If baby’s tugging on their ear, they may have an ear infection. Find out what causes this common childhood problem.

Ear infections are a very common amongt babies. In fact, National University Hospital’s associate consultant at the department of otolaryngology (ENT) ― Head & Neck Surgery, Dr Tay Sok Yan notes, “Five out of six children will have at least one ear infection by their third birthday.”

Both Dr Tay and Dr David Lau, an Ear, Nose and Throat (ENT) specialist T Gleneagles Hospital, spell out the common types of ear infections:

1) Acute Otitis Media

WHAT? One moment, bubba’s down with a cold, the next you realise he’s running a high fever and crying inconsolably — these are the signs of a possible middle ear infection. Dr Lau says that middle ear infection as a result of a cold is common among young children. “[That’s because] during a cold, [mucus] becomes trapped in the middle ear, allowing viruses and bacteria to multiply.”

“Fortunately, in most instances, middle ear infections resolve even without treatment, as the child’s cold gets better.”

If it isn’t treated in time, the infection can worsen and lead to meningitis, the inflammation of the delicate membrane covering your little one’s brain. Signs that your child’s ear infection is deteriorating include:
* Fever of 39 deg C.
* Increasing restlessness.
* Lethargy.
* Constantly tugging their ears.
* Trouble hearing.
* Ear discharge.

If untreated, you’ll soon start to see redness and swelling behind the ears indicating mastoiditis ― an infection of the bone behind the ears.
TREATMENT This is a serious form of infection, so be sure to bring your mini-me to the doctor as soon as possible.

2) Otitis Media with Effusion (OME)

WHAT? Otherwise known as glue ear. It is a condition where the fluid from a middle-ear infection stays trapped behind the eardrum, instead of flowing out. Dr Tay notes, “Parents of children with OME will [usually tell] us their child is not responding to sounds the usual way at home or in school.”
TREATMENT For the majority of children, it’ll just take longer to cure the infection with medication — sometimes up to three to six months. In recurrent cases of infection, a myringotomy is required. This is a surgical procedure where an incision is made to the ear drum to relieve the fluid build-up.

3) Acute Otitis Externa (AOE)

WHAT? Using cotton buds to extract dollops of “gold” from inside your munchkin’s ears after bathtime, can actually do more harm than good! Dr Tay shares the human ear is a self-cleaning mechanism. “There is a slow and orderly movement of earwax and dead ear skin cells outwards from the eardrum to the external ear opening.”

So placing a cotton bud into the ear disrupts the flow of earwax and pushes deeper into the ear canal. Over time, the earwax gets jammed and eventually results in, an infection of the ear canal or an outer-ear infection. Children suffering from AOE often complain of earache and sometimes produce ear discharge.
TREATMENT Your tot will typically be given topical antibiotic eardrops. Failing which, a culture test will be carried out. Based on the fluid or discharge obtained from the ear, this lab-based test will identify what bacteria it. Antibiotics will then be prescribed to neutralise the specific bacteria.

“In very few cases, the toxins released from the infection can cause damage to the nerves causing a more severe form of hearing loss — however, this is extremely rare.”

Both Dr Tay and Dr Lau answer your ear infection queries…

Can an unresolved infection result in deafness?

Dr Tay: Deafness from an unresolved ear infection is highly unlikely. An unresolved ear infection can result in reduced hearing due to a hole in the eardrum and damage to the ear bones. In very few cases, the toxins released from the infection can cause damage to the nerves causing a more severe form of hearing loss — however, this is extremely rare.

Dr Lau: If both ears are affected, loss of hearing is much more important as this is more likely to affect a baby’s speech development. However, without formal testing, it can be difficult to distinguish hearing loss in one or both ears.

Any preventative measures to take against an ear infection?

Dr Lau: Breastfeeding for six months or more can protect against middle ear infections in a child’s first few years of life. If your child is bottle-fed, try not to let him or her drink while lying down as this increases the risk of ear infections. You may also try to wean your child off their pacifier before 6 months of age. Babies who use pacifiers after 12 months of age are more likely to get ear infections. Also, ensure that your child receives all the recommended immunisations, which can protect against infections in the upper respiratory tract. Parents should also refrain from smoking. Ear infections are more common in children exposed to cigarette smoke in the home. Encouraging good hand hygiene can also help to reduce the spread of germs.

Dr Tay: For middle ear infections, studies have shown that vaccination — a pneumococcal vaccine — has reduced the incidences of ear infections in children. Try to keep a sick child away from a healthy child. This will limit the spread of infections from one child to another. For outer ear infections, I would recommend against the cleaning of your child’s earwax at home.

What are the signs of deafness in one or both ears?

Dr Lau: The warning signs that might alert a parent to hearing loss varies according to the child’s age. Shortly after birth, a baby should startle when there is a loud noise such as a hand-clap or door slamming. At a month, they may show signs of noticing sudden prolonged sounds such as a vacuum cleaner; and they may pause and listen when these sounds begin.

At 3 to 4 months, they may smile or show excitement to familiar sounds or voices. By 6 months, they may notice quieter sounds, and turn towards the sound. By a year, they may be responding verbally. Failure to meet these milestones does not necessarily indicate hearing loss as babies develop at different rates. However if you have concerns, do co advisable to contact your doctor.

Photos: iStock

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