An ear infection (Acute Otitis Media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Ear infections frequently are painful because of the inflammation and buildup of fluids in the middle ear. Moreover, children are more likely to get ear infections, than adults.
The onset of signs and symptoms of a ear infection is usually rapid.
In Infants/Children -Signs and symptoms common include:
- Ear pain, especially when lying down
- Tugging or pulling at an ear
- Difficulty sleeping
- Crying more than usual
- Acting more irritable than usual
- Difficulty hearing or responding to sounds
- Loss of balance
- Fever of 100 F (38 C) or higher
- Drainage of fluid from the ear
- Loss of appetite
Risk factors for ear infections include:
- Feeding Positions: Babies that are bottle-fed and drink milk on their back are at a greater risk of having an inflamed Eustachian tube as milk rolls down from their mouth into the ears while feeding. The 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 inflammation. Care should be taken while breastfeeding too since wrong feeding posture can cause ear infections.
- Undetected Amniotic fluid Accumulation: In newborns, it is observed, due to certain factors, that the mother’s fluid is accumulated behind the ear drum via Eustachian tube. If undetected and unresolved by itself can be the root cause of ear infections in the future.
- Age: Children between the ages of 6 months and 2 years are more susceptible to ear infections because of the size and shape of their eustachian tubes and because of their poorly developed immune systems.
- Group child care: Children cared for in group settings are more likely to get colds and ear infections than are children who stay home because they’re exposed to more infections, such as the common cold.
- Seasonal factors: Ear infections are most common during the fall and winter when colds and flu are prevalent. People with seasonal allergies may have a greater risk of ear infections during seasonal high pollen counts.
- Poor air quality: Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infection.
Most ear infections don’t cause long-term complications. However, frequent or persistent infections and fluid buildup can result in some serious complications:
- Impaired hearing.
- Speech or developmental delays.
- Spread of infection.
- Tearing of the eardrum.
- Hearing screening test in Newborns to detect Middle ear fluids/Permanent hearing loss after Birth
As per the international guidelines of WHO, JCIH and other organizations, it is advised to conduct new born hearing screening at birth since the PASS test results not only confirms the normal functioning of the peripheral hearing system but also suggests that conduction of sound is smooth through the middle ear. In case of Amniotic Fluid Accumulation behind ear drum or permanent hearing loss the results may come as REFER which is a RED FLAG sign and retest should be conducted as per Protocol of 1, 3 & 6 Months.
Mr. Vikas Kumar
Aster Hospital, Mankhool
Ear infection (middle ear) – Symptoms and causes – Mayo Clinic
WHO Guidelines 2009,2017
JCIH statement 2007
Vikas V.Ajai Kumar