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Middle ear infections are common in children.

By age three, more than three-quarters of children will have had an acute middle ear infection. One-quarter of children will have had three or more ear infections in the same time frame. Middle ear infection is called acute otitis media in medical terms and is one of the most common reasons children are brought to physicians' offices.

The most common symptoms of an acute ear infection are sudden ear pain and fever. If a child is too young to tell you what hurts, they may cry and be irritable (or more lethargic) and may pull at their ears.

Sometimes the child will have worse ear pain when laying their head on the side of the affected ear. A speaking child may complain of a feeling of fullness in the ear or have trouble hearing and may not want to eat. Other symptoms include vomiting, diarrhea, runny nose, or restless sleep.

Doctors will diagnose an ear infection after examining the child's ears with an otoscope (a lighted instrument to look in the ear).

Middle ear infections are caused by bacteria and viruses. Most middle ear infections will clear up in three to six weeks with or without antibiotics. Physicians usually prescribe antibiotics because untreated ear infections may have serious complications such as mastoiditis or meningitis (infection of bone or brain).

Fluid can collect behind the ear drum in the middle ear. The body's natural healing often causes the ear drum to rupture and pus and blood may leak from the ear.

If fluid remains in the middle ear after the acute infection, the child's hearing may be affected and a repeat infection may occur. Your doctor may prescribe antibiotic ear drops if the ear drum has burst.

The hearing loss experienced by children with middle ear infection is usually temporary and returns after the infection and fluid have cleared up. Your doctor may check your child's ears and hearing in the months following the infection.

Acetaminophen (e.g., Tylenol, Tempra) can be used for fever and pain relief. Avoid aspirin in children as it may cause Reye's syndrome (a serious illness that can lead to death). Warm cloths that are applied over the ear may help ease the pain. Antihistamines and decongestants haven't shown any benefit in treatment.

For some children with ongoing ear fluid or recurring ear infections, ear tubes (tympanostomy or T-tubes) may be inserted in the ear drums. T-tubes allow fluid to drain from the middle ear and they may decrease the number of infections.

Some children may also be given small doses of daily antibiotics during the winter season to prevent frequent infections.

Children at higher risk of getting middle ear infections are in the six-to 18-month age group, male, Aboriginal, have not been breast-fed, and attend daycare. Middle ear infection is more frequent in the winter season and if children are exposed to siblings with the infection. Second-hand smoke may also increase the risk of middle ear infections.

This column is for reference and education only and is not intended to be a substitute for the advice of an appropriate health care professional. The author assumes no responsibility or liability arising from any outdated information or from any error or omissions or from the use of any of the information contained within the text.

Dr. Pinette is a Metis family physician in Manitoba. If you have comments or suggestions for future health articles, write to Dr. Pinette care of this newspaper or email
COPYRIGHT 1999 Aboriginal Multi-Media Society of Alberta (AMMSA)
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1999 Gale, Cengage Learning. All rights reserved.

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Publication:Wind Speaker
Date:May 1, 1999
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