Recurrent Ear Infection

Middle ear infections, technically known as otitis media, are the most common reason for children to see the doctor. In most cases, it's nothing to worry about. Sometimes, though, this common illness develops into a big problem if your child keeps getting recurrent infections. You should be aware of treatment options and possible complications.

Identification

• A middle ear infection is an inflammation of the ear behind the eardrum. It begins with cold or flu symptoms, and after a few days, your child develops pain in his ear. He'll probably have a fever between 100 and 104 degrees, and you may see yellowish or clear liquid draining from his ear. An infant with an ear infection will cry a lot and pull on his ear. An older child will be able to tell you his ear hurts. Most children outgrow their tendency to develop them by age five.

  Recurrent ear infection means your child keeps getting ear infections with periods of health in between. It's generally defined as three infections within six months or four to five infections in a year.

Causes

• Ear infections are caused by a swelling of the eustachian tubes, which connect the middle ear to the back of the throat. This swelling can be caused by a virus or bacteria or by allergens. Children with asthma or allergies are more prone to ear infections, as are children in day care. Other factors that increase a child's risk of ear infections are exposure to secondhand smoke and bottle feeding.

  The eustachian tubes lengthen and become more rigid as a child grows, making ear infections less common.

Treatment

• In many cases, the best treatment is to let the infection run its course. With doctors' concern over bacteria growing resistant to antibiotics, many don't prescribe antibiotics as often as they used to. Your child's ear infection should clear within two weeks. In the meantime, you can give him acetaminophen or ibuprofen to help with pain, or apply heat to the affected ear.

  If your child's ear infection is severe or recurring, your doctor will probably prescribe an antibiotic such as amoxicillin. Your child's pain should disappear in a few days, but make sure he takes the full course of antibiotics. In some cases of recurrent ear infections, your doctor may prescribe a daily dose of preventative antibiotic to ward off future infections.

  Children with recurrent ear infections may benefit from a vaccine. FluMist can help prevent ear infections by increasing immunity in the mucous membranes. For children over age two who have frequent ear infections, Pneumovax is often recommended. Infants with recurrent ear infections may get help from a vaccine called PNCRM7.

Surgery

• If your child's ear infection doesn't clear up with antibiotic treatment, or if your child is prone to recurrent ear infection, your doctor may recommend surgery. Myringotomy involves making a small cut in the eardrum and helps prevent future infections. A newer procedure, called OtoLAM, uses a laser to make small holes in the eardrum.

  Your doctor may recommend tympanostomy, commonly known as having tubes put in. This requires general anesthesia. The doctor will place a small tube into the ear to drain fluid that has built up over several months. The tube will eventually fall out on its own.

Warning

• While rare, it is possible for children with severe, recurrent ear infections to develop hearing loss. This may lead to speech delays and difficulty learning to read. Recurrent ear infections should never be ignored.