear. These solutions are made of acetic acid or alcohol and are available at pharmacies. These should only be used in children who do not have ear tubes and when the parent knows there is no hole in the eardrum. Also, don’t use Q-tips or other cotton-tipped applicators in your child’s ears. Avoid putting any objects inside the ear canal and teach your child to do this also.

How is swimmer’s ear treated?

For most children, the doctor will prescribe antibiotic ear drops that are mixed with a steroid solution. This reduces swelling of the ear canal and wards off the infections. These are to be used several times per day for around seven days. If the swelling of the ear canal continues, the doctor may insert a cotton ‘wick’ into the canal to help carry the medicine up inside the canal. There are cases where the doctor must remove cerumen (wax) and pus from the canal to allow it to heal. Only in severe cases are oral antibiotic prescribed.