American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

Preventing and Treating Middle Ear Infections

Boy with earacheRemember to consult your physician if the signs and symptoms of ear infection exist especially when following a cold. Infants and children are more susceptible to bacterial middle ear infections when previous virus or colds are present first.

"It can be a cold, a throat infection or even an allergy attack that may set up an ear infection," explains Craig Wax, DO, an osteopathic family physician practicing in Mullica Hill, N.J. "The tubes that connect the middle ear to the throat, called the Eustachian tubes, can become blocked and trap fluid that would normally drain from the middle ear. This buildup can cause discomfort or pain. This fluid then becomes a favorable environment for bacteria or viruses to breed."

Dr. Wax explains that fluid build-up may lead to severe middle ear infections. Preferably, he suggests seeking medical attention when the fluid build-up becomes an ear infection. However, initially this stage may be difficult to identify in children, as some do not show any symptoms at all.

Symptoms of Fluid Build-Up

"Some common symptoms that can indicate a build-up of inner ear fluid are pressure in the ear or hearing popping or ringing sounds," explains Dr. Wax. "With younger children, you may notice them rubbing or pulling their ears to relieve the pressure."

Dr. Wax identifies loss of hearing, balance problems and dizziness as other symptoms of build-up. However, he cautions that hearing loss can also be difficult to identify in children. Instead he recommends looking for absent-mindedness or inattentiveness to alert you of potential hearing problems. Children may also seem grumpy or cranky.

Middle Ear Infections

In severe cases, the fluid in the middle ear builds and increases pressure on the eardrum until it ruptures. Once it ruptures, the fluid drains, and the pain usually subsides. The hole in the eardrum will usually heal by itself in a few weeks. However, if the eardrum does not release the fluid trapped within the tubes, a middle ear infection can worsen. Yellow, clear or bloody discharge can mean the eardrum has ruptured. Symptoms of middle ear infections include:

  • Mild to severe ear pain

  • Yellow, clear or bloody discharge to signal that the eardrum has ruptured

  • Fever

  • Thick and yellow discharge. Blood in this fluid can mean the eardrum has ruptured

  • Loss of appetite, vomiting and grumpy behavior

  • Trouble sleeping

  • Signs of inattentiveness or loss of hearing

"Most patients experience the symptoms of a middle ear infection two to seven days after a cold or respiratory infection," explains Dr. Wax. "If the symptoms of the infection last longer than a week, you should seek medical attention."

Dr. Wax states that 80% of ear infections get better without treatment. However, he recommends immediately visiting a physician if your child suffers from fluid build-up or middle ear infection symptoms, particularly children younger than three years old.

Preventing Ear Infections

As an osteopathic physician, Dr. Wax offers the following recommendations to prevent ear infections:

  • Wash your hands and your child's hands frequently.

  • Do not let babies and toddlers put unclean or inappropriate things in their mouth.

  • Avoid smoky environments. Ear infections are more common in people who are around cigarette smoke. Do not allow anyone to smoke in your home or car.

  • Breast-feed your baby if possible. Research indicates that breast-feeding helps reduce the risk of ear infections, particularly among children with a family history of ear infections. However, if breast-feeding is not an option, avoid bottle-feeding the baby while he or she is lying down.

  • Immunize your child. While immunizations do not prevent ear infections directly, they can prevent illnesses like the flu that often lead to ear infections.

  • Discontinue use of a pacifier. Babies who use pacifiers after 12 months are more likely to develop ear infections.  

 

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