Ear infections now more widespread.

Parents may remember their own childhood ear infections as excruciating experiences soothed with balm-soaked cotton. Yet middle-ear infections, or otitis media, are more of a problem now than they were in the past, due in part to the larger number of children in day care.

Two new studies show just how entrenched the problem is--but they differ on the extent to which black children are troubled by bouts of the illness.

A study by Bruce P. Lanphear and his colleagues at the University of Rochester (N.Y.) School of Medicine and Dentistry used an extensive database known as the National Health Interview Survey. The data, based on parents' accounts of illnesses in youngsters under age 6, disclosed 44 percent more cases of otitis media among children born in 1988 than in those born 7 years earlier.

This increase, the researchers found, affected children in "all racial and ethnic groups and all regions of the country." It translates into 1.8 million more ear infections "than we would have expected," Lanphear says. The findings, drawn from the most recent data, appear in the March Pediatrics Online.

The research indicates that ear infections are more common among children in day care and children with allergies. Like earlier studies, it also found fewer ear infections among black youngsters.

A study that focused more narrowly on 2,253 Pittsburgh infants revealed a different picture of the prevalence of otitis media among black children. Jack L. Paradise and his colleagues at the University of Pittsburgh School of Medicine showed that otitis media appears to be as common among black children age 2 and younger as among white children of similar socioeconomic status. The report appears in the March PEDIATRICS.

Paradise says the racial differences measured elsewhere may stem from a grim reality of U.S. medicine--that fewer black children than white children have access to needed medical care. Their ear infections may therefore never be diagnosed.

"A number of studies going back 10 or 20 years suggest that this is an issue of access," says Jerome Klein of Boston University School of Medicine.

The Pittsburgh team treated the children with frequent courses of antibiotics--totaling, on average, 6 weeks in each of the first 2 years of life. "We've stopped treating some cases of otitis media due to the rising presence of drug-resistant Streptococcus pneumoniae," says Paradise. One of every 16 children with otitis media had at least one of his or her eardrums pierced and a tube inserted to drain it.