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Your child has a bothersome cold for a week. Her nasal discharge turns a little green and her cough starts to keep you all up at night. Then one night she is up every hour extremely fussy with a fever. You take her into the doctor in the morning almost certain she has another ear infection.
Ear infections are one of the most worrisome illnesses for both parents and children to go through, especially if they frequently recur. They also are the most common reason for antibiotic prescriptions. Here's a guide to help you understand why ear infections occur, how to best treat them, and most importantly, how you can prevent them from happening too often.
Your child may have 2 or more of these symptoms:
1. No cold symptoms – if your child has some of the above symptoms but does not have a cold, an ear infection is less likely, unless your child has had an ear infection in the past without a cold.
2. Pulling at the ears or batting the ears in infants less than 1 year of age. Infants less than one are unable to precisely localize their ear pain. This means that they cannot tell that the pain is coming from the ear or from structures near the ear. Infants can pull on or bat at their ears for two other common reasons:
3. No complaints of ear pain in a child who is old enough to tell you, usually by age two or three.
DR. SEARS ADVICE
Are you tired of taking your fussy baby into the doctor just to check her ears, only to be told its probably just teething? TO help you decide, with teething:
Anatomy lesson. The ear is divided into three parts: the outer ear canal, the middle ear space where infections occur, and the inner ear where the nerves and balance center are. A thin, membranous eardrum divides the outer and middle ear. The middle ear space is also connected to the back of the nose via the Eustachian tube.
Immature Eustachian tube. In infants and young children this tube is much shorter and is angled. It is therefore much easier for bacteria to migrate from the nose and throat up into the middle ear space. As the child grows this tube becomes more vertical, so germs have to travel "up hill" to reach the middle ear. This is one-reason children "outgrow" ear infections.
Colds. When your child has a cold, the nasal passages get swollen and mucus collects in the back of the nose. This environment is a breeding ground for the bacteria that normally live in the nose and throat to begin to overgrow. Mucus is also secreted within the middle ear space just as it is in the sinuses.
Bacterial invasion. Germs migrate up through the Eustachian tube and into the middle ear space where they multiply within the mucus that is stuck there. Pus begins to form and soon the middle ear space is filled with bacteria, pus and thick mucus.
Ear pain. This pus causes the eardrum to bulge causing pain. It is this red, bulging pus-colored eardrum that the doctor can see by looking into the ear canal.
Diminished hearing. The discharge that collects in the middle presses on the eardrum preventing it from vibrating normally. This is what the doctor means by "fluid in the middle ear." Also the fluid plugs the eustachian tube and dampens the sound like the sensation in your ears during air travel.
Avoid antibiotic resistance - But doctor, amoxicillin doesn't work for my child, and it's so hard to give it to her three times a day! Can I please have the once a day for only five days stuff? Be careful about doing this. Always taking a stronger, more convenient antibiotic can make the bacteria that dwell in your child more resistant to the stronger antibiotics, and can make future infections more difficult to treat. Even if amoxicillin hasn't worked once or twice in the past, chances are that this new infection is a different bacteria that is sensitive to amoxicillin, especially if more than two months have passed since the last antibiotic. The good news is amoxicillin now comes in a twice-a-day form, and treatment is usually only seven days, not ten.
When to use a stronger antibiotic – it is usually best to start out with the simple amoxicillin. Here are some reasons to go with something stronger:
No, they are not absolutely necessary, but they are very helpful for several reasons:
Side effects can include:
CLICK ON SIDE EFFECTS OF ANTIBIOTICS FOR AN IMPORTANT DISCUSSION ON HOW TO MINIMIZE THE SIDE EFFECTS OF ANTIBIOTICS
There are two components of ear infections that need to resolve:
Most doctors will have you follow up anywhere from one to four weeks after an ear infection. There are several reasons for this:
IMPORTANT NOTE: Try to avoid over-treating with unnecessary repeated courses of antibiotics. At your follow-up visit with your doctor, there may still be fluid in the middle ear. If the ear is not red or bulging, and your child is acting fine, you may not need another course of antibiotics. Doctors will vary in how aggressive they like to treat ear fluid. You may be able to spare your child from an unnecessary course of antibiotics.
As stated above, sometimes it can take several months for the fluid to drain out of the middle ear space. During this period the hearing can be muffled. This isn't dangerous and does not cause permanent hearing loss. Thankfully, the fluid often drains out within two or three weeks. There are several situations, however, when you do need to worry about this fluid in the ear:
If your child has had several ear infections already, or you simple wish to lower her risk of getting them in the first place, here are some ways to prevent or at least lessen the frequency and severity of ear infections:
1. Breastfeeding. There is no doubt whatsoever in the medical literature that prolonged breastfeeding lowers your child's chances of getting ear infections.
2. Daycare setting. Continuous exposure to other children increases the risk that your child will catch more colds, and consequently more ear infections. Crowded daycare settings are a set up for germ sharing. If possible, switch your child to a small, home daycare setting. This will lower the risk.
3. Control allergies. If you think allergies are contributing to your child's runny nose and, consequently, ear infections,click on allergies to find out more about how to minimize your child's allergies.
4. Feed baby upright. Lying down while bottle-feeding can cause the milk to irritate the Eustachian tube which can contribute to ear infections.
5. Keep the nose clear. When a runny nose and cold start, do your best to keep the nose clear by using steam, saline nose drops, and suctioning. See colds for more info on this.
6. Cigarette smoke. There is strong evidence that smoking irritates baby's nasal passage, which leads to Eustachian tube dysfunction.
7. Echinacea - this is an herb which can safely and effectively boost the immune system. Click here for more information.
8. Chiropractic care - I firmly believe that chiropractic adjustments to the skull and neck can improve middle ear drainage and decrease ear infections.
9. Eat more raw fruits and vegetables - these can greatly boost your child's immune system and help fight off infections. If you have a picky eater, click here to read how Juice Plus can provide this nutrition for your child.
If your child is having frequent ear infections, more aggressive prevention may be indicated. There are different opinions as to the definition of chronic ear infections. How many is too many?
There are three forms of medical prevention:
While ear tubes do have their place in treating recurrent ear infections, there does exist some controversy over their use. The advantages are listed above. Some common concerns about tubes are: