Care Advice
Treatment for an Ear Infection
What You Should Know About Ear Infections:
- Ear infections are very common in young children.
- Most ear infections are not cured after the first dose of antibiotic.
- Often, children don't get better the first day.
- Most children get better slowly over 2 to 3 days.
- Note: for mild ear infections in older children, antibiotics may not be needed. This is an option if over 2 years old and infection looks viral.
- Here is some care advice that should help.
Keep Giving the Antibiotic:
- The antibiotic will kill the bacteria that are causing the ear infection.
- Try not to forget any of the doses.
- Give the antibiotic until it is gone. Reason: to stop the ear infection from flaring up again.
Fever Medicine:
- For fevers higher than 102° F (39° C), give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Note: fevers less than 102° F (39° C) are important for fighting infections.
- For all fevers: keep your child well hydrated. Give lots of cold fluids.
Pain Medicine:
- To help with the pain, give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Use as needed.
Cold Pack for Pain:
- Put a cold wet washcloth on the outer ear for 20 minutes. This should help the pain until the pain medicine starts to work.
- Note: some children prefer heat for 20 minutes.
- Caution: heat or cold kept on too long could cause a burn or frostbite.
Limits on Activity:
- Your child can go outside and does not need to cover the ears.
- Swimming is fine as long as there is no drainage from the ear. Also, do not swim if there is a tear in the eardrum.
- Air Travel. Children with ear infections can travel safely by aircraft if they are taking antibiotics. For most, flying will not make their ear pain worse.
- Give your child a dose of ibuprofen 1 hour before take-off. This will help with any pain they might have. Also, during descent (coming down for landing) have your child swallow fluids. Sucking on a pacifier may help as well. Children over age 6 can chew gum.
Return to School:
- Your child can go back to school when any fever is gone.
- Your child should feel well enough to join in normal activities.
- Ear infections cannot be spread to others.
What to Expect:
- Once on antibiotics, your child will get better in 2 or 3 days.
- Make sure you give your child the antibiotic as directed.
- The fever should be gone by 2 days (48 hours).
- The ear pain should be better by 2 days. It should be gone by 3 days (72 hours).
Ear Infection Discharge:
- If pus is draining from the ear, the eardrum probably has a small tear. This can be normal with an ear infection. Discharge can also occur if your child has ear tubes.
- The pus may be blood-tinged.
- Most often, this heals well after the ear infection is treated.
- Wipe the discharge away as you see it.
- Do not plug the ear canal with cotton. Reason: retained pus can cause an infection of the lining of the ear canal.
Call Your Doctor If:
- Fever lasts more than 2 days on antibiotics
- Ear pain becomes severe or crying becomes nonstop
- Ear pain lasts more than 3 days on antibiotics
- Ear discharge is not better after 3 days on antibiotics
- You think your child needs to be seen
- Your child becomes worse
Treatment for Hearing Loss with an Ear Infection
Brief Hearing Loss:
- During an ear infection, fluid builds up in the middle ear space.
- The fluid can cause a mild hearing loss for a short time.
- It will slowly get better and go away with the antibiotic.
- The fluid is no longer infected, but sometimes, may take weeks to go away. In 90% of children, it clears up by itself over 1 to 2 months.
- Permanent harm to the hearing is very rare.
Talking With Your Child:
- Get close to your child and get eye contact.
- Speak in a louder voice than you usually use.
- Decrease any background noise from radio or TV while talking with your child.
Call Your Doctor If:
- Hearing loss not better after the antibiotic is done.
Prevention of Recurrent Ear Infections
What You Should Know:
- Some children have ear infections that keep coming back.
- If this is your child's case, here are some ways to prevent future ones.
Avoid Tobacco Smoke:
- Contact with tobacco smoke can lead to ear infections.
- It also makes them harder to treat.
- No one should smoke around your child. This includes in your home, your car or at child care.
Avoid Colds:
- Most ear infections start with a cold. During the first year of life, try to reduce contact with other sick children.
- Try to put off using a large child care center during the first year. Instead, try using a sitter in your home. Another option might be a small home-based child care.
Breastfeed:
- Antibodies in breast milk lower the rate of ear infections.
- If you are able to, consider breastfeeding your baby during the first year of life or longer.
Do Not Prop the Bottle:
- During feedings, hold your baby with the head higher than the stomach.
- Feeding while lying down flat can lead to ear infections. It causes formula to flow back into the middle ear.
- Having babies hold their own bottle also causes milk to drain into the middle ear.
Get All Suggested Vaccines:
- Vaccines protect your child from serious infections.
- The pneumococcal and flu shots also help to prevent some ear infections.
Control Allergies:
- Allergies may lead to some ear infections.
- If your baby has a constant runny or blocked nose, suspect an allergy.
- If your child has other allergies like eczema, ask your child's doctor about this. The doctor can check for a milk protein or soy protein allergy.
Check Any Snoring:
- Large adenoids can cause snoring or mouth breathing. Suspect this if your toddler snores every night or breathes through his mouth.
- Large adenoids can contribute to ear infections.
- Talk to your child's doctor about this.
Ear Tube Surgery Questions
Ear Tubes:
- Ear tubes are tiny plastic tubes that are put through the eardrum. They are placed by an ENT doctor.
- The tubes allow fluid to drain out of the middle ear space. They also allow air to re-enter the space.
- This lowers the risk of repeated ear infections and returns the hearing to normal.
Ear Tubes - When Are They Needed?
- Fluid has been present in the middle ear nonstop for over 4 months. Both ears have fluid.
- Also, the fluid has caused a hearing loss greater than 20 decibels.
- Hearing should be tested first. Some children have nearly normal hearing and tubes are not needed.
- Ear infections that do not clear up after trying many antibiotics may need tubes.
- Prevention should be tried before turning to surgery.
- Talk to your child's doctor about when ear tubes are needed.
What to Expect:
- In most cases, the tubes come out after about a year. They fall out of the ear on their own. This happens with the normal movement of earwax.
- If the tubes stay in over 2 years, talk with your child's doctor. The surgeon may need to take them out.
Risks of Ear Tubes:
- After the tubes come out, they may leave scars on the eardrum. They may also leave a small hole that doesn't heal. Both of these problems can cause a small hearing loss.
- Because of these possible problems, there is a small risk with ear tubes. There is also a small risk when giving anesthesia to young children.
- Therefore, doctors suggest ear tubes only for children who really need them.
Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.