Nurture Article | The Portland Hospital Parenting Magazine
Autumn Issue 2012 | Sophie Goodchild
Ear infections can be extremely painful, especially for small children. They can also mean sleepless nights for parents and a lot of distress for a screaming child.
The key is to know when to seek medical advice, says Paediatric Ear, Nose and Throat specialist David Albert.
Around 60 per cent of children will get an ear infection by the time they are three, the most common being a middle ear infection.
Symptoms include fever, earache, ear discharge, lethargy and generally being unwell.
However, most will resolve themselves on their own and don’t require antibiotics, according to Mr Albert, a consultant at the Portland Hospital.
“Most ear infections are self-limiting and often don’t need antibiotic treatment. So parents can try painkillers initially if their child is otherwise well,” he says.
“They are painful though and it’s hard to tell what’s going on unless pus is coming out of the ear. Some children with frequent ear infections end up at sleep clinics because of their difficulty sleeping. Even for a GP it can sometimes be hard to tell if the ear is the cause of the temperature unless pus is coming out of it as the ear can be difficult to examine.”
A cold can trigger an ear infection and boys are believed to be more susceptible than girls.
Mr Albert explains: “It’s an infection in the space behind the ear drum. Symptoms often start after a cold and what can happen is that bugs travel up the (Eustachian) tube from the throat and into this space. Some people think inner ear infections are more common if you swim but there’s not much evidence for this.”
Parents should give paracetamol for the first 48 hours to reduce the fever and provide pain relief and then seek medical help if symptoms don’t improve.
However, earlier help may be required for young children or if the symptoms are severe, and it's vitally important to seek medical advice for children under the age of two, says Mr Albert.
“Those with a high temperature, those who are really ill (eg lethargic) and those in which the infection lasts over three days should also be seen by a doctor,” he explains. “Repeated infections also need specialist help.”
Low dose antibiotics can help to calm any inflammation although most infections disappear without drugs.
If children experience recurrent episodes of ear infections – three or more bouts in six months – surgery may be necessary, although it is only generally used as a last resort.
Doctors insert a tiny tube smaller than a match-head – known as a grommet - into the ear drum to help to keep the middle ear well-ventilated and the middle-ear lining stable.
Children who have repeated episodes of middle ear infection should be referred to a specialist if their hearing is affected.
For more information on ear infections or to arrange an appointment with one of our specialists at The Portland Hospital please call our Children's Services Enquiry Line on 020 7390 8020 to speak to an advisor.