Like colds and coughs, ear infections are a rite of passage for every child. EVELINE GAN ﬁnds out what you should know about this condition.
1 Hear hear, the warning signs.
Do you notice your little one scratching or hitting her ears? She may be too young to tell you that they are causing her pain.
She could be feeling the pressure caused by an infection or fluid build-up in the ears, says Dr Lynne Lim, a senior consultant Ear, Nose and Throat surgeon at Mount Elizabeth Medical Centre.
She may also appear unsteady while crawling, sitting up or walking. Watch for fever, crankiness or discharge from the ears, adds Dr Christelle Tan, a specialist in paediatrics at Raffles Specialists at Raffies Holland V.
Hearing problems may be another telltale sign. For example, your baby may be less responsive to sounds that normally startle her or cause her to turn around, Dr Tan says.
If the infection occurs only on one side, she may turn towards the opposite side when you call her because the sound would appear louder in the ear with normal hearing, she adds.
But these symptoms aren’t always obvious, especially if the infection is mild.
“Most cases of fluid trapped in the middle ear arise from a cold or flu and it may not be painful. Your child may not complain of any hearing problem, so it may be missed,” Dr Lim says.
2 It usually occurs after a bout of cold or flu.
In most kids, ear infections typically occur when fluid gets trapped in the middle ear (the part of the ear located behind the eardrum) and is infected by germs.
This can happen when the Eustachian tube (the narrow passageway connecting the back of the nose and throat to the middle ear) becomes blocked – for example, when your little one has a cold, flu or an untreated nasal allergy.
In a March 2016 study published in Pediatrics, researchers followed 300 babies and found that nearly every ear infection diagnosed manifested after a bout of the common cold.
There are other factors that can raise your little one’s risk, such as drinking from a bottle or sippy cup while lying down, reflux issues or exposure to second-hand smoke, experts say.
It may also occur in the outer ear canal when small objects as well as infected water and debris (from swimming in dirty water, for example) get trapped in there, or when you clean your baby’s ear canal too aggressively, Dr Lim says.
3 The younger your child, the more vulnerable she is.
Ear infections are generally more common between the ages of one and six, peaking in the first two years of life, Dr Lim says.
By the age of three, about two thirds of all children would have suffered at least one bout of it, Dr Tan adds.
Why are they so common in babies and toddlers? Compared to adults, younger kids have a shorter, narrower and more horizontal Eustachian tube. This makes it easier for infections from the throat to spread to the ear, as well as more vulnerable to blockage, Dr Tan explains.
In addition, your little one’s immune system is still developing and she will have a tougher time fending off nasty germs compared to big kids and adults.
4 Unfortunately, it tends to come back.
Coming down with an occasional ear infection is challenging enough, but some kids suffer from repeated infections up to four times a year. It typically takes one to three months to clear, Dr Lim says, so, technically, it is possible for your kid to nurse ear infections all year round.
Thankfully, there’s light at the end of the tunnel. Beyond the age of six, recurrent episodes tend to be less common, Dr Tan says.
5 It could affect hearing, speech and even school performance.
If your baby has a severe ear infection, or is not getting better and has a high fever, her doctor may start her on antibiotics.
Untreated infections can affect your baby’s hearing development, which is why it is important to get it treated promptly, Dr Lim says. Studies show that even periodic or mild hearing loss can lead to speech delays that affect school performance later in life.
“When left untreated, recurring ear infections would mean the child may not be hearing well in that entire year, which has been shown to affect the development of the hearing brain,” Dr Lim says.
“Sometimes, after treatment, the child may continue to have auditory hearing issues that make her appear inattentive. She hears sound, but her brain does not process the information,” she adds.
In rare cases, leaving a severe ear infection untreated might even lead to a brain infection.
6 Ditch those ear picks and cotton buds.
Refrain from “cleaning out” your little one’s ears – it’s not necessary as they’re naturally self-cleaning. Digging your baby’s narrow ear canal using an ear pick or cotton bud can push debris and wax farther in, traumatising the skin and causing an infection to set in, Dr Lim warns.
Likewise, dirty bath or pool water can cause an infection when it is trapped in the ear canal. If water gets into your baby’s ear, turn her on her side and lightly massage the front of the ear so that the water flows out of the ear canal, Dr Lim advises.
7 Breastfeed and vaccinate to prevent ear infections.
In the March 2016 Pediatrics study, babies who were exclusively breastfed for at least six months were less likely to develop an ear infection.
Another effective mode of protection is to vaccinate your child against bugs that can cause ear infections, Dr Tan says.
The pneumococcal vaccine, commonly given at the age of two to three months.
The haemophilus influenzae vaccination, given as a combination vaccine in three primary doses from the age of six weeks to six months.
The influenza vaccine, an optional vaccine that can be given from the age of six months.
Other measures to lower Baby’s risk of getting ear infections include: Avoiding second-hand cigarette smoke.
Avoiding letting your baby drink from a bottle or sippy cup while lying down.
Limiting pacifier use in the first six months.
As much as possible, limiting your child’s exposure to other sick children.
"Refrain from cleaning out” your little one’s ears - it’s not necessary as they’re naturally self-cleaning."