Kids Health Ear infections are far more common in infants than adults and are diffi cult to detect as the ears are still concealed. Ear infections quite often cause your baby to become colic and clingy. So how do you deal with the situation?
What is an ear infection? Th e human ear is segmented into three sections viz. outer, middle and inner. Th e middle ear is connected to the nasal cavity through a tube called the eustachian tube. Th e tube is narrow at the beginning but widens as it reaches the middle ear. It is for the most part closed but opens once in a while to equalise the air pressure in the middle ear and drain the fl uids secreted by the middle ear. Th is exposes the middle ear to virus and bacteria from the sinonasal cavity, making the region the primary center of ear infections.
Ear infections are of three types:
1.Acute otitis media (AOM)
2.Otitis media with eff usion (OME)
3.Chronic otitis media with eff usion (COME): AOM is the case when the middle ear suff ers a bacterial infection, causing severe pain and discomfort. OME is also referred to as glue ear and is caused when there is an accumulation of fl uid in the middle ear that eventually gets infected by bacteria.
When this condition repeatedly occurs with or without an infection, then it is called Chronic Otitis Media with Eff usion (COME). When the baby develops an infection in both his ears, then it is a case of bilateral ear infection. In any case, the baby will show discomfort due to an infl ammatory reaction of the tympanic membrane, also known as the eardrum.
Why are babies more prone to ear infections? Babies are prone to ear infections primarily due to the following reasons:
1. Underdeveloped immune system Babies have an underdeveloped immune system. Th is invariably means they have less resistance to fi ght pathogens and take a longer time to fi ght an infection.
2. Developing eustachian tubes Like many other parts of their body, eustachian tubes are also still developing. Th ese tubes are shorter, narrower and horizontal in babies.
Th is makes it easier for mucus and fl uids to move from the nasal cavity to the middle ear but diffi cult for it to drain back. As your baby grows, the eustachian tube will slowly become longer and more vertical. In short, a baby’s developing body makes him vulnerable to ear infections. But you might want to know the causes of ear infection in babies so that you can be careful.
What Causes Ear Infection?
Ear infection can be the result of several factors, right from a cold to allergies. Here are some common reasons for ear infection: 1. Common cold Cold is the leading cause of ear infection in babies.
Th e cold bacteria can conveniently travel to the middle ear through the short eustachian tube and cause a swelling of the tubes and the middle ear. Th e swelling entraps the natural fl uidlike secretions of the middle ear, which may soon become a harboring site for bacterial growth, leading to infection.
2. Allergy General allergy towards a certain food or airborne irritants can lead to an infl ammation of the sinonasal cavity. Th is can create pressure on the eustachian tube narrowing it down to the point that it can no longer allow the passage of the fl uids from the middle ear to the nasal cavity.
Th is can lead to infection in the fl uid collected in the middle ear. Sometimes, an allergy may show a direct eff ect on eustachian tube causing it to swell.
3. Sinonasal infection Sinusitis, the infection of nasal sinuses, cause the eustachian tube to swell, thus creating pressure on the middle ear. Th e bacteria may infect the inner lining of the eustachian tube causing it to bloat.
Either way, it leads to an ear infection due to the invasion of bacteria in the fl uid secreted by the middle ear.
4. Adenoid infection Adenoids are a pair of lymphatic tissue, quite similar to tonsils, located right above the posterior end of the nasal cavity. Just like tonsils, they are known to play a role in maintaining the immunity of the body.
When adenoids infl ame, due to bacterial or viral infection, they can put pressure on the eustachian tube that is small and horizontal in babies. Babies have larger adenoids than adults making them more prone to blocked eustachian tubes due to swollen adenoids.
5. Accumulation of milk in eustachian tube Babies that are bottle-fed and drink milk on their back are at a greater risk of having an infl amed eustachian tube as milk rolls down from their mouth into the ears while feeding. Th e oral and nasal cavities are connected and drinking while on the back can cause the milk to pass into the nasal cavity. From here the milk can move towards the middle ear by passing through the horizontal eustachian tubes of the baby. Here the milk may get accumulated with the natural milk bacteria causing infection and infl ammation.
Risk factors
Th ere are certain conditions that can put your baby at a higher risk of contracting an ear infection. Following are the common risk factors for ear infections:
1.Premature babies: Premature babies are born with an immensely underdeveloped immune system. Th ey also have a poorly developed fi rst line of defence, such as skin and mucus membrane, that help keep bacteria at bay.
2.Babies that suff ered serious illness early in life: Th ose aff ected by a disease during early months of their life can have a weakened immune system. Such babies are prone to ear infections. 3.Babies constantly exposed to pollutants: Pollutants can be something as generic as cigarette smoke. Th ey can harm the baby’s immunity development, eventually making him prone to various infections.
Signs And Symptoms Of Ear Infection
Your baby cannot talk. Th e only way he can communicate is through his cries. But his cry can mean many things, so how can you understand that he is crying due to ear infection? Recognize the symptoms:
1. Fluid discharge from the ear It is the paramount sign of an ear infection. If you notice a clear or yellowishred fl uid draining from your baby’s ears, then it defi nitely means something is wrong. A perforated eardrum could be leaking the accumulated and infected fl uid from the baby’s middle ear. Th e yellowish nature of the fl uid is due to the buildup of pus that is an aggregation of white blood cells that attack pathogens. It is thus a defi nite indicator of an infection. 2. Unpleasant smell from the baby’s ear You may notice an unpleasant smell emanating from the baby’s ear even when he is clean. Th e smell is distinct from that of ear wax and lasts for days together. Th e smell usually derives from the pool of infected fl uid that lies behind the eardrum.
3. Tugging at ears while crying Th e baby may tug at his ears especially during his chronic bursts of crying. It is a sign of discomfort in that part of the body. Your baby may tug or pinch severely when he is lying down or sleeping. Since young babies cannot talk, tugging at the ear is their way to communicate a feeling of discomfort.
4. Fever An ear infection can cause high fever for several days without any visible illness. Th is means the baby will not have a cold or any other infection, but his temperature will be more than 102 degrees F. According to Dr. Max M. April from the American Academy of Otolaryngology, a constant fever around 102 degrees F is one of the hallmarks of a baby’s ear infection. Sometimes, your baby may not have a fever but may still have an ear infection. Dr. Jennifer Shu of American Academy of Pediatrics states that parents must also check for other symptoms of ear infection and not just rely on the fever. 5. Delayed or lack of response towards sounds An ear infection can be one of the several underlying reasons for a baby’s lack of response to sounds. When fl uid builds up in the middle ear, it slows the passage of sound towards the inner ear. Th e infection makes the fl uid thicker, thus impeding the movement of sound impulses from the outer ear to the inner ear. It means your baby will have trouble responding to sounds and voices. 6. Reduced appetite Eustachian tubes widen naturally while swallowing. During an ear infection, the walls of the tube swell thus making their widening quite painful. For this reason, the baby may want to avoid the feeds. He may get irritable when he is coaxed to feed and stop halfway. In some cases, the baby may make choking sounds or cough due to the pain caused by the infection. 7. Loss of balance If your baby is old enough to crawl or walk a few steps on his own, then he may lose his balance. His walk can be unstable. He might also crawl in a zig-zag pattern. Th is could mean that the fl uid buildup in the middle ear is so much that it now puts pressure on labyrinth – the part of the inner ear also responsible for maintaining body balance. In a worst-case scenario, it could mean the infection has trickled down to the inner ear but this is not likely to happen until or unless every symptom of middle ear infection is neglected. 8. General irritability Th e baby may show signs of general irritability especially when he is being held or lying down. It means that the baby is feeling uncomfortable, which is an indicator of an ear infection. To be continued
