Earaches are kid's stuff

Sep 28, 2007 at 9:29 p.m. ET

The end of summer means back to school -- and back to daycare -- for millions of American children. For many of these children, it also means back to ear infections.

Child with ear infection at doctor

A common ailment
Officially called otitis media, middle ear infections may be the most common childhood ailment and one of the most common reasons for doctor visits, medication and time lost from work. About two out of three children have at least one ear infection before their third birthday, and half have three or more infections before turning three.

Many children with recurring ear infections require doses of preventive antibiotics or ear tubes to prevent further infections. Without these precautions, children may have delayed speech and language development and may have trouble in school if they miss a lot of class or can't hear the teacher.

"This is the time of year when we start seeing more ear infections, because children are exposed to more bacteria and viruses once they are in school or daycare," says James Hicks, MD, an otolaryngologist with The Austin Diagnostic Clinic. "That's especially true among infants and toddlers in a daycare with four or more other children." Hicks notes that ear infections have been on the rise in recent years. The number of ear infections reported in children rose by 44 percent during the 1980s. Doctors believe this is largely because most parents work outside the home and put their children in daycare. Children who have multiple ear infections at a young age are more likely to continue having them.

Important precautions
Children in daycare have a greater risk of ear infections because they are exposed to a greater variety of bacteria and viruses that can cause respiratory infections. When a child is congested, fluid accumulates in the ear drum. In older children and adults, the fluid easily drains away through the eustachian tube. However, in young children, the eustachian tube is small, narrow and easily blocked, allowing fluid to build up in the ear drum and cause painful pressure and decreased hearing.

"The problem for many children is that they go right from one ear infection to another. It can take several months for fluid in the middle ear to clear up, and during that time, children are susceptible to follow up infections," he says. "Children with recurrent ear infections tend to develop speech and language skills more slowly because their hearing is affected. However, permanent hearing loss rarely occurs because of ear infections."

Most parents are familiar with the symptoms of ear infections -- fever, irritability and fussiness, sleeplessness, loss of appetite, and tugging on the ears. Acetaminophen (Tylenol) or a similar pain medication can ease the symptoms until the child sees a doctor. Since about 85 percent of ear infections are caused by bacteria, doctors usually prescribe an antibiotic that will kill the bacteria within a week. It is important for parents to continue using the medication as prescribed even if the child feels better. "One of the most common reasons for repeat infections is that parents stopped giving the antibiotic too soon," he says.

Hicks recommends taking preventive steps to keep children from developing ear infections. "The best way to stop ear infections is to keep children from being exposed to so many bacteria and viruses. That means keeping infants away from daycare as long as possible, and choosing as small a daycare group as possible."

Other important steps include breastfeeding instead of bottle-feeding and not exposing children to cigarette smoke. "These precautions are no guarantee that a child won't ever get an ear infection, but they should limit the number and severity of infections," he says.

Risk factors for ear infections

  • Being around cigarette smoke
  • Being in daycare
  • Being born premature or having a low birth weight
  • Being bottle-fed instead of breastfed
  • Having a personal or family history of ear infections
  • Being a boy