An ear infection (also known as otitis media) is a rather common problem in infants and children, but it can also affect adults. Almost 90% of children suffer from at least one ear infection before the age of three. It is a pathology that can become very painful due to the accumulation of fluids that creates pressure on the eardrum. Many average otitis can be treated directly at home with home remedies, but in severe cases or when the infection affects a very young child, it may be necessary to take antibiotics prescribed by the doctor to completely eradicate it.
Recognize the infection
1) Know who is at greater risk of getting an ear infection.
In general, it is children who are more likely to suffer from average otitis than adults. This is because the Eustachian tubes (the ducts that from the middle of each ear reach the back of the throat) are smaller in children and therefore more prone to fill with liquid. In addition, children also have a weaker immune system than adults and may be more prone to viral infections such as colds. Anything that blocks the ear canals can cause an otitis. Keep in mind, however, that there are other risk factors that can facilitate the development of this infection, including:
Respiratory infections such as colds and sinusitis;
Infection or problems with the adenoids (lymphatic tissue in the upper area of the throat);
Excessive production of mucus or saliva as often occurs during dentition;
Living in a cold climate;
Sudden changes in altitude or climate;
Feed with artificial milk;
Attend a kindergarten, especially a rather large nursery, with many children.
2) Recognize the symptoms of a middle ear infection.
This infection, also called acute otitis media, is the most prevalent and is caused by a virus or bacterium. The middle ear is the space behind the eardrum, which contains tiny bones that transmit vibrations to the inner ear. When the area fills with fluid, bacteria and viruses can enter and cause an infection. Otitis generally develops after a respiratory infection such as a cold, although severe allergies can also cause it. The main symptoms are:
Ear pain or otalgia;
Feeling of fullness in the ear;
Hearing loss in the infected ear;
Liquid leaking from the ear;
Fever, especially in children.
3) the difference between an infection of the middle ear and “the ear of the swimmer”.
The swimmer’s ear, also known as external otitis or “external ear infection”, affects the external ear canal due to the presence of bacteria or fungi. Humidity is the main cause of this type of illness (which is why it is called the swimmer), but also scratches or foreign objects penetrated into the ear canal can cause this problem. Symptoms usually start mildly, but often get worse and include:
Itching in the ear canal;
Redness of the internal area of the ear;
The discomfort that gets worse when you pull or push the outer ear;
Fluid leaking from the ears (initially light in colour and odourless until becoming pus).
Among the most serious symptoms it is possible to find:
The sensation of fullness or obstruction of the ear;
Severe pain that radiates outward, to the face or neck;
Swollen lymph nodes in the neck;
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4) Observe the signs of otitis in children.
Children may exhibit different symptoms than older children and adults. Given that children are often unable to describe their state of discomfort, pay attention to these behaviours:
They pull, pull or scratch their ears;
They continually move their heads;
They are annoyed, irritated or cry constantly;
They sleep badly;
They have a fever (especially infants and very young children);
Liquid escapes from the ear;
They are clumsy in their movements or have problems with balance;
They have hearing problems.
5) Know when it is time to immediately contact a doctor.
Most ear infections can be treated at home, often successfully. However, if you or your children have some symptoms, you should contact your doctor right away. These symptoms include:
Blood or pus that drains from the ear (may appear white, yellow, green or pink/red);
High persistent fever, especially if it is more than 39 ° C;
Dizziness or vertigo;
Pain or swelling behind or around the ear;
The pain in the ear lasts more than 48 hours.
6) Take your child to the doctor if he is less than six months old.
If you notice any symptoms of ear infection in a newborn, you should take it immediately to the paediatrician. Young children have not yet fully developed their immune system and have a much higher risk of contracting serious infections; so they will certainly have to take antibiotics right away.
Do not try to treat the infection of newborns and very young children with home remedies. Always contact the paediatrician to find the most appropriate therapy.
7) Let the doctor examine the ears of your child or yours.
If you fear that you or your child have a severe ear infection, be prepared to undergo several tests, including:
A visual examination of the eardrum with an otoscope. It may be difficult to keep the baby steady during this examination, but it is an important test to determine if there is an ongoing infection.
An examination to verify the presence of any material that blocks or fills the middle ear using a pneumatic otoscope, which blows a little air into the eardrum making it move back and forth. If a liquid is present, the eardrum will not move easily or readily as would normally be expected, indicating the likely presence of an infection.
An examination with a tympanometer, which uses sound and pressure to check for any fluid in the middle ear.
If the infection is chronic or is a serious case, you will need to consult an audiologist to perform a hearing test and determine if a loss has occurred.
8) Prepare for the doctor to examine the eardrum more scrupulously if the infection is resistant or chronic.
If you or your child begin to experience severe discomfort due to ear problems, the doctor can create an opening in the eardrum and extract a sample of fluid from the middle ear. The sample will then be sent to a laboratory for analysis.
9) Be aware that many ear infections can be treated at home.
Many entities resolve themselves without the need for any treatment. Some disappear within a few days, but most of them spontaneously reduce within 1-2 weeks, even without treatment. In the USA, the American Academy of Pediatrics and the American Academy of Family Physicians recommend a “wait-and-see” approach by following these guidelines:
For children, 6 to 23 months of age: wait to understand the progression of the infection if the pain in the inner ear is mild, lasts less than 48 hours and the temperature is below 39 ° C.
For children of 2 years: it is advisable to wait in case of the pain to one or both internal ears is mild, last for less than 48 hours and the temperature is lower than 39 ° C.
After 48 hours, if the problem persists, it is important to consult a doctor. An antibiotic will often be given to prevent the spread of otitis and to reduce the risk of further infections potentially life-threatening (albeit rare).
Although rarely, some more serious complications may develop, including mastoiditis (an infection of the bones around the skull), meningitis, spread of brain infection or even hearing loss.
10) Be very careful when you have to take a plane with a child who has an ear infection.
If your child has the active infection, there is a greater risk of suffering from a disorder called barotrauma, which can occur when the middle ear tries to balance the changes in pressure. Chewing gum during take-off or landing can reduce this risk.
If you have a baby with an ear infection, feed it with the bottle during take-off and landing, to help regulate the pressure in the middle ear.
Treating the Pain of Infection at home
11) Get over-the-counter painkillers.
You can take ibuprofen or paracetamol if the pain is not reduced by itself or if no other symptoms develop. These drugs can also help reduce your child’s fever and make it feel a little better.
Never give aspirin to children and young people under the age of 18, as this drug has been associated with Reye’s syndrome, which causes severe brain and liver damage.
Administer the drugs with pediatric dosage when they are intended for your child. Follow the directions for the dosage that are listed on the package or informed by the paediatrician.
Do not give ibuprofen to children younger than 6 months.
12) Apply a warm compress.
A heat source on the area helps to reduce the pain caused by the infection. You can use a warm damp cloth.
Alternatively, you can fill a clean sock with rice or beans and tie or sew the open end. Put the sock in the microwave oven for 30 seconds at a time until the rice reaches the desired temperature. Apply the compress to the ear.
You can also use salt as a natural remedy. Heat a cup of salt and put it in a cloth. Tie it with a rubber band and place it on your affected ear for 5-10 minutes, when the heat is bearable, while you are lying down.
Place it on the painful area no more than 15-20 minutes at a time.
13) Takes rests a lot.
The body needs rest to recover from infections. Make sure you do not ask too much of your body and do not overdo the activities during the active phase of otitis, especially if you also have a fever.
Paediatricians usually do not recommend keeping the child home from school for an ear infection, unless they have a fever. In any case, be sure to check your activities to make sure you are resting as much as you should.
14) Keep yourself hydrated.
You must drink more fluids, especially in case of fever.
Researchers recommend drinking at least 3 litres of fluids a day, if you’re a male, and at least 2.2 litres if you’re female.
15) Try to carry out the Valsalva manoeuvre only if you do not feel any pain.
This is a technique that can be used to open the Eustachian tubes and relieve the feeling of “plugged” ear that often accompanies otitis in the active phase. Be sure to perform the manoeuvre only if you do not currently experience pain in your ears.
Take a deep breath and close your mouth.
Squeeze the nostrils to close the nose and when it is tightly closed, it “blows” from the nose gently.
Do not blow too hard, however, otherwise you may damage the eardrum. At this point, you should hear a “pop” in your ears, a sign that they are open.
16) Put a few drops of hot Verdasco oil or garlic in your ear.
Both of these oils are natural antibiotics and can provide relief from the pain caused by the infection. Use a dropper to instill 2-3 drops of hot (never boiling) oil in each ear.
Always consult the paediatrician before trying these remedies on children.
17) Try a natural remedy.
Research has found that a herbal remedy, especially olive oil, garlic and mullein, can be helpful in reducing the pain caused by average otitis.
Always consult your doctor before applying this remedy. Do not give alternative medicines to your child without first asking the paediatrician for advice.
Keep the situation under observation
18) Carefully monitor the condition of the ear.
Often measure your child’s fever or that of your child and pay attention to any other symptoms that may occur.
If you develop a fever and notice flu-like symptoms such as nausea or vomiting, the infection may have worsened and the home treatments you are practising may not be effective enough.
Among the symptoms that should cause you to go to the doctor, there are confusional state, stiffness and swelling of the neck, pain or redness around the ear. These symptoms indicate that the infection may have spread and that you should undergo treatment immediately.
19) Pay attention in case I felt an intense pain in the ear that settles almost immediately without any pain.
This could mean that the eardrum is broken and, in this case, can cause temporary loss of hearing. A rupture of the eardrum makes the ear more susceptible to infections, further aggravating the situation.
In addition to the absence of pain, you may also notice the leakage of fluid from the ear.
Although a broken eardrum generally heals within a couple of weeks, even without treatment, some problems may persist and require medical intervention or treatment.
20) Call your doctor if the pain gets worse within 48 hours.
Although most caregivers recommend a “wait-and-see” approach for up to 48 hours after the onset of symptoms, if the pain increases during this period, you should contact your doctor. He will be able to advise you on a more incisive treatment or even prescribe antibiotics.
21) Submit yourself or your child to a hearing test, in case the liquid continues to form inside the ear even after three months from the onset of otitis.
This can be a problem related to significant hearing disorders.
Sometimes, a temporary hearing loss (hearing loss) may occur, especially in children up to two years of age.
If your child is under 2 years of age and is subject to frequent accumulation of fluid in the ears, in addition to other hearing disorders, the doctor will not wait three months to start treatment. Hearing problems that occur at this age may affect the child’s ability to speak, as well as other developmental difficulties.
Antibiotics and other medical treatments
22) Get antibiotics prescribed by your doctor.
Antibiotics do not cure an ear infection, if it is caused by a virus, therefore they are not always prescribed in the treatment of average otitis. In any case, all children under the age of 6 months are treated with antibiotics.
Tell your doctor about the date of last antibiotic intake and their type; in this way, help the doctor choose the most effective one for you.
Make sure that you or your child take all the doses of the drug on schedule, to avoid possible recurrences.
Do not stop taking antibiotics before you have completed the full course as prescribed to you, even if you start feeling better. If you stop the antibiotic treatment prematurely, you may not kill all the bacteria, which in this way would become resistant to the drug, making it even more difficult to treat this type of infection.
23) Ask the doctor prescribing you for ear drops.
Ear drops, such as those based on antipyrine-benzocaine-glycerine (Auralgan), can help alleviate the pain caused by average otitis. However, be aware that your doctor will not prescribe ear drops if you have torn or perforated eardrums.
To give the drops to a child, heat the solution first by placing the vial in hot water or holding it in your hands for a few minutes. Lay the child on a flat surface with the infected ear facing up towards you. Be sure to give him the recommended dosage. Have the child keep the head tilted with the infected ear upwards for about 2 minutes.
Since benzocaine causes numbness, it’s best if you get help from someone else to give the drops to your ears. Prevents the dropper from touching the infected ears.
Benzocaine may cause mild itching or redness. In addition, it has also been associated with a rare but serious disease that affects levels of oxygen in the blood. Never give more than the recommended amount and consult the paediatrician to make sure you give the right dosage to your child.
24) Consult your doctor about trans-tympanic ventilation tubes if you suffer from recurrent ear infections.
Frequent recurrent otitis can be treated with a procedure called myringotomy. The recurring term means that there have been three episodes in the last six months or four episodes during the previous year, with at least one recurrence in the last six months. Even individuals with an ear infection that does not disappear after treatment are valid candidates for this procedure.
Myringotomy, which consists of the surgical incision of the eardrum membrane, is a procedure that can be performed as a day hospital. The surgeon inserts small tubes into the eardrum so that the fluids behind it can drain more easily. The tympanum usually closes again when the tube falls or is removed.
25) Evaluate with your doctor the possibility of undergoing an adenoidectomy to remove swollen adenoids.
If the adenoids of the tissue masses behind the nasal cavity swell you often, surgery may be needed to remove them.