Ear Infections

   An ear infection or Otitis Media is an inflammation of the middle ear. The middle ear is located just behind the ear drum. In a healthy ear, sound travels from the outside air into the ear canal to the eardrum causing it to move back and forth. This movement causes the small bones inside the middle ear to also move. Sound waves are transmitted to the inner ear which sends sound messages on to the brain. Any fluid or infection in the middle ear can disrupt this process and lead to decreased hearing.

   Ear infections can be caused by many types of bacteria or viruses. Most ear infections occur along with an upper respiratory infection or cold. Children six months to two years of age have the most frequent ear infections.

   Symptoms of an ear infection can be a feeling of fullness in the ear; a red, painful and bulging eardrum; fever and decreased hearing. Children more prone to ear infections are those with immature immune systems, short and narrow eustachian tubes, allergies, gastro esophageal reflux, and who are exposed to environmental irritants and attend daycare.

   Treatment for ear infections is usually achieved by taking an antibiotic. Relief of the symptoms should begin within 48 hours of starting this treatment. If relief does not begin then the antibiotic being used might need to be changed. Symptomatic pain relief may be achieved by using anesthetic ear drops, warm oil or warm compresses applied to the ear. An associated fever can be treated with acetaminophen and ibuprofen. For all of these treatments, the evaluation and advice of the child’s doctor must be sought out.

   Ear infections can be avoided by avoiding exposure to ill contacts, frequent hand washing and a small day care size. Immunity can be increased by achieving good nutrition, plenty of rest, decreased stress, and the administration of flu and pneumococcal vaccines.

   After treatment for an ear infection, fluid may remain in the middle ear for many months. Middle ear fluid can contribute to decreased hearing and thus subsequent learning impairment. Usually the fluid will go away with time but occasionally further treatment will be necessary. Additional antibiotics may be administered or ear tubes inserted to assist with draining the fluid.

   It is important that all international adoptees have their hearing screened within 3 months of arriving home. Almost half of adoptees have been found to have ear infections. All of the children should be referred for screening by a speech therapist as a part of their Early Intervention evaluation. Ear infections may have gone on untreated for some time prior to adoption. They can be fairly easy to treat once diagnosed and contribute to an easier adjustment period for the child and the family.

Cindy Sundman R.N., BSN, CLNC