One of the common health problems in babies, ear infection usually occurs when the baby ages between 6 months to 3 years. 75% of the babies have this painful experience spanning over 2 to 3 days. The infection should disappear within a few days. If you find your baby keep pulling the ear, chances are your baby is still suffering from ear infection. Also known as otitis media, this infection causes painful inflammation in the middle ear. Accumulation of pus or infected fluid usually behind the eardrum promotes the growth of viruses or bacteria. This growth leads to bulging in the middle ear. The eardrum becomes red and painful.

Also known by other names including the pharyngotympanic tube and auditory tube, Eustachian tube is a tube connecting the middle ear and the throat. This tube drains fluid accumulated in the middle ear. To see how this tube can cause ear infection in babies and young kids, let’s see the difference between Eustachian tube in babies and Eustachian tube in adults.

In babies
and young kids
In adults
Size 18 mm 35 mm
Position Inclined at 0⁰ Inclined at 45⁰

Clearly, Eustachian tube is horizontal in babies and young kids. As this tube is not inclined at any angle, this tube does not drain any fluid accumulated in the middle ear. Fluid is collected in this tube and creates the habitat viruses and bacteria need to grow. Sometimes ear infection is also accompanied by fever.

Types of Ear Infection in Babies

Following are the two types of baby ear infections:

  • Middle ear infection
  • Outer ear infection

Middle Ear Infection

Middle ear infection is more common than an outer ear infection. Eustachian tube gives viruses and bacteria a route to enter the ear and this causes the middle ear infection. Babies have horizontal and narrow Eustachian tube which makes them more prone to ear infection. Swelling of this tube due to sinus allergy also causes the middle ear infection.

Fluid build-up inside the middle ear not only causes pain but also puts pressure on the eardrum. Usually, no treatment is required as the fluid is drained in a few days. In case this does not happen, the pressure ruptures the eardrum and you can see bloody, yellow or white discharge from the ear. This will relieve both pain and pressure. Usually, the baby needs no treatment for a ruptured ear. However, the infection may not heal without middle ear infection treatment.

Outer Ear Infection

This infection is also known as swimmer’s ear or otitis externa. Excess moisture creates a moist environment which is ideal for bacterial growth in the ear canal.

Causes of Ear Infection in Baby

Following are the causes of ear infections in babies:

  • Bacteria infecting fluid accumulated in the middle ear
  • Eustachian tube blockage leading to fluid build-up in the middle ear
  • Eustachian tube blockage due to a sinus infection, allergies or cold

Symptoms and Signs of Ear Infection in Baby

Your baby is not going to tell you how painful it is. You will have to look for the signs of ear infection in baby. Ear infection symptoms include:

  • Ear discharge
  • Baby tugging at ears
  • Fever
  • Irritability
  • Loss of balance
  • Sleep problems
  • Poor appetite or loss of appetite
  • Crying due to pain which increases when lying down
  • Headache
  • Baby not responding to sounds

Baby Ear Infection – Risk Factor and Complications

Age (6 months to 3 years) is an obvious factor due to the size and shape of the Eustachian tubes. Secondly, babies don’t have a strong immune system. Infants in group child care are also susceptible to getting an ear infection and other infections such as common cold. Bottle feeding while lying down increases the risk of ear infection in babies. The risk of ear infection in babies is high during the winter. Pollution and exposure to tobacco smoke can also be risk factors.

Although, there are no long-term complications associated with ear infections in babies. Do not ignore the high frequency or persistence of the ear infection. Infection causing permanent damage to the structure of the middle ear can cause permanent hearing loss. Hearing loss, whether it is temporary or permanent, can delay critical skills such as social skills. Infection can spread to and damage other tissues. A ruptured eardrum usually does not require any medical intervention. Sometimes the surgical repair is the only solution.

Baby Ear Infection – Diagnosis And Treatment

Diagnosis is based on signs and symptoms. The doctor will also examine the ears, nasal passages and throat of the baby using an otoscope. Your doctor may also use a stethoscope to examine the breathing of the child. The doctor may also use a pneumatic otoscope to examine the movements of the eardrum. This instrument pushes a gentle blow of air in the middle ear. If this puff of air does not move the eardrum then this indicates accumulation of fluid in the middle ear.
Usually, ear infection does not take more than one or two weeks to heal. The ear infection treatment depends on the severity of ear infection and the age of the child. If you still notice the symptoms of ear infection then see a doctor. The doctor might give antibiotics for ear infection. Warm compress over the infected ear can provide relief from pain. The doctor can also recommend ibuprofen or acetaminophen for pain management. In case infection recurs and the antibiotic is not working, the doctor will perform some additional tests such as tympanometry, acoustic reflectometry or tympaocentesis.

Ear Infection Prevention

  • Do not skip vaccination.
  • There are many important antibodies in the breast milk providing protection from infections.
  • Babies have a weak immune system and exposure to smoking further suppresses their immune system. Therefore, avoid smoking near the baby.
  • Risk of ear infection is high if your baby is receiving care in a daycare center.
  • Make sure that your baby’s head is elevated while breastfeeding or while drinking milk or water. Otherwise, water or milk will enter the Eustachian tube.
  • Use hypoallergenic bedding, keep pets away and keep your kid’s room dust free. This will protect the baby from allergies.

When To See A Doctor

  • Infection does not heal within one or two weeks.
  • Infection is recurring.
  • There is redness or tenderness behind the ear.
  • The child is not responding to sounds.
  • The child is suffering from a fever of 102.2⁰ Fahrenheit or higher.
  • Discharge coming from the ear.

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