Why They Happen
During one of my daughter's recent play dates with some neighborhood friends, a mother lamented to me that her 14-month-old son had just been diagnosed with his fourth ear infection in the past three months. "He's been on one antibiotic after another and I hate the idea of having to give him more medicine. What's worse, last month the antibiotic didn't work and they had to give him three shots to clear it up. Now he's not sleeping, not eating, and I'm at the end of my rope! What am I doing wrong? Will he ever be well?"
As a parent, you can most likely spell amoxicillin without batting an eye. You've probably become so adept at picking up on your child's symptoms that you can make the diagnosis yourself before ever darkening your pediatrician's door. Ah, yes, the badges of parenthood should be worn proudly. As a pediatrician and a mother, I've faced this issue from both sides. While ear infections are frustrating to us as parents, they can be equally troubling to physicians. Fortunately, understanding why ear infections develop and how they should be treated can help ease the pain associated with this condition for both you and your kids.
Here Comes Ear Trouble
Fluid accumulates within the middle ear space (located behind the eardrum) when the eustachian tube, which leads from the middle ear to the back of the throat, becomes blocked. This is usually due to the swelling and congestion of the nasal lining that occurs during a cold or with seasonal allergies. Your child might also be at risk if she has a family history of ear infections, or if she attends childcare, which increases exposure to infection-causing bacteria and viruses.
When the eustachian tube can't drain adequately (this is often the case with young children; their eustachian tubes are smaller and angled less steeply than those of adults), fluid inside the middle ear stagnates, making it the perfect breeding ground for germs. Add to that the fact that their immature immune systems make them more vulnerable to the colds that cause congestion and blockage, and suddenly you're up all night with a fussy child who even the best episode of The Wiggles won't entertain! As a child grows, his eustachian tubes lengthen and become better at draining, allowing him to outgrow the tendency toward ear infections by 2 years of age.