Ear Infections - A guide to Hearing Loss

Children are prone to coughs, colds, stomach upsets and ear infections especially at a very young age. Most if not all children will have experienced an ear infection at least once in their lives but it’s not uncommon to have repeated infections. Around half of all children will have several ear infections in the first three years of their life. But all children grow out of ear infections by the age of eight or so. Ear infections are caused by bacteria and viruses which are highly contagious and spread through the air or from personal contact. A head cold often turns into an ear infection.

Another factor is passive smoking. A child who is exposed to ‘second hand smoke’is more prone to ear infections than a child in a smoke free environment.

There are two types of ear infection: otitis media (middle ear) and otitis externa (outer ear). Otitis media is much more common than otitis externa.

Babies and ear infections

A newborn baby has some protection against ear infections and infections in general which is mainly due to the presence of antibodies which passed to the baby before birth, via the mother’s placenta.

This immunity is further boosted if the mother breastfeeds (which is why this is strongly encouraged) and lasts for about six months. After six months the baby becomes susceptible to illness or infection.

Young children and ear infections

Ear infections are prevalent at this age which often coincides with their attendance at a nursery or when they start primary school. Once they are in the presence of other children then bacteria and viruses easily spread from one child to another, often from coughing and sneezing, or from physical contact.

And linked to this is the fact that the immune system in young children isn’t as well developed as an adult’s which means that they are open to picking up any illness or infection that happens to be going around.

If your child has just started at nursery then don’t be surprised if he/she develops colds or ear infections on a regular basis which he/she will then pass on to you!

With ear infections another factor here is that the mechanism of the middle ear: the Eustachian tube is smaller and flatter than an adult and is less effective at preventing access from bacteria and viruses. This enables these triggers for infections to easily pass from the nose to the middle ear.

How does an ear infection develop?

Once a virus or bacteria reaches the middle ear they inflame the soft tissues lining the Eustachian tube. These tissues produce a viscous fluid to fight off the infection which fills this tube and increases pressure on the ear drum.

This increased pressure causes the ear drum to tighten which results in pain and discomfort.

The ears will feel ‘blocked’ and hearing is muffled.

Symptoms of an ear infection

These include pain, fever, nausea (and possibly vomiting), earache, red face, loss of appetite and generally feeling unwell. A toddler or baby will be unable to communicate this clearly and will show their distress by persistent crying and pulling their ears.

Pressure within the middle ear can build up to the point where the ear drum bursts, releasing a nasty smelling discharge from the ear. This is entirely normal and the ear drum will heal naturally over a period of time. Hearing may start to improve as the infection drains away although it can still be a little muffled. It can take up to a month before it returns to normal. A middle ear infection such as otitis media comes in two forms:

  • Acute otitis media
  • Chronic otitis media

The acute version is a short term infection and is usually a ‘one-off’ type of infection.

Chronic otitis media is the name given to repeated ear infections and in some cases, surgery may be required to drain off the fluid.

Most ear infections such as acute otitis media, tend to clear up after three to four days and don’t require any medical treatment. If your child has pain and a fever then you can give him/her paracetamol such as Calpol or junior Ibuprofen which will reduce these symptoms but check with your pharmacist first.

Treatment of an ear infection

You can treat the ear infection at home by doing the following:

  • Give the child paracetamol on a regular basis. If this doesn’t seem to help then junior ibuprofen will help as long as your child isn’t allergic to either of these.
  • Place a warm (not HOT) towel against the infected ear.
  • Give the child fluids to sip on a regular basis.

But if symptoms persist, worsen or your child is aged under two then see your GP. Contact your GP if your child gets ear infections on a regular basis as these may be symptomatic of an underlying problem.

If the ear drum bursts then this will cause fluid to pour away from the ear. This is a good thing in that it will immediately relieve the pressure and pain. You can then use a cotton wool ball to clear away any excess fluid but do not use a cotton wool bud to clear any discharge near the ear drum itself.

Avoid getting water into the ear during bath time and make sure that your child wears a swimming cap at your local pool.

The ear drum normally heals on its own accord but if it hasn’t after a month then see your GP.

GP visit

Your GP will ask about your child’s symptoms and will examine his/her ears using an instrument called auriscope. This enables him to see inside the middle ear to check for signs of an infection and to ascertain the condition of the ear drum as well.

If your GP feels that antibiotics are necessary then this will prescribed in the form of ear drops or tablets.

GP’s can be reluctant to prescribe antibiotics on the grounds that in most cases, the infection clears up by itself or to prevent bacteria becoming resistant to this medication. Plus there is also the fact that antibiotics have side effects such as sickness and diarrhoea which can be unpleasant. If your child has chronic otitis media then your GP may recommend grommets. These small tubes are inserted into the ear drum to allow fluid to drain off from the middle ear. He or she may also look at possible causes of these infections such as passive smoking, swollen adenoids or an allergy or refer you to an ear, nose and throat (ENT) specialist for further investigation.

Complications are rare but there is a risk that acute otitis media can lead to mastoiditis in which the infection spreads to the mastoid bone.

Your child’s hearing may be slightly muffled even when the infection has cleared up but this will return to normal. If there is still a problem with hearing then this may be due to the fact that not all the infection has cleared (fluid drained away) or your child has developed ‘glue ear’.

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