Ear infection in children

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Manage your child’s ear infection. (Image: Supplied)
Manage your child’s ear infection. (Image: Supplied)

What is an ear infection?

Ear infection, also known as otitis media, is an infection of the middle ear.1,2 It is caused by a bacteria and usually develops after a cold or the flu.1,2

It is different to swimmer’s ear infection, which is infection of the outer ear canal that goes up to the eardrum. It is possible to have middle ear infection and swimmer’s ear at the same time.2

Otitis

“Otitis” means inflammation of the ear and “media” means middle 2

What happens during an ear infection? 

Ear infection causes swelling of the mucous membranes of the nose and throat, which increases the number of bacteria in the nose.1 A cold or the flu can also affect the Eustachian tube function. When the tube is infected it changes the pressure in the middle ear.1 Fluid may form in the middle ear and bacteria and viruses follow, resulting in infection of the middle ear.1 Increased pressure can cause the eardrum to bulge leading to symptoms of pain and fussiness in your child.1

Otitis

Causes of an ear infection

  • Children often develop a cold or the flu before getting an ear infection2
  • Blockage, malformation or inflammation of the Eustachian tube2
  • Bottle feeding your baby2
    • It is best to hold your baby rather than to make them lie down with the bottle
Ear infections

Children who have ear infections before 6 months are likely to have more later in childhood2

The signs of ear infections are sudden and may include:1

  • Fever (temperature higher than 38°C)
  • Pulling on the ear
  • Fussiness, irritability, or restless sleep
  • Decreased activity
  • Lack of appetite or difficulty eating
  • Vomiting or diarrhoea
  • Draining fluid from the outer ear
Crying baby.

Ear infection complications

  • Rupture of the eardrum (tympanic membrane rupture)1
    • It is caused by fluid pressing on the eardrum, reducing blood flow and causing the tissue to weaken
  • Hearing loss1
    • Fluid collects behind the eardrum (effusion) even after the pain of an ear infection resolves. The effusion causes trouble hearing and when it persists can interfere with learning and speech

Do’s and don’ts of treating an earache:3

Do:

  • Give your child pain medication such as paracetamol to help ease the pain
  • Place a warm or cold cloth on the ear
  • Remove any discharge from the ear with a cotton wool

Don’ts

  • Do not put anything inside the ear to remove the ear wax
  • Do not let water get in the ear

Paracetamolsuppositories are indicated for the relief of pain and fever.4

Suppositories are an effective alternative to oral treatment with the following benefits5

  • Not swallowed or taste-masked;6 no spitting out, ensuring full dose is delivered
  • Ease of administration, especially in uncooperative6,7 or drowsy infants and children
  • Ideal in cases of nausea and vomiting6
  • Avoid stomach irritation7
  • Alternative to oral5
  • Can be administered to a sleeping child
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    References:

    1. UpToDate®. Patient education: Ear infections (otitis media) in children (Beyond the basics). [online] [cited on 1 Dec 2020] Available from: URL: https://www.uptodate.com/contents/ear-infections-otitis-media-in-children-beyond-the-basics/print
    2. MedicineNet. Middle ear infection in infants, toddlers, children and adults. [online] Oct 2019 [cited 26 Jan 2021] Available from: URL: https://www.medicinenet.com/ear_infection/article.htm
    3. NHS. Ear infections. [online] May 2018 [cited on 2 Dec 2020] Available from: URL: https://www.nhs.uk/conditions/ear-infections/
    4. Van den Anker JN. Optimising the management of fever and pain in children. Int J Clin Pract Suppl 2013;178:26-32.
    5. Havaldar VD, Yadav AV, Dias RJ, et al. Rectal suppository as an effective alternative for oral administration. Research J Pharm and Tech 2015:8(6):1-9.
    6. Jannin V, Lemagnen G, Gueroult P, Larraouture D, Tuleu C. Rectal route in the 21st Century to treat children. Adv Drug Deliv Rev 2014;73:34-49.
    7. Kulkarni R, Dave N, Bartakke A, Nair A, Kadam PP, Thatte UM, et al. Pharmacokinetics of rectal compared to intramuscular paracetamol in children undergoing minor surgery. Ind J Pharmacol 2007;39(4):187-191.

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