Cries erupt the silence of the night. Your little guy’s awake and needs you. After the routine bottle and a clean diaper, he’s still not comfortable. That’s when you notice a slight fever, but there are no other symptoms. Could it be an ear infection?
Know the Signs
When it comes to big kids and what ails them, sometimes it’s easy as asking a question or two. However, when it comes to a baby, it’s his non-verbal cues you need to pay attention to, and an ear infection is one of the hardest things to detect. “A fever is the hallmark of ear infections, with many children exceeding 102 degrees,” says Siva Chinnadurai, M.D., MPH, associate professor of otolaryngology at Vanderbilt University Medical Center. A fever could be just the first sign, though. Chinnadurai says a loss in appetite and fussiness are also signs of a possible ear infection. Another common sign she says is ear pulling or tugging, but she also says this is seen with teething — which makes it even more difficult for you to know if it’s associated with an ear infection or not.
Over time, if your child has repeated ear infections, you may begin to wonder what could happen to his ears. Chinnadurai says although it’s unlikely that permanent damage can occur from multiple ear infections, some recurrent perforations of the eardrum from severe infections could affect hearing in the long term (you can recognize eardrum perforations from pus draining from the ear). She also adds that very young children — particularly those younger than 2 who have less developed immune systems — are slightly more likely to develop rare complications, such as infections of the bone behind the ear. “Another long-term risk to consider is antibiotic resistance,” says Chinnadurai. “If kids are on antibiotics too frequently, this can contribute to antibiotic resistance, making future infections harder to treat.”
The Eustachian tubes, your ears' natural drainage tubes, allow fluid to drain out and air to fill the middle part of the ear. If your child experiences frequent ear infections, those tubes may not work properly Chinnadurai says. In this case, ear tubes may be inserted by an ENT surgeon with the use of a microscope. Although tubes can be placed in babies and children, Chinnadurai says it’s unlikely to have enough ear problems that your pediatrician or ENT would recommend them before 6 - 8 months old. “Ear tubes are meant to help [drainage] by creating another path for liquid to leave the ear and for air to get in,” says Chinnadurai noting they help to decrease the number of infections, make it easier to diagnose infections when they occur and allow for treatment with antibiotic drops. “Using drops minimizes the side effects that come with oral antibiotics. Those side effects include upset stomach, diarrhea and yeast infections,” assures Chinnadurai.
Cleaning Baby’s Ears
Clean Baby’s ears by simply wiping the outside of the ear’s opening with a warm washcloth — during bath time. “Occasionally, your healthcare provider may recommend something more, such as diluted hydrogen peroxide,” says Chinnadurai. “Do not do this unless recommended. And never try to clean your baby’s ear canal by inserting something into it.”
Did you know that a major, preventable contributor to ear infections is exposure to cigarette smoke? “While smoke irritates the lining of the ears, it also prevents the natural cleaning function of the ears,” says Chinnadurai. “This increases fluid in the ears and prevents it from being cleared out. As a result, this increases the risk of infections.” She says that kids are 37 percent more likely to have ear disease if you smoke. Even more alarming — 86 percent more likely to need ear surgery! Another cause for ear infections is the way you feed your baby. “Feeding babies while they’re flat on their back can allow liquid to move up the Eustachian tube and into the ears,” adds Chinnadurai.