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Ear Infection

The ear infection is caused by a stuffy runny nose and the baby cannot "pop" open the eustacian tube to get air in the middle ear and the fact that babies have low antibodies. Infections are not caused by getting water in the ear, wind blowing in the ear, or anything the parent does. Decongestants, cold meds do not help prevent them. Nothing the parent does causes them and nothing the parent does can prevent them. So get off the guilt wagon!

You can help the pain by giving pain medications (see dosage web page), by keeping the head elevated (sleep in big chair with their head on your shoulder.) (Did he say sleep?), by putting the ear next to   the warmth of  your body, or luke warm heating pad.  What really can help is to put a few drops of  luke warm  olive oil  in their ears.

Ear infections are not contagious but the green runny nose is contagious. Half of the children with pink eye have an ear infection. (Pink eye causes the white of the eyes to be red bloodshot. Just having green mucous in the corner of the eyes is not pink eye.)  And many infants rub or pull on their ears.  If they are sleeping fine, acting fine, eating, and no fever, then it is not an ear infection.  If it is such a mild infection that there is no fever or crying in pain, then I would just as soon let their own immunity take care of it.   And 70% will go away without antibiotics.  So don't be afraid that you might be missing an ear infection.   If it is that mild, I would rather not over do antibiotics and let them take care of it.

Treatment of Ear Infections

  • Ear infections can be painful. The pain may be worse when your child is sucking on the bottle or lying down. You may notice your child crying more or tugging on his/her ears. Tylenol (acetaminophen) or Motrin (ibuprofen) may help relieve the pain temporarily. Check with the dosage web page.
  • If your child is given an antibiotic, be sure to give this exactly as you were directed. Even if your child is feeling better in a few days, be sure to give all of the doses to your child to make sure the infection has been treated completely.
  • It usually takes 24 to 48 hours after you start the antibiotics for your child to feel better. If your child still has a lot of pain and or if he/she still has fever 48 hours after starting the antibiotic, call the office or come into the emergency room.

Call Your Doctor Or Go To The Emergency Room/Urgent Care Clinic If:

  • Your child appears lethargic or you can’t do anything to make him/her happy.
  • Your child still has a fever or is not better after 48 hours of antibiotics.
  • Your child is getting worse.
  • You have any other concerns.

If your child has very frequent ear infections ( six times a year), you and your doctor may want to talk about having PE tubes inserted in the ears.


PE Tubes Surgery????

The American Academy of Otolaryngology came out with some recommendations on who should get PE tubes in their ears for fluid or infections in the middle ears.  They mention that many children get tubes who do not need them.   Around 670,000 PE tube surgeries are done each year.  By age 3 yrs. old around one in 15 children have had this surgery.  I am conservative in medications, X-rays and surgery.  Many children get tubes who have only had a few infections.   If we average ear infections, they typically have 3-4 the first winter,  1-2 the second winter, and rarely have them the third winter.   Around 2-3 years of age their immune system matures and their muscles in their throat are able to “yawn and pop open their ears” letting the fluid out.  Parents do not cause the infections.  The fluid does not decrease the hearing significantly in most children and does not slow down their speech.  But around 18-36 months of age many kids start talking and the parents think it is because they put tubes in their ears.  My opinion is that if the infant is having ear infections in the summer when they should have stopped, or if we are not able to clear up the infections at all, then put in  tubes. 

 See article: http://www.usatoday.com/story/news/nation/2013/07/01/ear-tubes-surgery-guidelines/2465303/


Roger Knapp MD

Video on flying with children and their ears ..... pain on flying?