Understanding ear infections in babies and toddlers

As a child, I remember ear infections as a time when I got to drink some pink medicine and stay home from school. However, with our first child due in a few weeks, I’m combing through new-parent literature and am discovering that ear infections can actually have serious, long-term complications. Is this true? What causes ear infections, and is there anything I can do to prevent them?

Five out of six children will have at least one ear infection by their third birthday. In fact, ear infections are the most common reason parents bring their child to a doctor. Ear infections can make your child very uncomfortable, but they usually aren’t an emergency.

As you are discovering in your research though, it is important to keep a watchful eye for the symptoms of an ear infection, and make sure that the condition is monitored and treated appropriately.

Ear infections usually start with another illness, such as a cold or sinus infection, that causes swelling in one of the thin passages that connect the middle ear to the throat. These passages, called the eustachian tubes, are responsible for keeping pressure from building up by letting air move in and out of the middle ear. When bacteria or viruses from an illness become trapped in a swollen eustachian tube, an ear infection can be the result. For children aged 3 and below, the eustachian tubes are very small, and less able to keep germs out, which is the reason ear infections are so common in infants and toddlers.

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If babies could speak, they would let their parents know when they’re experiencing symptoms that typify an ear infection — including ear pain, trouble hearing, and popping or ringing in the ears. Since it will be some time before your baby can elaborate on his or her ear woes, it’s important to keep your eyes peeled for the telltale signs of an ear infection. These may include fever, fluid draining from the ear, unresponsiveness to quiet sounds, a sudden change in mood or increase in fussiness during a cold or other respiratory infection, an unwillingness to lie flat, or night-waking more frequently.

If these signs and symptoms last longer than a day, call a doctor, who can examine your child’s ears and make the proper recommendations. Treatment for ear infections may consist of antibiotics (such as “the pink stuff” — amoxicillin) and, if your baby is more than 6 months old, an over-the-counter pain reliever such as Tylenol or ibuprofen. If antibiotics are prescribed, make sure the child takes the entire prescription, or the infection may recur. Chronic ear infections are rare, but left unaddressed, they may lead to fluid, swelling, or an infection behind the eardrum that does not go away or keeps coming back, which may cause long-term or permanent damage to the ear.

While it’s impossible to eliminate your child’s risk of developing an ear infection, there are some good ways to tip the odds in your favor.

Keep your baby up to date on vaccines, breast-feed your baby for a minimum of six months, and make sure your baby is never near tobacco smoke. Aside from reducing the chances of an ear infection, each of these are beneficial practices in their own right.