Is an Infant Ear Infection
Keeping Your Baby Awake?

An infant ear infection can devastate a goodnight's rest like few other things. The spontaneous scream that emits from the previously-serene nursery can rattle you to the bones.

Part One:
Causes ~ Symptom Tests ~ Prevention Tips

Part Two:
Antibiotics ~ At Home Relief ~ Ear Tubes

And then there's the helpless rocking, late into the night...the countless nursery songs that end up as exhausted blurbs of quasi-melody. All haunted with the lingering question: what is wrong with her?

Speaking from experience, the "unknown" of an infant ear infection is a tough pill to swallow. Here are some tips and clues to help you identify when she may need that visit to the doctor.

Getting an Earful

Ear infections are extremely common for babies and young children. In fact, nearly two-thirds of all children will have at least one ear infection by their second birthday.

Nearly 75% of all children will have had at least one infection by age 3. The "Witching Age" for an infant ear infection is 6-18 months old.

{Photo by bigeoino's}

The most common ear infection for babies is an infection of the middle ear, called acute otitis media in the medical lingo.

The middle ear is an air-filled space behind the eardrum and in front of the Eustachian tubes ("you-STAY-shee-un") that connect to the back of the throat.

It is the area that holds all the tiny bones that transmit sound from the eardrum to the inner ear.

The Eustachian tubes are vital for secretions and other fluids to drain out of the ear and into the throat. In a healthy body, the tubes are allowed to drain when your baby yawns or swallows.

An Infection is Born:
Causes of the Infant Ear Infection

Ear infections never happen by themselves. They are always preceeded by some kind of nose or upper respiratory annoyance - such a cold, allergies, or flu. That sickness then blocks up the Eustachian tubes in the back of the throat - usually by draining mucus from the nose.

The result? Any fluid left in the tubes settles down in the inner ear and waits for passing bacteria to settle in. Mr. Bacteria loves the warm temperature of his personal pool, so invites Mrs. Bacteria...and before you know it a colony has formed.

Of course, that growing family will need more room, so the tissue and eardrum will swell and become more and more irritated (causing pain) while your baby calls in the National Guard (a.k.a. white blood cells) to kick the squatters out.

Your Baby:
An Ear Infection Magnet

Babies are particularly prone to getting an infant ear infection because those little tubes are very short (1/2 inch) and horizontal. As your baby grows, the Eustachian tubes will grow longer and more vertical, helping the ear drain naturally.

Also, babies are still developing their immune systems, making them more prone to sickness.

Which Babies are More Likely to Struggle with Ear Infections?

Babies at a day care with more than 5-6 children.
Formula-fed infants who are allowed to self-feed on their backs
Native American and Eskimo children

Testing for Ear Infection Symptoms

Catching the symptoms of an ear infection can be tricky. Every baby is different and will exhibit symptoms differently. After all, it isn't likely your baby will suddenly sit up and declare: Mummy, my middle ear is exhibiting a painful sensation!

{Photo by tostadophoto}

As always, it's up to us to decipher the clues and translate them into action.

Here are a few "infection tests" to watch for. If just one symptom "passes," I would wait before calling your doctor. If several symptoms seem to pass the tests, go ahead and make an appointment.

Alone they may mean nothing, but tied together, these tests build a strong case for treatment.

Test One: Cause and Effect

As indicated above, no one just "gets" a middle ear infection. It's not contagious on its own. It is always a symptom caused by something else. So ask yourself...

Has my baby had a cold, allergies, or flu lately?
Has my infant been struggling with acid reflux?
Has my infant been exposed to second hand smoke for long periods of time?
Do I allow my infant to drink a bottle while laying flat on her back?

If you answered "yes" to any of these questions, you've passed the first test.

Test Two: Pulling or Tugging on Ears

Babies will often resort to tugging or pulling at the things that are giving them discomfort in an effort to alleviate themselves. Does he seem to be fidgeting and tugging on his ears more than normal?

The "Tug Test" is unreliable with babies younger than 3 months, since they have no control over their hands. She cannot deliberately point or touch hurtful areas of her body at this young an age.

Besides ear-tugging, you could also look for excessive head-shaking, or even head-banging against the floor or crib.

Side Note: Again, this test is not conclusive by itself. There are many other reasons your infant could be tugging on his ear too: an itch (caused by remaining soap or shampoo), teething, exploration, comfort, or simple habit. It is just ONE symptom to look for.

Test Three: Fever

A fever is your body's way of trumpeting "Sickness! Rally the Troops!". It is often the first signs that something is amiss. Look for a fever between 100-104 degrees Farenheit.

However, with that said, only one-third of babies ever actually develop a fever. Elena never did. This is why this test should be used in conjunction with the others, and never as a stand alone.

Test Four: Irritability at Night

As if you needed another lack-of-sleep opportunity, an infant ear infection is often most painful at night, when your baby is reclining.

When your baby lies down, the pressure inside his ear changes. This change of pressure can cause increased pain and discomfort.

Test Five: Temporary Hearing Loss

Due to all the fluid, dammed up behind the eardrum, it's very common to have some temporary hearing loss. Does your baby seem less responsive to you words and voice than usual? Naturally, once the fluid is gone hearing will go back to normal.

Test Six: Drainage

In severe cases, you can see blood-tinged yellowish liquid draining from the ear. This discharge means that the eardrum has developed a small hole (called a perforation) and the fluid is draining out the front of the ear.

Although this sounds terrifying, it is not a sign of impending deafness. Call your doctor for treatment of the infection, the hole will usually heal itself.

Test Seven: Other Possible Symptoms

Does my baby cry during (or refuse) feedings? Sucking and swallowing cause painful pressure changes in the middle ear.
Is this during the "Cold and Flu Season"? Most (but not all!) infant ear infections occur December - March.
Is there a foul odor coming from the ear?
Does my infant have diarrhea? Some viral-caused infections affect digestion.

The Final Exam: "Time to Call the Doctor"

If your baby seems to split down the middle, having some tests and not having others, there is one more definitive "final exam" you can perform to be sure.

The EarCheck tool is invaluable in giving that affirmative "Time to Call the Doctor" answer you're struggling for. It uses sonar-like technology to see if there is fluid behind the eardrum. No fluid? No infection.

Although the presence of fluid doesn't guarantee you've got an infection on your hands, it provides a strong indicator that you should be setting up an appointment with your pediatrician. He will then look inside to be sure.

I highly recommend getting one. although it's fairly expensive ($70), you can use it for years and years on everyone in the house. Preventing those false alarms will be worth its weight in Co-pays.

Preventing Infant Ear Infections

As with all sicknesses, there are simple things you can do to prevent an infant ear infection.

Wash your hands (and your baby's) more frequently. Keep instant sanitizer on the changing table, in diaper bags, and in your purse.
Breastfeed as long as you can. The immune-boosting antibodies will give your newborn a boost. Even if you only make it 6 months, just that little time has been shown to be beneficial.
Don't allow your baby to bottle-feed laying down. Not only is it a choking hazard, fluids can leak back into the Eustachian tubes and prompt an infant ear infection.
Limit pacifier time. The sucking motion triggers the Eustachian tubes to open and close, allowing mucus and bacteria from the back of the throat and nose to enter the middle ear.
Limit your baby's exposure to smoke.
Keep your baby's vaccines up-to-date. Recent studies have shown that some vaccines (Hib for example) can really help reduce incidents.

{Photo by Brankinha}
Consider specific vaccines, like the flu or the pneumococcal vaccine that can reduce infant ear infections by as much as 20%. As always, speak to your doctor before giving your baby any vaccine (including the flu vaccine).
Look for a daycare with less than 6 children. Studies have shown that smaller daycares keep your infant's risk about the same as other babies who stay home.

Although the chances of an infant ear infection becoming serious is slim, you should still perform your motherly due diligence and get your infant in for treatment as soon as you suspect him of having an ear ache.

Not only will it make him feel better, it will start you on the path of sleeping better too.