Inner Ear Problems in Children

Although ear infections are common in young children, they are not always easy to treat. Pediatricians see a lot of kids with this problem, especially youngsters under the age of 2. While some children suffer repeated bouts of ear infections, inner ear infections are usually more common than infections involving the outer ear. Fortunately, parents can do their part to help to prevent ear infections and related complications by being aware of the risk factors.

Risk Factors

• A child is more likely to suffer recurrent ear infections if someone else in the family; particularly a parent or sibling has a history of ear infections. Being around a large group of children such as in a day care setting is another major risk factor, as children are repeatedly exposed to colds and other viruses. Breathing in tobacco smoke can cause ear problems as well. It is not uncommon for a child to be more prone to ear infections when one or both parents smoke. Laying a baby down to drink a bottle is something that also should be avoided.

Symptoms

• The symptoms of a middle ear infection, also known as acute otitis media, include fever, irritability, crying, loss of appetite, trouble sleeping and tugging or rubbing at the ears. Constant crying, general irritability and disrupted sleep patterns are all signs that a child may be experiencing pain. White or yellow pus draining from the ear is another sign of infection, although pain may decrease once pressure is released as fluid in the ear begins to drain. Ear infections frequently occur within a short time following a cold or other upper respiratory infection, the result of inflammation that causes fluid to build up behind the eardrum.

Treatment

• Some ear infections go away by on their own, but frequently antibiotics are needed to clear the infection. Because the bacteria that cause ear infections can be resistant to antibiotics, ear infections can be difficult to treat. Resistance occurs most often in younger children who have recently been on antibiotics or who were exposed to other children who were on antibiotics. In these cases, a pediatrician may choose to prescribe a combination of drugs, including a regular antibiotic and another medication to fight the resistant strain of bacteria. Antibiotics may also need to be taken for a longer period of time. Although fluid in the ear eventually clears up on its own, it can take several months. Your child's pediatrician may choose to drain the fluid, especially if pain is severe.

Pressure Equalization (PE) Tubes

• Children who suffer recurring ear infections may need to have tubes placed in their ears. Tubes normally remain in the ear for a year or two before being removed. Placement involves an outpatient surgical procedure under a general anesthetic. In some cases, complications do occur. There may be drainage from the ear or perforation of the eardrum. Your pediatrician may refer your child to an ENT specialist for evaluation if he has had more than six ear infections in a period of one year.

Other Symptoms

• Other less common symptoms to watch for include ear infections that occur during the summertime months, loss of balance, what appears to be clumsiness, and even subtle changes in a child's behavior. As children grow older, ear infections tend to become less common. However, in cases of persistent ear infections, hearing loss can occur. Take notice if your child begins to sit closer to the television, does not seem to be paying attention to you when you talk, or starts to talk louder than normal. Complaints of dizziness can be another sign of ear problems. Parents should instruct children to say something if they are not feeling well.

Prevention

• According to the American Academy of Pediatrics Guidelines for ear infections, the condition most often occurs in children between the age of 3 months and 3 years old. If your child suffers from chronic ear infections, keep her away from other children who are sick. Ear infections cause the Eustachian tube to swell, making it easier for fluid and mucus from a cold or upper respiratory infection to collect inside. Position a baby so that her head is above her stomach when breastfeeding or bottle-feeding. Milk can carry viruses and bacteria from the baby's mouth to the back of the throat to the middle ear by way of the Eustachian tubes. Since breast milk protects a baby's immune system, breast fed infants are less likely to have ear infections. Wean your child from the pacifier before her first birthday, as Finnish researchers found that pacifier use increases the frequency of ear infections in babies older than 6 months. Results of the study were published in a 2000 issue of Pediatrics.

Warning

• While complications from ear infections rarely occur, hearing can be affected, which could lead to speech problems in younger children. Other possible problems include facial paralysis, mastoid infection or scarring of the eardrum. Mastoid infections often occur when a middle ear infection goes untreated. Parents should speak to their child's pediatrician, especially if an infant younger than 6 months old experiences multiple episodes of ear infections.