What Causes Ear Infection in Babies & Toddlers
What is an Ear Infection in Babies?
When viruses or bacteria infect the air filled space behind the eardrum and the inner ear called the middle ear leading to fluid build up or pus its called an ear infection. The fluid pushes on to the ear drum causing pain and muffled hearing sometimes which gets better as the infection subsides.
What Causes Ear Infections in Babies and Toddlers?
Ear infections are usually caused after a cold, flu or allergies where the bacteria or virus causes the nasal passage, throat and eustachian tubes to swell. The eustachian tubes connect the middle ear to the back of the throat and regulate air pressure in the ear. When swollen they don't function as they should and this leads to an infection in then middle ear.
The eustachian tubes function better in adults compared to children and also their immune system is still developing, as a result children are more prone to ear infections than adults.
Usually ear infections clear on their own and seldom cause any serious complications, but if your child seems in severe pain, discomfort then talk to your doctor who may prescribe antibiotics and pain killers based on your child's condition.
Symptoms of Ear Infections in Babies and Toddlers
Fever
Severe pain in the ear
Pulling or tugging at the ear
Dizziness
Refusing to eat or breast/bottle fed
Difficulty in sucking or swallowing
Trouble sleeping
Trouble hearing or temporary hearing loss
Fussy or more cranky than usual
White/Yellow / Brown discharge from the ear (ruptured ear drum)
Ruptured ear drum can cause dizziness, ringing in the ear, vomiting or nauseous, vertigo and pain that subsides. Ruptured eardrum usually heals on its own in a few weeks but to ensure its on course its best to talk to your doctor as in some cases it needs a patch or repair.
Complications of Ear Infections in Babies and Toddlers
Ear Infections don't usually cause any long term side effects or complications and and get better as the infection subsides. Occasionally they may cause temporary or permanent damage
Hearing Loss: Usually temporary and gets back to normal as the infection clears. Repeated ear infections that's are severe can cause permanent hearing damage, so ensure to get your child tested if you suspect ear infections that are frequent.
Torn Eardrum: Though most eardrums heal on their own in a matter of weeks and should cause any major damage sometimes they need to be repaired with a patch.
Infection Spread: In rare cases the infection spreads to other parts of the body like brain and spinal cord causing serious complications like meningitis that need immediate treatment and care.
Developmental delays: Repeated long ear infections can cause speech and language delays as child needs clear hearing to learn the sounds and words.
Diagnosis Ear Infections in Babies and Toddlers
The doctor can diagnose your child has an ear infection by doing a physical exam and they would also use an otoscope, an instrument with light to look at your child's eardrum.
If the eardrum looks inflamed, swollen red would indicate an ear infection and based on the severity your doctor would prescribe antibiotics or pain killers.
If your doctor feels a need for further tests he may ask for tympanometry (check for fluid in middle ear), tympanocentesis (drain the fluid and test for infection to treat) and or hearing tests to assess the impact.
Treatment of Ear Infections in Babies and Toddlers
Often the ear infection resolves on its own without a need for treatment. The doctor may wait and watch to see if it resolves on its own or for any signs of severe infection or ruptured ear drum to treat.
Treatment depends on severity, child's age, frequency of infection and if fluid doesn't drain on its own. Usually the doctor waits for three days to monitor if the infection is mild to moderate
Antibiotics: If the infection doesn't resolve on it's own and your doctor suspects it to be bacterial, he may prescribe a course of antibiotics to treat. Be sure to complete the course even if your child feels better.
Pain killers: In the child is in pain the doctor may prescribe ear drops or over the counter pain medicines to help.
Ear tubes: If the antibiotics and pain killers don't help and the fluid build up remains affecting hearing the doctor may refer to an ENT who would insert an ear tubes, small tubes made of plastic or metal into the eardrum to let air in and drain the fluid. The tubes remain and fall off on their own in 12 to 18 months, if not a surgery is needed to take them out. The ear drum heals completely after the tube is out.
How to Prevent Ear Infections in Babies and Toddlers
Maintain good hygiene and teach good hygienic practices to your child.
If possible avoid large day care centres with higher chances to catch a cold or an infection
Stay up to date on vaccinations
Breastfeed your child for 6 months to an year as antibodies in breastmilk can help prevent infections
Bottle feed in upright position or hold the head higher up than body to prevent milk from collecting in to eustachian tubes.
When to see a Doctor?
See your doctor immediately if your child displays any of the below symptoms.
Ear pain doesn't get better even after antibiotic treatment
Severe ear pain that doesn't let your child eat or sleep
Child's walk is unsteady or wobbly
High grade fever that won't get better
Pus or Brown/ bloody discharge from the ear
Stiff neck and swelling