Playing it by Ear–Guidelines for Ear Infections

Many parents bring their children with ear infections to express care, urgent care, and even the emergency department to request antibiotics for ear infections. But, sometimes, antibiotics aren’t the right choice. Most ear infections cure themselves without the help of antibiotics. Recommendations today recommend starting with home care remedies first. Doctors are concerned with the overuse of antibiotics, which can lead to resistance of certain bacteria, as well as unnecessary side effects that can be prevented.

An ear infection is a bacterial or viral infection that affects the ear. It becomes painful when build-ups of fluid and inflammation occur in the air-filled space behind the eardrum. Signs and symptoms of infection often show up quickly, and can include, but are not limited to:

  • Pain in the ear, especially when lying down.
  • Difficulty sleeping.
  • Pulling or tugging the ear.
  • Difficulty hearing or responding to sounds.
  • Fever or headache.

Generally, an ear infection will improve within the first couple of days and clear up within one to two weeks without any treatment. It is recommended to use the wait-and-see approach for:

  • Children ages 6 to 23 months with mild inner-ear pain in one ear for less than 48 hours and a temperature less than 102.2 degrees F.
  • Children ages 2 and older with mild inner-ear pain in one or both ears for less than 48 hours and a temperature less than 102.2 degrees F.

Home remedies can help manage a child’s pain. Try placing a warm, damp washcloth over the affected ear. Most providers recommend an over-the-counter (OTC) medications, such as ibuprofen or acetaminophen, to relieve pain. Use the medications as directed on the label. You can alternate ibuprofen every 6 hours with acetaminophen every 4 hours if needed.

Your medical provider can suggest the best treatment for your child. Antibiotics may be beneficial for certain children with ear infections. Your provider can explain the potential side effects and concerns about antibiotics creating strains of resistant disease. If antibiotics are prescribed, be sure to use the entire antibiotic as directed. Failing to do so can result in recurring infection and resistance of bacteria to antibiotic medication. Just because your child is feeling better doesn’t mean the infection is totally gone. As well, instead of oral antibiotics, ear drops may be prescribed.

You can prevent a lot of ear infections in younger children by not allowing them to go to sleep with a bottle. The eustachian tubes in children are more horizontal than in adults, which means it is easier for fluid to go up into the ears while in a lying position. A pacifier is okay. Not allowing a child to go to sleep with a bottle also helps prevent dental caries as well. Keep children away from cigarette smoke. Make sure they are eating a healthy diet.