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Ear Infections

Ever wonder why your kiddo is fussier than normal? Constantly, I know. There seems to be something new every week:  illness, food issues, growth spurts, teething. How can we keep it all straight? In particular, you might notice that your child keeps tugging on his ear during a meltdown, or even tells you “ouch” or “hurts” when pointing to an ear. With or without a fever, your mom radar (and my nurse radar!) screams ear infection.

There are three types of ear infections, with the middle ear infection being the common earache we see in our kiddos because of an illness. It is also called otitis media. There is also an outer ear infection, referred to as swimmer’s ear or otitis externa. And then an inner ear infection, which is very rare and needs medical treatment.

What causes ear infections?

They are very common in our littles for a few reasons:

  1. Their immune systems are still developing, so they can’t fight off bugs as well as we can.
  2. Their eustachian tubes (the part of the ear that drains fluid when we get a cold or infection) are more horizontal than ours, which makes draining tougher and causes a buildup of pressure and fluid in the ear.
  3. Enlarged adenoids (common in young kids) can also block fluid drainage, creating a cozy place for bacteria to grow.

And guess what, Mom and Dad: ear infections in adults can happen too! Not as common for you as it is for your babes, but this info can apply to you as well.

Debating about asking for antibiotics? Current recommendations say to avoid them if possible, so if the symptoms are mild and your Kinsa thermometer is reading less than 102℉, you’re okay to hold back and see how this plays out. Unless your babe is <6 months old – in this case, go ahead and call the doctor to have things checked out sooner than later. Ear infections typically are more common beginning at 6 months old so hopefully you won’t have to deal with this with a newborn.

If your child is still having ear pain and running a fever after 2 days (even with medication), or if the fever rises above 102℉ or you see drainage from the ear, call your doctor.

Let’s break it down into a list to recap, shall we?

What are ear infection symptoms?

Again, these are middle ear infection symptoms we’re discussing. The most common symptoms are:

  • Verbalizing ear pain or tugging/pawing at ear
  • Irritability
  • Fever of 100℉ or higher
  • Trouble sleeping
  • Ear drainage
  • Difficulty hearing
  • Recovering from a respiratory illness

When can we wait it out at home?

  • Fever is less than 102℉
  • The ear pain has been present for less than 48 hours
  • If your babe is >6 months old

How to treat ear infection?

  • Tylenol or Ibuprofen for pain or fever
  • No medications for our babes <3 months old
  • No ibuprofen for our babes <6 months old
  • No Aspirin for our kids <18 years old
  • Warm compress or cold packs to infected ear
  • Most of us have a preference to warm or cold, let your child decide or even alternate both! 20 minutes max for either option — we want to avoid burns and frostbite.
  • Sleep with the painful side up. Sometimes pressure on the ear hurts more.

When should we call our pediatrician?

  • If your little one is <6 months old with symptoms
  • Fever greater than 102℉
  • Ear pain and fever lasting longer than 48 hours
  • White, cloudy drainage from ear
  • Blood-tinged pus draining from ear
  • Injury to ear or possible foreign body in ear

How can we prevent ear infections?

  • Wash hands to prevent other illnesses
  • Stay up-to-date on immunizations
  • Avoid smoke!
  • Control allergies. Just another way fluid builds up in those ears.
  • Don’t put your baby to bed with their bottle. The formula can flow into those eustachian tubes we discussed and cause an ear infection.

Are ear infections contagious?

Technically, no! The ear infection itself is not contagious. That being said, keep in mind that if a virus caused the ear infection, that likely IS contagious.

How long do ear infections last?

The duration of an ear infection depends on how severe the infection is. If your doctor prescribes antibiotics, most earaches should feel better by 2 days and resolve in 3 days. The accompanying fever should resolve in 2 days. If you are not sure what you are dealing with and if the ear pain doesn’t feel better after 2 days, call your doctor.

If your doc starts your kiddo on an antibiotic (usually 7-10 days), it’s very important not to miss any doses and continue the full course of antibiotics so the ear infection doesn’t return. While the antibiotics begin kicking in (the initial 2-3 days), your child may still need some medication to help with pain. If your child has been on antibiotics for 3 days but they are still having ear pain and/or fevers, call your doctor back. Some kids will have recurrent ear infections and the discussion of ear tubes might come up to allow better fluid drainage. This is typically discussed after 4 months of fluid in the ears and multiple rounds of antibiotics, so don’t worry about this too soon in the game. One ear infection at a time!

High five for battling another curveball – you’re crushing this parenting thing.

Blake Wageman

Blake Wageman, RN, BSN has over 14 years of nursing under her belt, primarily focused on NICU babies and, just as importantly, their worried parents.