Jennifer Shanda ‘s daughter Lauren wasn’t eating or sleeping. Every time Jennifer lay her down, she cried. A visit to the doctor confirmed the 6-month-old child’s problem: an ear infection. “She was up a lot during the night because of the pressure of lying down,” recalled Shanda, of West Des Moines. Lauren is now 2 1/2, but it’s been a tough road. She suffered several subsequent infections — one so severe it led to her having tubes surgically placed in her ears.
For the Shandas and other parents, ear infections are a common source of pain for young children and those who try to console them. Three out of four children get an ear infection by the time they are 3 years old, and ear infections are the most common sicknesses among babies and young kids, according to the National Institute on Deafness and Other Communication Disorders.
Winter is a prime time for ear infections, especially in kids, who are naturally more susceptible. It’s also during cold and flu season that upper-respiratory infections crop up, which can lead to ear infections. Treatment includes everything from antibiotics and pain relievers to surgery, as in Lauren’s case.
Antibiotics took care of Lauren’s first, second and third infections. But four different antibiotics, including antibiotic shots, couldn’t cure her severe infection that ran for four months in 2004.
That’s when the Shandas went to see Dr. Eytan Young, a pediatric ear, nose and throat specialist, who recommended that tubes be surgically placed in Lauren’s ears to help ventilate and drain the fluid trapped in her ears.
The tubes have been in for almost 14 months, and Jennifer said Lauren seems like a different child.
“I think having fluid in her ears hindered her vocabulary and she didn’t start walking until late because of it,” she said. “She’s always been a pretty laid-back and easy baby, but afterward she was much more curious, she listened to us better and bedtime was much easier.”
Many ear infections, which can be caused by a virus or bacteria, happen in the middle ear. The infection happens when fluid cannot drain from the middle ear and becomes stagnant.
One reason children are more susceptible to recurring infections is because the anatomy of their ears makes it difficult for fluid to drain, said Young, a pediatric ear, nose and throat specialist at ENT of Iowa.
The fluid drains out of the Eustachian tube, which connects the middle ear to the throat. The tube also helps ventilate the ear.
Young said the angle of the tube is more horizontal in kids than in adults; that can hinder drainage and create a breeding ground for infection. Children’s immune systems aren’t fully developed and have trouble fighting off infections.
The first “peak” in ear infections is in babies 13 to 15 months, and a second peak between 4 and 6 years old, Young said. Children who are exposed to cigarette smoke, who go to day care and who stop breast-feeding have a greater risk for ear infections.
Symptoms include fever, pain, fussiness, pulling on the ears, vomiting and nausea, said Dr. Eric Haugen, a pediatrician at Blank Children’s Hospital. These infections can lead to temporary hearing loss, but if they happen very often, in the most extreme cases there can be permanent hearing loss. Treatment includes antibiotics plus a decongestant, or numbing and antibiotic ear drops, or surgery.
Haugen said he usually refers children to an ear, nose and throat physician if they have had five or six ear infections before they turn 1-year-old. He’ll also refer kids to a specialist if they are becoming resistant to antibiotics or are having overlapping ear infections.
A physician will look at medical factors that include the number of infections and types of antibiotics used to determine whether tubes are appropriate, Young said.
Both of Daphne Christensen ‘s children have had tubes put in their ears, with very different results. Her 3 1/2-year-old son, Tucker, had the tubes put in place at 10 months old. They fell out on their own, as they should, about nine to 12 months later, she said.
“Tucker has never had an ear infection since,” said Christensen, from Norwalk.
For Dylan, who is 18 months old, the tubes were inserted when he was 4 1/2 months old. They were put in as a precautionary measure, Daphne said, because Dylan was born with cleft lip and palate, and doctors expected him to have chronic ear infections.
Over the last several month, Dylan has had three tubes in his left ear, and four in his right ear, she said. “For whatever reason, drainage has clogged the tubes so they no longer function so that they’ve been replaced several times.”
He also had surgery when he was 10 months old to remove part of the bone behind his ear, Christensen said, to help alleviate some of the drainage. The last set of ear tubes seems to have made the biggest difference, she said.
“Dylan seems to be more sensitive to sound. He was finally able to have a hearing test so we could assess where he’s at with hearing. And he’s making more sounds, and that’s reassuring, so we hope that his talking improves.”
By Dawn Sagario