**UPDATED: JANUARY 2019**
Ear infections represent one of the most common childhood illnesses. Many things cause ear infections; however viral infections, bacterial infections, and allergies are the most common causes. Swelling in the nasal cavity leads to fluid becoming trapped behind the eardrum.
The eustachian tube sits almost directly across from the nose of an infant and grows longer and more slanted with age. This tube connects the ear to the back of the nose and normally allows air to remain behind the eardrum.
Ear infections occur in both adults and kids, but they are most common between the ages of 6 and 18 months. Infections become less frequent after age 3 and nearly resolve by age 5 because of the development of the eustachian tube.
There are a wide range of symptoms associated with ear infections. The age of the child and the number of associated symptoms are important factors that physicians consider when treating patients.
Many children never develop ear infections despite “known” risk factors. Physicians understand that some situations increase the chances that a child will develop recurrent ear infections. If your child is evaluated by an ENT specialist, knowing the full history is extremely important.
Ear infection facts are important to know because false information can be found everywhere. I have previously debunked common ear infection myths, but I now feel that sharing additional facts will benefit many parents.
When parents have useful information about medical problems, they are better able to interact with their child’s physician.
The following ear infection facts will help parents understand why their child’s symptoms are different from another child’s. These ear infection facts will also help understand why the treatment recommended is different from another child.
To gain more detailed information, I share a discussion on my podcast about important ear infection information parents need to understand. Sometimes hearing a discussion may be more useful than reading about the facts.
7 Ear Infection Facts Every Mom Needs to Know!
1. Infections occur in the outer, middle and inner part of the ear
All ear infections are not the same. Depending upon which part of the ear is infected, different symptoms are present. The treatments for each ear infection type is also different.
Middle ear infections (called otitis media), are the most common type and occur when fluid collects behind the eardrum. These infections are caused by swelling in the nose which leads to blocking the eustachian tube. This is the type of ear infection most people are discussing when they simply say “ear infection”.
Outer ear infections (called otitis externa, or swimmer’s ear) occur where there is an infection of the skin of the ear canal. These infections are caused by bacteria or, less commonly, fungi. When doctors see redness, swelling, and pus. they prescribe ear drops. Antibiotics are needed for severe cases.
Inner ear infections (called labyrinthitis) result from inflammation of the innermost part of the ear, which is covered by hard bone and contains the hearing and balance nerves. These infections are rare in kids and are usually due to viruses; however, they can also be caused by bacteria, immune system problems or an injury. The main symptom is extreme dizziness.
2. Persistent middle ear fluid is still an ear infection
Mothers know that pain and fever are common ear infections symptoms. But they don’t know that ear infections can be diagnosed with only simple ear fluid (called an effusion). Children often show no symptoms, and the fluid is found on a routine doctor visit or when a hearing test is failed.
The hearing loss that exists with middle ear fluid is a temporary loss and should not be confused with the more serious forms of hearing loss in kids.
Air normally fills the middle ear, so when fluid is present, it is always abnormal. Follow up with your pediatrician until it has resolved. Children may benefit from placement of ear tubes if fluid does not resolve.
3. Larger numbers of antibiotics prescribed does not mean more severe infections
Viruses cause most ear infections. Antibiotics do not treat viral infections, so many doctors do not prescribe antibiotics when children are first diagnosed.
However, if a child has persistent pain and cold symptoms, parents take their kids to immediate care centers where they often get antibiotics. The more visits a child has to a physician, the greater number of antibiotics which tend to be prescribed. This does not mean it is a more severe infection.
After your child has been initially seen, focus on treating other symptoms and allow the infection a chance to heal. If fever persists or pain worsens, your child will need to be seen again. But difficulty sleeping and pulling on the ear does not mean an antibiotic is needed.
4. Ruptured eardrums are common
Severe ear infections often show fever, ear pain, or decreased eating and sleep. Some children do not show any of these symptoms, and parents suddenly notice blood and pus leaking out of child’s ear. This is a ruptured eardrum.
Eardrums can rupture repeatedly but do not typically cause any permanent damage. The rupture is a tiny hole, like a pin popping a water balloon. The hole usually heals up quickly, and if ear infections recur, another rupture may happen.
Ruptured ear drums release pressure that builds up behind the eardrum. If the pressure is not released by rupture or medications, more severe complications can occur if the fluid gets trapped deeper in bones around the middle ear.
5. Ear infections can lead to speech and language delay
Children develop speech by copying the sounds that they hear. This explains why young kids learn multiple languages quickly.
When fluid is trapped behind the eardrum, a mild hearing loss is present. It does not cause the deafness many parents fear, but kids will hear sounds like what we hear when we have a cold or have clogged ears while on an airplane.
Muffled sounds can lead the child to repeat sounds that were heard incorrectly. It is important to follow-up with pediatrician until fluid is gone, or it can lead to a toddler speech delay.
6. Ear infections can lead to balance problems and delayed walking
Equilibrium describes our normal status where we walk and function in complete balance.
Fluid that builds up behind the eardrum causes balance problems. In some children, this imbalance causes a delay in reaching standard milestones, like sitting or walking.
Many things cause equilibrium problems; however, in children, it is important to check the middle ear for fluid before starting physical therapy or seeing a neurologist.
7. After ear infections resolve, consequences can persist
Most children outgrow recurrent ear infections. However, after the infections are gone, some children suffer from long-term problems.
If fluid was present for a long time, children may develop symptoms similar to sensory processing disorders.
The ear sends information to the brain. The brain uses balance to help process other senses, and hearing is important to develop normal sensory input signals.
Any long-term problems with hearing or balance in young kids could lead to sensory integration problems.
Additionally, after infections have resolved, a variety of physical complications may persist. Complications such as scar tissue, a chronic hole in the eardrum, cholesteatoma, and mastoiditis are discussed in a separate blog post.
I hope this post can be combined with the ones that help you debunk common ear infection myths, and understand how to reduce ear infections. My goal is to share bite-sized pieces of medical information that will help keep kids healthy!
Be sure to share your new knowledge with friends, family, and acquaintances. The more people who know this information, the more children will have healthier ears. You might also want to check out a post by a pediatrician who shares the difficult process of diagnosing ear infections.
As always, much love for supporting my work. I will be adding many more posts to highlight parenting and healthcare tips, so be sure to consider subscribing to my podcast or to my blog to avoid missing a post!