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Now ear this

Recognizing an ear infection isn't always as easy as you may think. Here’s what you need to know.

Ear infections are very common, especially in children between six months and three years old, according to the Canadian Paediatric Society. Until their small skulls grow, the Eustachian tubes — one per ear forming a passageway from the middle ear to the back of the throat — aren’t very efficient at draining, making for a convenient bacteria superhighway. An ordinary cold virus can trigger a secondary infection in the ears, as can allergens or irritants that cause congestion and clog the tubes.

Is it or isn’t it?
An acute ear infection often causes pain, fever and irritability, a surefire recipe for a thoroughly miserable child. But this triad of symptoms doesn’t show up in all cases. Some kids signal a problem by pulling at their ears — if they’re old enough to reach for them. Others might eat less or sleep more.

The general rule is that the younger the child, the less able he is to indicate where the problem is and the less specific the symptoms can be, says Glen Ward, a paediatrician in Surrey, B.C. He’s seen babies with raging ear infections who had little to show for it beyond diarrhea.

A doctor can diagnose otitis media (ear inflammation) with an otoscope. If infected, the eardrum will appear inflamed and may bulge. And though it’s usually bacteria partying in your child’s ears, the inflammation could also be due to a virus, which is untreatable with antibiotics. “The only true way to know if it’s bacterial is to stick a needle in,” says Ward. Since that’s unlikely to be a child’s idea of big fun, treatment is usually based on age and physical symptoms rather than a lab test.

Paediatricians once reached for their prescription pads at the first sign of a red ear — just in case bacteria were the culprits. That was before worries about drug-resistant superbugs. Increasingly, doctors now take a wait-and-see approach, mostly in cases where the child is older than two years and fever is mild. Various studies support this strategy, showing no greater risk of complications. “About 80 percent of ear infections clear spontaneously,” explains Ward. “It’s a small set that actually needs antibiotics.” You can thank your child’s mighty white blood cell soldiers, which can fight off many bacterial infections.

If you opt to wait it out on a doctor’s recommendation, be prepared to clear your calendar for a couple of days so you can keep a close eye on your kid. Watch for changes such as a spiking fever (39ºC/102ºF), or pain that isn’t relieved with acetaminophen, which may mean the infection is getting worse. If these symptoms occur, it’s time to go back to the doctor.

Whether or not antibiotics are prescribed, the main focus of home treatment is to control the pain, so stock up on acetaminophen or ibuprofen for the first day or two. (The CPS cautions to use ibuprofen only if your child is drinking reasonably well because in rare cases it can cause kidney injury in dehydrated kids.) Keep your child well hydrated, and make sure she gets plenty of rest. Remember to talk to your doctor or Pharmacist for more help with ear infections.