Childhood illnesses: The ears have it

When it comes to ear infections, the Boy Scouts had it right: Be prepared. After the common cold, an ear infection is the most common childhood illness, according to the American Academy of Pediatrics.

Most children have had at least one ear infection by the time they are age three. And the younger a child is at the time of first infection, the more likely he is to have infections again.

Babies are especially likely to get them because their Eustachian tubes are short. Eustachian tubes in the ears drain fluid that accumulates from colds, sinus infections and allergies. If the fluid can't drain, it gets trapped in the middle ear and becomes a home for bacteria to grow. Once infection sets in, so does pain and fever. As children grow, these tubes get longer and better able to drain fluid.

If you suspect your baby has an ear infection, call your doctor and have your child's ears examined. Untreated infections can lead to hearing loss and scarring. In rare cases, untreated ear infections can lead to infections of the skull or brain.

Watch for these signs of infant ear infection:

Baby pulling on an ear (may signal pain)

Diarrhea

Poor appetite. The ear infection can cause tummy upset or make it painful for baby to swallow milk from either bottle or breast.

A nasty odor coming from the ear

Yellow or white fluid draining from the ear

Irritability and crying in a normally cheerful baby

Difficulty hearing

Antibiotics often, but not always, recommended

It used to be that doctors routinely prescribed amoxicillin, known by many parents as "the pink stuff," for ear infections. It's still true that where babies are concerned, doctors are more likely than not to prescribe amoxicillin along with children's acetaminophen or ibuprofen to relieve pain.

However, recent research indicates that many ear infections will clear up without treatment. This is something you will want to talk over carefully with your pediatrician.

Risk factors for frequent childhood ear infections

Age: Infants and young children are more likely to get them.

Sex: Boys have more ear infections than girls.

Heredity: Ear infections can run in families.

Colds and allergies often lead to ear infections.

Smoking by parents puts children at a higher risk.

Bottle-fed babies are more prone to ear infections than breastfed babies.

Prevention is the best medicine

Breastfeed for a minimum of six months.

Reduce exposure to tobacco smoke.

Keep your baby current on vaccinations. Certain vaccines reduce ear infections in babies.

Special treatment for repeat infections

In the United States doctors perform about one million ear-tube insertions each year. Called tympanostomy, the procedure is the most common surgery performed on North American children under age four.

The surgery is done under general anesthesia. A tiny incision is made in the eardrum, and a small tube is inserted to act as a vent to let air in and fluid out so that bacteria can't gain a foothold. Eventually, the tubes fall out by themselves.

This procedure is controversial, so you should talk to your doctor and perhaps a second doctor about whether your baby is a good candidate.

Date last reviewed: October 2002.

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