The 411 On Ear Infections

By Nancy Gottesman

Some toddlers get them every month. Others, a few times a year. Even the most robust young children will likely come down with at least one during their preschool years.

In fact, three out of four kids will have a minimum of one ear infection by their third birthday, and half of those kids will have more than three!“In our clinical setting, ear infections are the second most common reason [the first being common cold/upper respiratory infections] for a child’s sick visit,” confirms Lisa deYbarrondo, MD, a pediatrician and an assistant professor of pediatrics at the University of Texas Medical School at Houston.

Although acute otitis media—as you’ve probably heard your pediatrician call an ear infection—mainly affects infants and toddlers, the condition becomes a family problem when you have to keep your sick child at home.

The National Institutes of Health estimates that in America, parents’ lost wages and toddler medical costs amount to $5 billion a year due to ear infections alone. Here’s what you need to know about treating and preventing this common childhood ailment. What causes an ear infection?

Have you ever wondered why you and your adult friends never seem to come down with ear infections? The first reason: Your immunity is stronger than your toddler’s developing immune system and keeps you from catching everything your child gets. Second, child-size anatomy actually promotes otitis media, the clinical term for inflammation or infection of the middle ear. (Swimmer’s ear, in case you’re curious, affects a different part of the ear and is called otitis externa.)

A toddler’s eustachian tube— which allows air into the middle ear and equalizes pressure there—is shorter and more horizontal than an adult’s. Because of this formation, the tubes are susceptible to blockage from mucus and can’t easily drain. When fluids collect in these normally air-filled tubes, it creates a breeding ground for germs.

An infection ensues, causing swelling, redness, hearing problems and sometimes a whole lot of pain. Whether the germs are bacterial or viral—or a mix of both—disease-fighting white cells in the bloodstream enter the middle ear, leading to the formation of pus as the cells kill the bacteria and die off themselves.

What all of this means is that even a minor case of barely noticeable kiddie sniffl es can result in a much more worrisome ear infection. So can a cold virus, influenza and RSV (respiratory syncytial virus, the most common cause of lung inflammation in young children).

“Germs can even get blown into the middle ear from sneezing or nose-blowing and cause infection,” says Dr. deYbarrondo. The good news is that by the time your child is in preschool, she’ll have a great deal fewer ear infections. “After she’s 3 years old, you’ll see a rapid decline in the amount of ear infections your child will get,” deYbarrondo says.