Middle Ear Infection in Infants

Middle-ear infections, or otitis media, are extremely common in infants and toddlers. Sometimes they can lead to more serious intervention, like surgery, but for most babies, they are temporary illnesses that can be easily treated.

Causes

• Bacteria or viruses usually cause ear infections, but sometimes allergies can lead to infections also. In their book, "What to Expect the First Year," authors Arlene Eisenberg, Heidi E. Murkoff and Sandee E. Hathaway write that babies are especially susceptible to middle ear infections. The Eustachian tubes, which drain fluids and mucus from the ears down the back of the nose and throat, are shorter in a baby, so germs can easily travel through them into the middle ear. This is especially true because babies spend a lot of time lying on their backs. Infants' tubes are also horizontal rather than vertical, like adults', so drainage is poor. Additionally, the short length of babies' tubes makes them more subject to blockage. When the fluid can't drain normally, it builds up, creating a perfect breeding place for infection-causing bacteria.

Symptoms

• Ear infections can be painful, and because babies can't tell us what's bothering them, they often get unusually fussy. Many infants pull or rub their ears when they are hurting. According to Eisenberg, Murkoff and Hathaway, sometimes, the pain radiates to the jaw and makes sucking uncomfortable, so infants might cry during feedings. Ear infections are often accompanied by fever, but not always. Occasionally, babies with ear infections have nausea, vomiting and loss of appetite. Many little ones with ear infections show no obvious symptoms at all, and the infection only becomes apparent when a doctor peers into the baby's ear. Upon examination, an infected eardrum appears red and bulging. Without treatment, pressure can burst the eardrum, releasing pus into the ear canal.

Treatment

• According to the authors of "What to Expect the First Year," ear infections require medical treatment and cannot be healed at home. A pediatrician can prescribe antibiotics to eliminate the bacterial infection as well as an anti-inflammatory drug to reduce swelling. Children's ibuprofen or acetaminophen can be administered to relieve pain. A decongestant also can help open a blocked tube and eliminate sinus drainage, which often precedes and complicates the ear infection, but these should only be given to infants if prescribed. Sometimes, doctors also prescribe eardrops. Heat applied to the ear in the form of a warm compress or heating pad set on low can reduce pain. Babies or young children who have chronic ear infections can be treated with a myringotomy--minor surgery to drain infected fluid from the ear--or insertion of a tiny tube to drain fluids.

Prevention

• Eisenberg writes that there is no surefire way to prevent ear infections, but parents can take some steps to reduce risks. The first of these is overall good health including good nutrition, plenty of sleep and regular medical checkups. Breastfeeding for at least three months will build up a newborn's immunity. When a child has a cold, feeding him in an upright position and elevating his upper body while sleeping (place a few pillows under his mattress, never in the crib) will prevent sinus drainage from collecting in the ears. For babies with allergies, decongestants can prevent sinus drainage (ask your doctor before administering). Doctors don't believe that ear infections are contagious through direct contact, but babies who attend daycare seem to be more vulnerable.

Warning

• A foreign object in the ear, swimmer's ear and symptoms of a respiratory infection can mimic an ear infection, so it's absolutely necessary to see a doctor for a proper diagnosis. Serious ear infections can lead to hearing loss, so it's important to get your child treated as soon as you notice symptoms.