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When Ears Hurt: Coping with Otitis Media

Is your child touching their ear or saying it hurts? This could be a sign of a middle ear infection, also known as otitis media. Ear infections, particularly acute otitis media, are quite common in children, with over 80% experiencing at least one episode by the age of three. Knowing the causes, recognizing the symptoms, and understanding treatment options are crucial for helping your child feel better and recover.



Ear examination with ortoscope

© Wix



Recognizing the Symptoms


  • Ear pain: Your child may tug or rub their ear.

  • Fever: above 38.5°C.

  • Irritability or restlessness.

  • Difficulty sleeping: Pain can worsen when lying down.

  • Fluid discharge: In severe cases, fluid may drain from the ear.


 

Causes and Pathogens


Middle ear infections develop due to bacteria or viruses. These infections typically follow upper respiratory tract illnesses, where fluid builds up in the middle ear, creating an environment where germs can thrive.


 

When to Seek Medical Help


It’s important to get medical help if:

  • Your child is under one year old: Babies can’t communicate where the pain is, but ear infections often present with fever. Fever is a temperature over 38.5°C. See a doctor the same day if your child has fever or you suspect an issue.

  • Ear discharge: If you notice pus, fluid, or discharge coming from the ear, seek medical attention.

  • Persistent or worsening symptoms: If symptoms do not improve or get worse after 2–3 days, consult a healthcare professional.

  • Hearing difficulties: Any signs of hearing loss should be evaluated promptly.


 

Diagnosis and Treatment


Diagnosis involves examining the ear to look for signs of fluid and inflammation. According to the guidelines from the German Society for Otolaryngology, accurate diagnosis is critical to avoid unnecessary antibiotic use​.

The treatment for a middle ear infection depends on the severity and the child’s age. A doctor may prescribe:

  • Decongestant nasal drops or sprays: These help reduce swelling in the nasal passages, easing pressure in the ear and improving drainage.

  • Pain medication: Ibuprofen or paracetamol can effectively reduce pain and fever.


  • For infants under two years, severe infections, or prolonged cases, amoxicillin is often prescribed. However, antibiotics should be used cautiously, as overuse can lead to side effects and antibiotic resistance.

  • For children over two years with mild symptoms, a watchful waiting approach may be recommended. This means monitoring the child for 48–72 hours to see if symptoms improve without antibiotics.


Note: Always use nasal drops under the guidance of a pediatrician. Adult nasal sprays are not suitable for children, and it is crucial to use the right concentration for your child’s age and weight. Prolonged use of nasal drops can dry out or damage the nasal mucosa.


 

How You Can Support Your Child


  • Rest and Comfort: Ensure your child gets plenty of rest and stays in a slightly elevated position to reduce ear pressure.

  • Stay Hydrated: Offer plenty of fluids, such as water or warm herbal teas, to keep them hydrated.

  • Apply Warmth: A warm compress, like a heat pad or grape seed pillow, can help ease ear pain.

  • Elevate During Sleep: Use an extra pillow to slightly raise your child’s head while they sleep to promote fluid drainage.

  • Natural Remedies: Try onion wraps on the ear for a soothing, natural way to relieve discomfort.

  • Lukewarm Compress for Fever: Lukewarm compresses on the legs can help bring down a high fever.

  • Protect the Ears: Keep water out of your child’s ears during bathing or showering and avoid swimming while they recover.

  • Keep an Eye on Symptoms: Monitor for any worsening symptoms, and don’t hesitate to seek medical attention if needed.


 

Prevention Strategies


Preventing ear infections isn't always possible, but you can reduce the risk by:

  • Encouraging frequent handwashing.

  • Avoiding close contact with sick individuals.


 

Understanding the Role of Antibiotics


Antibiotics can help reduce the risk of complications and speed up recovery in some cases, but they are not always necessary. Overuse can lead to antibiotic resistance, disrupt the gut flora, and cause side effects such as gastrointestinal issues.









Resources


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