Ear Infections in Children May Flare in Winter Months

Michael Dantzer, M.D. Pediatrician at Dreyer Medical Clinic - Yorkville

Dreaded by children and parents alike, ear infections seem to be inevitable, especially during the winter. With prevention and proper care, we can limit the risk of these possibly harmful infections.

Ear infections are caused by bacteria and viruses, to which children are more prone than adults. Because a child’s immune system is not fully developed (meaning they have not been exposed to most viruses), they are more likely to become ill from coming in contact with bacteria or viruses that may be present. Secondly, the ear structures of a child are different from those of an adult. Adults have longer eustachian tubes that slope downward, facilitating easier draining. Children have shorter, narrower tubes that can trap fluid where bacteria may grow.

Antibiotics are the most common treatment of ear infections. However, it is possible for bacteria to eventually become resistant to particular antibiotics, causing them to be ineffective. This does not mean there is a problem with the child’s immune system, it simply means that the bacteria present have “figured out” the current medication, so to speak, and a different one should be prescribed.

For children over two years of age, it is beneficial to try to hold off treatment of ear infections for 48 hours, as most cases will resolve on their own without antibiotics. This approach can also be considered for children aged six months to two years. Limiting the use of antibiotics may decrease or slow the rate of developing resistance to antibiotics.

It is important to seek care promptly, however, if the child’s symptoms worsen, if they are not resolved within 48 hours, or if new symptoms arise. More serious infections such as meningitis or mastoiditis (an infection of the mastoid, a tiny bone behind the ear filled with air holes) can develop from an ear infection.

If there is an excessive amount of ear fluid that does not drain within three to four months, hearing loss may become a risk. Artificial or prosthetic tubes may be recommended in such cases, or in cases of excessive numbers of ear infections.

Precautions can be taken in an effort to prevent a child from experiencing numerous ear infections. Since they are caused by bacteria and viruses, it is a good idea to try to avoid environments that are conducive to spreading colds, such as day care centers, and contact with other people who already have colds. It is essential to maintain good hygiene habits as well, such as washing hands frequently or using an alcohol-based hand sanitizer, to prevent the spread of bacteria and viruses.

A pneumococcal vaccine, which protects against the most common bacterial cause of ear infections is available. It is given as a series at the following ages: 2 months, 4 months, 6 months, and 12 months. The influenza vaccine can also contribute toward preventing ear infections, since upper respiratory infections (such as influenza) can lead to ear infections.