A Parent's Toolkit for Managing Ear Infections in Children - December 2024

Ear infections affect everyone at one point in our lives. Including kids. They can be uncomfortable, alarming and sometimes even downright painful. We sat down with Pharmacist Nazatul Amira Hamzah from Primabumi Sdn Bhd to learn more about how parents can manage ear infections in children. Nazatul is a qualified pharmacist with 10 years of experience in pharmacy practice involving both hospital and community settings. She currently holds the position of Pharmacist and Key Account Manager at a renowned pharmaceutical company in Kuala Lumpur. Here's a pharmacists' expert opinion on what parents can do when their kids get an ear infection. What is an ear infection? An ear infection happens when a certain part of the ear is inflamed due to the presence of harmful bacteria, viruses, or fungi. The two most common ear infections are otitis media and otitis externa. Otitis media is an infection of the middle ear, the air-filled space between your eardrum and inner ear. Infection of the ear canal—the passage that carries sounds from the outside of the body to the eardrum—is known as otitis externa. How do I tell if my child has an ear infection? There are many symptoms that can point to an ear infection. The first, of course, is pain in the inner ear, often accompanied by redness, swelling and/or itchiness. You may see your child pulling or tugging at their ear as a result. There may also be a feeling of fullness or pressure in the ear. Colourless or yellowish, pus-like fluid in the ear can also be a sign of an ear infection. An ear infection may cause a fever, difficulty eating, drinking, or sleeping, loss of appetite, and irritability and crying. In more serious cases, ear infections can cause clumsiness or problems with balance and even hearing problems. How did my child get an ear infection? Otitis media ear is often caused by viruses or bacteria that spread to the middle ear. The infection can come from many sources: a sore throat, a cold, or an upper respiratory infection. As the bacteria or viruses grow, fluid accumulates behind the eardrum. Otitis externa is brought on by bacteria, or sometimes fungi, that enter the ear canal by foreign objects. These can be anything from cotton buds, water (i.e. swimmer's ear), hearing aids, earplugs (especially if they are not cleaned properly). Sometimes irritants can enter the ear and cause the infection. Hair dye or hair spray, and secondhand smoke are just some examples. Are ear infections common in children? Are they dangerous? Children have a higher chance of getting ear infections because of several reasons. First, their immune system is still immature. As a result of this, they also tend to have more frequent colds which also increases the likelihood of ear infections. Another risk is structural in nature. The Eustachian tubes of children (the canals that connect the middle ear to the back of the throat) are more horizontal and shorter than those of adults. This makes it easier for bacteria and viruses to enter the middle ear. Also, because the tubes are smaller, blockages are more likely to occur, causing infections to build up in the middle ear. When the pressure from the fluid buildup gets high enough, it could cause the eardrum to rupture. Severe or frequent ear infections may result in serious damage, including hearing loss or speech delay. How long does an ear infection last? Middle ear infections normally clear up on their own within two to three days without treatment. However, even after an infection goes away, fluid frequently remains in the middle ear. Additional treatment may be required if the fluid is still there for more than three months. How do you treat an ear infection? Depending on the severity of the symptoms, your child may be prescribed antibiotic-containing ear drops to treat the infection. Alternatively, ear drops that contain both an antibiotic and a corticosteroid may be required if your child’s ear canal is too swollen. Ear drops are usually given several times a day for 7 to 10 days. In some cases, the doctor may need to remove pus and other buildup from the ear with gentle cleaning or suction to increase the effectiveness of the ear drops. The table below outlines some of the most commonly prescribed ear drops to treat ear infections. Content(s) Active Ingredient(s) Treatment Purposes An antibiotic Chloramphenicol Ear infections caused by certain bacteria Gentamicin sulphate Ofloxacin One or more types of antibiotics plus a corticosteroid Neomycin sulphate Dexamethasone Ear infections caused by certain bacteria where the use of a corticosteroid is necessary. Gentamicin sulphate Betamethasone sodium phosphate Neomycin sulphate Polymyxin B sulphate Hydrocortisone An antifungal Clotrimazole To treat and prevent ear infections caused by certain fungi. *The table above serves as general guidance only. Please consult your healthcare professional before starting any treatment for your child. Painkillers such as paracetamol or ibuprofen could help relieve the pain and/or fever that your child experiences for the first 24 to 48 hours until the inflammation starts to subside. Your doctor or pharmacist will be able to advise you on the most appropriate treatment for your child. Does my child need an oral antibiotic? Your child may have a more severe or persistent ear infection. In these instances, an oral antibiotic may be needed. If an oral antibiotic is prescribed, your child must complete the course of treatment to ensure that the infection is completely cleared. Should my child stay at home while undergoing treatment for an ear infection? Ear infections aren’t contagious. However, your child may still need to stay at home for a couple of days until they feel better. An ear infection is not only uncomfortable but painful. It will likely distract them from having any sort of productive learning experience at school. Your child can attend school or daycare once their infection is fully gone and their fever and other symptoms have subsided. How do I help prevent my kids from getting ear infections? As mentioned earlier, upper respiratory infections are the main culprit of ear infections. So, to ensure they don't get colds or the flu often, make sure your child’s vaccinations are up-to-date. This should include their yearly influenza vaccination. You’re also strongly recommended to ask your paediatrician about vaccines against meningitis and pneumococcal disease. Next, teach your child to wash their hands thoroughly and regularly. Hand washing can help shield your child against the flu and cold by preventing the spread of germs. If possible, breastfeed your infant for the first six to twelve months of life. Breast milk contains antibodies that help your child fight against infections. Hold your baby upright when bottle-feeding them, so their head is higher than their stomach. This way, you prevent milk formula or other liquids from recirculating and accumulating in your child’s ear. If your child or their playmates are ill, try to keep them away from other kids as much as you can. Finally, keep your kids away from cigarette smoke. When should I bring my child to see a doctor? Bring your child to see a doctor immediately if they display the following: your child’s symptoms don’t improve after two days with or without treatment your child has severe and recurrent middle ear infections your child has an earache and a fever Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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