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Childhood Illnesses: TNL’s Guide to Ear Infections

What is it?

Ear infections are most commonly caused by viruses, like colds and flu, but can also be a result of bacterial infections. Viral infections may cause swelling in the nose and throat which are linked to ear passages, resulting in further swelling in the ears. Ear infections can affect the inner ear or the outer ear.

Some severe ear infections can lead to such complications as ruptured or torn eardrums, hearing impairments, mastoiditis, or delays in speech development (due to lack of hearing). Children can often contract ear infections more than once and they also affect adults. Most ear infections will disappear in a few days without medication.

Ear infections can be diagnosed by a doctor who will assess the symptoms, look in the ears and nostrils through an otoscope, perform an acoustic reflectometry (a sonar-based technique to diagnose middle ear effusion), tympanometry (air pressure used to assess eardrums and conduction bones), or tympanocentesis (removal of fluid from the ear). Hearing and balancing tests may also be performed.

Young doctor examining baby boy with otoscope
Photo sourced from iStock

What are the Symptoms?

The symptoms for ear infections include:

Inner ear infections:

  • ear ache and pain inside the ear
  • a high temperature (above 38C)
  • difficulty hearing
  • discharge coming out of the ear
  • a feeling of pressure inside the ear
  • nausea and vomiting
  • tiredness
  • feeling irritable and restless

Outer ear infections:

  • itching and irritation on and around the ear
  • scaly skin, scabbing, swelling on and around the ear
  • a high temperature (above 38C)
  • nausea and vomiting
  • tiredness
  • feeling irritable and restless

Very young children and babies may also:

  • rub or pull their ear
  • not react to some sounds
  • loose their appetite
  • keep losing their balance

For more information visit Ear infections - NHS

Photographer: Tim Bish | Source: Unsplash

What is the Treatment?

The best treatment is prevention. Ear infections are not contagious but the viruses and bacteria that cause ear infections are. Regularly disinfecting surfaces and items, including bedding, drinks bottles and toys handled by children, will reduce transmission of viruses and bacteria.

Encouraging children not to share cups, bottles or cutlery is recommended, as is teaching good hygiene such as regular hand washing and using tissues to blow noses or sneeze and cough into. Failing this, children should be shown how to sneeze into the inside of their elbow.

Other preventative measures that can be shared with parents are:

To avoid inner ear infections:

  • make sure vaccinations are up to date
  • keep children away from smoky environments
  • try to refrain from using dummies after the age of 6 months old

To avoid outer ear infections:

  • do not stick cotton wool buds or fingers in ears
  • use earplugs or a swimming hat when swimming
  • avoid water or shampoo getting into ears when bathing
Photographer: Sharon McCutcheon | Source: Unsplash

If practitioners and parents are unsure, advice from a doctor should be sought. If a child has contracted an ear infection, the best ways to treat them are:

  • Keep them comfortable at home
  • Monitor their temperature
  • Keep them hydrated, drinking plenty of water rather than juice
  • Place a warm or cold flannel on the ear
  • Clean any discharge by wiping the ear with cotton wool
  • DO NOT place cotton wool, tissues or cotton buds IN the ear
  • Let them rest
  • Give them paracetamol OR Ibuprofen to bring down temperatures and ease aches and pains, if needed. Do not use both. Labels should always be read to ensure age-appropriate dosage is given. Parental permission must be acquired before giving ANY medication to children. It is recommended that first aiders administer medications.
  • Consult pharmacists or doctors for further advice and information on suitable treatments.
  • Make an appointment with a GP if the symptoms do not improve or disappear after a suitable length of time. The suggested time frame is 3 days, but personal judgement should always be used. If symptoms worsen within this time frame, such as consistently high temperatures, vomiting, loss of hearing, or swelling in the ear, seek advice from a medical professional by calling 111 or 999 immediately.
Photographer: Christine Sandu | Source: Unsplash

Antibiotics are not usually prescribed because infections inside the ear often clear up on their own and antibiotics make little difference to symptoms, including reducing any pain. However, antibiotics might be prescribed if:

  • an ear infection does not get better after 3 days
  • a child has fluid coming out of the ear
  • a child has a pre-existing health condition increasing the risk of complications
  • a child is under 2 years old and has an infection in both ears

Other treatments prescribed by a doctor may include antibiotic eardrops (for bacterial infections), steroid eardrops (to reduced swelling), antifungal eardrops (for fungal infections), or antibiotic tablets (for sever infections).

Fun Facts (courtesy of WhatThaFact.com)

Ears play a role in our sense of taste. This does not mean we directly taste food through our ears, but there are nerves (chorda tympani) that run through the middle ear, connects areas of the tongue to the brain. This is why ear infections can result in a loss of taste.

Photographer: Ben White | Source: Unsplash

There are three bones in each ear which can fit jointly on a penny. One of these bones is the stirrup bone which is the smallest bone in the body. The internal ear is about the size of a pencil eraser and contains more than 20,000 hairs.

Our ears never stop working, even while we are asleep. The brain shuts out noises while we sleep but the ears are still functioning, this is why loud noises can often cause us to wake up.

Ears are self-cleaning. Pores in the ear canal fabricate cerumen (ear wax) and the tiny hairs, called cilia, move the wax forward out of the ear.