Why Your Child Gets an Earache

Other than the common cold, an ear infection is the most diagnosed childhood illness in the United States. One third of all children have at least one ear infection by the time they reach age 3.

The ear has three parts and a complicated set of waves and vibrations responsible for hearing and balance. It isn't necessary to completely understand the workings of the ear to understand what is happening when your child complains of pain in his ear.

What is involved in most earaches is the middle ear. To function properly, the middle ear needs to have the same pressure as the outside world. A tube called the Eustachian tube takes care of this pressure balance. The Eustachian tube is a small passage that connects the middle ear to the back of the throat behind the nose.

This tube allows air to reach the middle ear to equalize pressures. The 'pop' that is heard sometimes when yawning or swallowing is the Eustachian tube adjusting the pressure in your middle ear. If this tube malfunctions and becomes blocked by congestion and mucus due to a cold or an allergy, fluid builds up inside the middle ear. Bacteria or viruses also get trapped in the middle ear. The germs breed in the trapped fluid and this infection is what causes an earache.

Your doctor may refer to this infection in the middle ear as Otitis Media. When there is fluid and pus in the middle ear, there will be symptoms of pain, redness of the eardrum and probably, fever. This is called acute otitis media. This is the most common form of earache.

Children have ear infections frequently during the first two to four years of life due to several things. A child's Eustachian tubes are shorter and more horizontal than adults and this allows bacteria and viruses to enter the middle ear more easily. Also, a child's Eustachian tubes are narrower and less stiff which makes them easier to block.

The adenoids (gland-like structures in the back of the throat) are large in children and can interfere with the opening of the Eustachian tubes.

Children's immune systems aren't fully developed until around the age of 7 so they have more trouble fighting infections.

Many things contribute to your child getting an ear infection. One of the most commons ones is when a child is exposed to cigarette smoke. Also bottle feeding can contribute to earaches as well as being around other children at day care situations. Ear infections are more common in boys and are more common in children whose families have a history of ear infections. The winter season is when most ear infections occur because colds and upper respiratory tract infections are more frequent.

Watch for the following signs and symptoms in your child:

Pain. An older child may complain of ear pain but a young child may tug at the ear, be unusually irritable and cry more than usual.

Because lying down, chewing and sucking can also cause painful pressure changes in the middle ear, you may notice that your child is eating less or having trouble sleeping.

If the pressure builds up high enough, the eardrum may rupture resulting in drainage from the ear. When this happens, it usually brings relief from the pain.

Loss of balance. Your child may complain of feeling dizzy or you may notice that he is wobbly or walking funny.

Your child may have trouble hearing due to the fluid buildup in the middle ear, so watch for symptoms of not responding to sounds, turning up the TV or radio louder than usual, talking louder and appearing to be inattentive in school.

Also your child may have a fever, nausea and/or vomiting.

Ear infections are frequently associated with upper respiratory tract infections so watch for symptoms of runny or stuffy nose or cough. Ear infections are not contagious but the cold that may lead to one can be.

Usually middle ear infections go away on their own within 2 or 3 days, so many physicians are now taking the 'wait-and-see" approach where they recommend giving the child pain medication without antibiotics for a few days. However, in children who get a lot of ear infections, the physician may prescribe a long-term course of antibiotics to help prevent future infections. Young children with more severe illness may require antibiotics too.

Another approach for children with persistent earaches associated with hearing loss or speech delay is ear tube surgery. A physician surgically inserts tubes (called tympanostomy tubes) in the tympanic membrane to allow fluid to drain from the middle ear and help equalize the pressure because the Eustachian tube is not able to.

There are several things to do to minimize the development of ear infections:

Breastfeeding infants for at least 6 months. If a child is bottle-fed, fed the infant at an angle rather than lying down.

Avoid exposing your child to secondhand tobacco smoke.

Reducing your child's exposure to large groups of children.

Practice good hand-washing for both parents and children.

Keep children's immunizations up-to-date.

If you suspect your child has an ear infection, check with your physician. Untreated otitis media can lead to more serious complications.

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