Our toddler has been particularly fussy and is waking up much more than usual. He wakes up crying as if he's in pain, so we're wondering if he might have an ear infection.
It's quite possible, since ear infections are common in young children. Their ear tubes are short, wide, and horizontal—giving bacteria from the nose and throat an easy path to the ears. Ear infections are often associated with a cold or allergies, which create more mucus in the middle ear.
Two-thirds of children under age three have had an ear infection, and half of them have multiple infections. As children get older and their ear tubes mature, they will no longer be so susceptible to ear infections. In the meantime, an untreated ear infection will prevent your child from sleeping well, since the pain is more intense when lying down versus being upright.
Ear infections happen when bacteria and fluid build up in the inner ear. This situation often occurs following a cold, sinus infection, or other respiratory illness, or in conjunction with allergies. The fluids get trapped in the ear, causing a throbbing pain.
Your child may exhibit all, some, or even none of the following symptoms. It's always important to see your health care provider if you even suspect an ear infection. These symptoms may indicate an ear infection:
• A sudden change in temperament: more fussiness, crying, or clinginess
• Increased night waking
• Waking up crying as if in pain
• Fever
• Diarrhea
• Reduced appetite or difficulty swallowing
• Runny nose that continues after a cold
• Drainage from the ear
• Fussiness when lying down that goes away when child is upright
• Difficulty with balance, frequent falling, sensations of dizziness (these symptoms should be discussed with your health care professional)
• Signs of difficulty hearing (this should always be checked by a doctor)
These symptoms almost always indicate an ear infection:
• Ear pain or frequent pulling, grabbing, or batting at the ears
• Green, yellow, or white fluid draining from the ear
• A dry crust on the outer portion of the ear after sleeping
• An unpleasant odor emanating from the ear
If your child is exhibiting any of the preceding symptoms and you suspect an ear infection, make an appointment with your health care provider right away. This is important because an untreated ear infection can lead to speech difficulties, hearing loss, meningitis, or other complications.
Your doctor may suggest some of the following treatments if your child does have an ear infection (but don't try to solve this problem on your own without an expert's direction):
• Give your child a pain reliever, such as acetaminophen (Tylenol) or ibuprofen. (Never give your child aspirin unless a doctor tells you to, as it can be hazardous.)
• Keep your child's head elevated for sleep. You can do this by raising one end of her mattress (try taping tuna cans under one end).
• Place a warm compress over the affected ear.
• Keep the ears dry and out of water.
• Offer plenty of liquids.
• Administer prescribed antibiotics or instill prescribed ear drops.
• Provide homeopathic remedies such as echinacea, goldenseal, chamomile, or herbal oil ear drops.
Any child can get an ear infection, but a few measures can reduce the likelihood:
• Prevent the colds and flu that introduce the bacteria into your child's system. Wash your hands and your child's hands frequently. When possible, keep your child away from anyone who is obviously sick with a cold or flu.
• Keep your child away from cigarette smoke. Just one afternoon spent with secondhand smoke can increase your child's chances of developing an ear infection.
• Never let your child sleep with a bottle unless it is filled with water. Milk or juice can pool in the mouth and seep into the ear canals. (Plus it might cause tooth decay.)