Ear Infections (Otitis Media) and Hearing Loss in Young Children

What is Otitis Media?

Ear infection, also called otitis media or inflammation of the middle ear, is an infection of the part of the ear behind the eardrum. Next to the common cold, otitis media is the most common illness diagnosed during childhood. It’s also one of the most common reasons for the prescription of antibiotics and other medications to children.

Who gets it and how?

Middle ear infections are common in children between the ages of 1 month and 6 years, and most common under age 3. Ear infections can run in families, and boys are more affected than girls. Some children develop ear infections a few days after a cold starts. Some children have one infection after another, whereas others never have any. Conditions that increase a child’s risk of ear infections are frequent colds, allergic runny noses, bottle propping, exposure to smoke and attendance in group settings such as child care.

What are the signs and symptoms?

Symptoms result from swelling of the middle ear. The child may cry persistently, tug at the ear, have a fever, have trouble sleeping, be irritable and have hearing problems. When infection occurs, pus develops, pushes on the eardrum, and causes pain and often fever. Sometimes the pressure is so great that the eardrum bursts and the pus drains out into the ear canal. Although this yellow-white discharge may frighten parents, the child feels better and the hole in the eardrum will heal over. Sometimes the child may have diarrhea, nausea and vomiting.

What are the complications?

Most of the time ear infections clear up without causing any lasting problems. However, if not treated, otitis media can cause problems such as hearing loss, infection of the inner ear, and even meningitis. Fluid may remain in the ear as long as six months after an infection is gone.

When should a child be excluded?

Since ear infections themselves are not contagious, there is no reason to exclude the child from your facility unless he or she has a high fever, cannot participate in activities because of pain, or needs more care than you can give without compromising the care given to other children.

How can reduce ear infections?

Prevent the spread of colds and other upper respiratory infections which may lead to otitis media.
Practice good hand washing.

• Teach children to cough into their elbow and away from people.
• Wipe noses with clean tissues, dispose of them properly and wash your hands.
• Don’t share food, bottles, toothbrushes or toys that can be put in the mouth.
• Play outdoors often. Let fresh air into your program daily.

How do I care for children who get frequent ear infections?

• Never use cotton swabs and never put anything smaller than your finger into a child’s ear. Do not allow the child to do so either.
• Do not feed or bottle-feed infants lying on their backs. Never prop bottles while feeding.
• Be especially alert for any sign of hearing or speech problems that may show up. Refer the child to the family’s health care provider or other community resources.
• Be sure that prescribed antibiotics are taken for the full amount of time to avoid resistant infections.

How do I care for children with ear tubes?

An ear tube creates a hole in the eardrum so fluid and pus may drain out. It usually stays in for three to six months. Since pus can drain out, water from the outside world (which has germs in it) can also run into the middle ear easily. Therefore, you must be very careful that children with tubes do not get water in their ears. This usually means no swimming unless there are special earplugs and permission from the health care provider. Watch for any sign of hearing or speech problems.