Otitis Media In Children

What is otitis media?

Otitis media is an ear infection. Your child may have an ear infection in one or both ears. Children are most likely to get ear infections when they are between 3 months to 3 years old. Ear infections are most common during cold and flu season, usually in the winter and early spring months. Children often have more than one ear infection.

What causes otitis media?

Your child may get an ear infection when his eustachian tubes become swollen or blocked. Eustachian tubes are tiny tubes that connect the middle ear to the back of the nose and throat. Eustachian tubes drain fluid away from the middle ear. Children with ear infections have a buildup of fluid and pressure in their ear. The ear may become infected by germs, which grow easily in the fluid trapped behind the eardrum.

Who is at an increased risk for otitis media?

• Children who go to day care or school.
  
  
• Children who live or play around people who smoke.
  
  
• Children whose brother, sister, or parent has had problems with ear infections.
  
  
• Babies who get their first ear infection before 6 months of age.
  
  
• Children born with conditions such as cleft palate or Down syndrome.
  
  
• Children who suck on pacifiers after 10 months of age.
  
  
• Children who drink bottles while they lie flat.

What are the signs and symptoms of otitis media?

The following may help caregivers diagnose an ear infection:

• Your child has a fever.
  
  
• Your child has ear pain. He may tug, pull, or rub his ear. He may not eat as much due to pain when he sucks, swallows, or chews.
  
  
• Your child is fussy and restless. He may also have trouble sleeping.
  
  
• Your child has pus or yellowish fluid coming out of his ear.
  
  
• Your child has trouble hearing. He may not hear quiet noises that he normally hears in the room. He may seem like he is not paying attention to you. He may try to sit very close to the TV or ask to turn up his music so it is louder.
  
  
• Your child may be dizzy or lose his balance.

How is otitis media diagnosed?

Your child's caregiver will look inside your child's ears. The caregiver may blow a puff of air inside your child's ears. These tests will tell caregivers if your child's eardrums look healthy. If your child's eardrum is infected, it will not move as it should. A tympanogram is another test that may be done. During the test, an ear plug is put into each of your child's ears to see how the eardrum moves. It can help your child's caregiver learn if your child has fluid in his middle ear.

How is otitis media treated?

• Medicines:
  
  
  • Antibiotics: Your child may be given antibiotics if he has an infection. Antibiotics help kill the germs that cause infection. Give this medicine until it is completely gone, even if your child feels better.
    
    
  • Ibuprofen or acetaminophen: These medicines are available without a prescription. They may decrease your child's pain and fever. Ask your child's healthcare provider to tell you the right amount of medicine to give to your child, and how often to give it.
    
    
  • Ear drops: This medicine may help treat your child's ear pain.
    
    
  • Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not helping, or if he has side effects. Tell your child's healthcare provider if your child is taking any vitamins, herbs, or other medicines. Keep a list of the medicines he takes. Include the amounts, and when and why he takes them. Bring the list or the pill bottles to follow-up visits.
    
    
  • Do not give aspirin to children under 18 years of age: Your child could develop Reye syndrome if he takes aspirin when he is sick. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  
  
• Surgery: Your child may need ear tubes if he has ear infections a lot. He may need them if he has fluid in his ears for a long time and it is causing hearing loss. The caregiver may do a surgery called a myringotomy. During a myringotomy, the caregiver will cut a small hole in your child's eardrum. The caregiver will put in a tiny tube to help fluid drain out of the ears. They may help keep your child from having ear infections and hearing loss.

What can I do if my child cannot hear well?

Ear infections can cause your child to have a short-term hearing loss. Your child's hearing may return to normal when the infection is gone. Sometimes ear infections lead to hearing loss. Hearing loss can cause your child to have problems with learning and speaking clearly. If you think your child's hearing does not fully return after an ear infection, tell his caregiver. Tests may need to be done to check your child's hearing.

What can I do to help prevent otitis media?

• If possible, breastfeed your baby. Your baby may be less likely to get an ear infection if he is breastfed.
  
  
• Do not give your child a bottle while he is lying down. This may cause liquid to leak into your child's eustachian tube.
  
  
• Keep your child away from people who smoke. Babies and children who are around smokers are more likely to have ear infections.
  
  
• Keep your child away from crowds. Germs are easily and quickly spread in daycare centers. Keep your child away from sick playmates. Try to keep him home if there is a cold or other infection going around the daycare.
  
  
• Wash your and your child's hands often. Wash with warm water and soap to help keep germs from spreading through your household.
  
  
• Vaccinate your child. Talk to your child's caregiver about the shots your child needs.

Call your child's caregiver if:

• Your child has a fever.
  
  
• You see blood or pus draining from your child's ear. This may be a burst (torn) eardrum.
  
  
• Your child is still not eating or drinking 24 hours after he takes his medicine.
  
  
• Your child still has signs and symptoms of an ear infection 48 hours after he takes his medicine.
  
  
• Your child has new problems that may be due to the medicine he is taking. These problems may include a new rash, nausea, or vomiting.

Seek care immediately or call 911 if:

• Your child seems confused or cannot stay awake.
  
  
• Your child has a stiff neck, and a fever.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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