Parent Perspective Has your child been experiencing ear infection after ear infection? Do you worry that every cold or runny nose will result in an earache? Are you concerned that your child’s hearing might be affected due to the number of ear infections he/she has had? Are you hesitant to put your child on another round of antibiotics? We have had a very similar experience with our son. His first infection came after his first cold and there were many more to follow. We quickly learned that his ear infections did not always cause high fevers and other obvious symptoms. Sometimes we noticed subtle changes such as an increase in fussiness, decrease in appetite, and ear tugging. We also came to realize that with our son, each runny nose was followed by an ear infection. Finally after careful consideration and consultation with our pediatrician and the ENT specialist, we decided to have tubes surgically placed in our son’s ears to aid in the proper drainage of fluid. So far, he has been ear infection free and his hearing has tested normal. Now we just have to be vigilant about keeping water out of his ears by using ear plugs, which is a minor inconvenience considering the overall health of our son. By taking advantage of the various resources at the Junior League Family Resource Center, you can educate yourself as to why children are susceptible to this common childhood illness and the different treatment options that are available. The Resource Center has books, videos, articles, and website listings for both adults and children. You will also find a list of national and local organizations that can provide educational materials and clinical services. Kristin Price Mother of John Patrick, 1 year old

Professional Perspective Otitis media is an infection of the middle ear (behind the eardrum). It is not to be confused with otitis externa, which is an infection of the ear canal (sometimes called “swimmer’s ear”). Otitis media is most common in children aged 6 months to 2 years, although it can occur at any age. Symptoms can range from fever, sleeplessness, fussiness, and decreased appetite to ear pain (among older children who can communicate verbally). Although pulling on the ears can be a sign, many infants pull on their ears for various reasons and this is not always a true indication of ear infection. Parents may also occasionally note drainage from the ear if the pressure in the eardrum from the infection causes perforation. Older children may also occasionally report decreased hearing from fluid retained in the ear, or even vertigo, while younger children may develop a wobbly gait. The only way to diagnose an ear infection correctly is for your medical provider to examine the ear with an otoscope. Many ear infections frequently follow an upper respiratory infection, or common cold. This is because colds may cause swelling of the Eustachian tubes which help drain the ear and relieve pressure. In small children these do not drain very well. Other risk factors for developing an ear infection include day care attendance, a history of ear infections, certain medical conditions (Down Syndrome, cleft palate), ethnicity (e.g., Native Americans), tobacco and smoking exposure, bottle propping, use of pacifiers, male sex, and lack of breastfeeding. Most ear infections are caused by three common bacteria which frequently inhabit the nasal passages of children. The majority of ear infections usually get better without antibiotics. The younger the child, the more likely antibiotics may be needed to treat, and a small group of children may need several courses of antibiotics. This is because we are seeing increased resistance among some of the bacteria that cause infections due to overuse of antibiotics. The common cold is almost always caused by viruses and antibiotics do not treat the common cold. Medications to treat the ear pain are also commonly used and may include acetaminophen, ibuprofen, and occasionally ear pain drops. Complications of middle ear infection are rare but may include persistent infection, and rarely perforation (i.e. the eardrum may “burst” spontaneously). Very rarely, children may develop an infection of the skull area adjacent to the ear (mastoiditis). The most common complication following ear infections is persistence of fluid in the ear behind the eardrum (also called an effusion). This may normally persistent for 4-6 weeks and may also cause a slight hearing loss. If the fluid persists beyond several months, or if infections recur with high frequency, consultation with an otolaryngologist (ENT) may be warranted for consideration of placement of special small tubes which can help drain the ear and prevent fluid. Gregory S Plemmons M.D. Assistant Professor General Pediatrics Vanderbilt University

My Ear Hurts: A Complete Guide to Understanding and Treating Your Child’s Ear Infections By Ellen Friedman, Barassi James P., Patricia Shea New York, NY: Fireside Books, 2001. Pages: 240 Library of Congress Number: RF225.F75 2001 Category: Specific Chronic Health Condition   This book about ear infections provides parents with a detailed and understandable guide to the causes of and treatments for ear infections. The book provides tools for assessing the severity of attacks, deciding which treatment to pursue, and coping with a sick child. The style is easy to read and the book includes lots of illustrations, lists, and diagrams to help parents learn about childhood ear infections.

Parent's Complete Guide to Ear Infections, The By Dr. Alan R. Greene, MD Allentown, PA: Peoples' Medical Society, 1997. Pages: 256 Library of Congress Number: RF225.G74 1997 Category: Specific Chronic Health Condition   This comprehensive book on ear infections offers information on the normal functioning of the ear, why children get ear infections, and which children are most likely to develop them. The book provides information on a variety of treatment options including medications, home remedies, and surgical therapies.

Sound Advice About Your Child's Ear Infection Wyeth-Ayerst Laboratories, 1997. Length: 12 min. Category: Specific Chronic Health Condition   This is an informational video about children who have otitis media, also known as a middle ear infection. The video contains commentary from doctors and parents, and describes symptoms, causes, procedures for checking and caring for the infection, and potential consequences of infection.

Ear Infection and Middle Ear Fluid (Otitis Media) http://www.med.umich.edu/1libr/guides/om/index.htm Author: University of Michigan Health Systems, Clinical Reference System This website is a parent’s guide for understanding otitis media in children. The site includes a basic description of the infection and includes a link to a helpful diagram of otitis media.

Earache and Otitis Media http://www.sinuscarecenter.com/omaao.html Author: Sinus Care Center of Jackson and the American Academy of Otolaryngology-Head and Neck Surgery This website is a copy of a brochure by the American Academy of Otolaryngology-Head and Neck Surgery. It provides answers to questions regarding ear infections, diagnosis, and treatments.

National Institute on Deafness and Other Communications Disorders (NIDCD) - Otitis Media http://www.nidcd.nih.gov/health/hearing/otitismedia.asp Author: National Institute on Deafness and Other Communications Disorders The general website for the NIDCD provides information on a variety of issues regarding hearing, ear infections and speech issues. The site contains information on otitis media, its causes, diagnosis, types, treatments, and surgical options.

Otitis Media with Effusion http://www.drgreene.com/21_1276.html Author: Dr. Alan R. Greene, M.D. This article explains the difference between Acute Otitis Media (AOM) and Otitis Media with Effusion (OME) and describes the different ways OME can be diagnosed and treated. Dr. Greene, a pediatrician who has written extensively on AOM and OME, describes causes, symptoms, treatments, and complications regarding OME.

Parents Place, iVillage, The http://www.ivillage.com/topics/parenting/0,10707,166602,00.html Author: iVillage.com This section of iVillage’s parenting website includes a number of informative articles about children’s ear health. Articles include discussions of ear infections, ear discharge, ear tubes, laser surgery for ear infections, symptoms, and prevention. Keyword is "ear infection".

Vanderbilt Bill Wilkerson Hearing and Speech Center 1215 21st Avenue South, Medical Center East - South Tower Nashville, TN 37232 Phone: 615.936.5070 Fax: 615.936.5088 (hearing) Website: http://www.mc.vanderbilt.edu/VanderbiltBillWilkersonCenter/index.html Through three major clinics, the Bill Wilkerson Center provides diagnostic and therapeutic services to persons of all ages who have speech, language, hearing, or neurological disorders such as stuttering, apraxia, autism or sensory integration dysfunction. The Wilkerson Center offers the only communication based intervention program for preschoolers in the Middle Tennessee area. The program works in collaboration with children, families, their primary doctors, and the local school systems. Therapists conduct evaluations, provide speech therapy and help children gain communication and behavioral skills.

3-8 years

Tubes in My Ears: My Trip to the Hospital By Virginia Dooley New York, NY: Mondo Publishing, 1996. Pages: 24 Library of Congress Number: RJ242.D66 1996 Category: Specific Chronic Health Condition   This straightforward and upbeat look at having ear tube surgery is perfect for helping kids understand the basics of the procedure without scaring them or increasing pre-surgery jitters. The illustrations and a light but honest tone make the book accessible to different age levels. The book discusses preliminary tests, anesthesia and post-surgery experiences, and defines and illustrates key phrases.

4-9 years

Chris Gets Ear Tubes By Betty Pace Washington, DC: Kendall Green Publications, 1987. Pages: 44 Library of Congress Number: RF225.P33 1987; C:3 Category: Specific Chronic Health Condition   This is a story about a young boy, Chris, who has trouble hearing. His doctor speaks with him about getting tubes in his ears to help the hearing problem. When he finds out it means having an operation, Chris isn't sure he wants to go through with it. The doctor, staff, and his parents help Chris feel more comfortable and we follow his story through to the successful conclusion of the operation and his restored hearing.

All Ages

Kids E.N.T. Health http://www.entnet.org/KidsENT/ears_index.cfm Author: The American Academy of Otolaryngology –Head and Neck Surgery (AAO-HNS) The Kids E.N.T. Health site includes a Just for Kids section where kids can learn all about ears, nose, and throat -"How do your ears work?", "What are tonsils and what hapens when you need them removed?" are some of the topics covered.

All Ages

What is an Ear Infection? http://www.kidshealth.org/kid/ill_injure/sick/ear_infection.html Author: Kidshealth and the Nemours Foundation This website from Kidshealth explains ear infections in an easy-to-understand style. The article discusses causes of ear infections, the different ways doctors might treat the infection, and how to prevent ear infections in kid-friendly language.

Que es una infeccion de oido http://kidshealth.org/kid/en_espagnol/comunes/ear_infection_esp.html Author: Kidshealth and the Nemours Foundation This Kidshealth article describes Acute Otitis Media (AOM) in great detail, including causes, treatment, and prevention.

Tuotromedico http://www.tuotromedico.com/temas/otitis_media.htm Author: Sanitas, a Health insurance provider from Spain The website, run by Sanitas and Tuotromedico, offers information about otitis media in Spanish including information on causes, symptoms, treatment, and complications.

All information on this website is for educational purposes only. Specific medical advice, diagnoses, and treatments can only be given by your personal health care professionals