Dr. Charles Ison — Why Infants Are Prone to Earaches

Otitis media is the medical term for an infection of the middle ear. The condition, usually caused by bacteria, is extremely common in infants and young children, but it can occur at any age.

There are reasons that infants are more prone to it, though.

The middle ear is a pair of air-filled structures (on either side of the head) with three bones in each one that take up a lot of the space.

The outer wall consists of the eardrum (tympanic membrane), which looks like a piece of plastic wrap: it is what we see when we look in the ear canal with an otoscope.

Sound waves that enter the external ear canal make the eardrum vibrate. The bones in the middle ear transfer the vibrations to the inner ear, where they are processed.

The three bones of the middle ear are washed by a fluid that the middle ear makes.

This fluid drains out of the middle ear by a passageway called the Eustachian tube, which empties into the back of the nasal passages (one on each side).

Anything that blocks the Eustachian tubes and prevents the fluid from draining out of the middle ear can potentially cause otitis media. These obstructions include viruses (especially head colds) and allergies.

Other risk factors include being around secondhand smoke, changing altitude (in a car or airplane) and sucking a bottle while lying down flat.

Any bacteria that have made their way up the Eustachian tube into the middle ear can find themselves in a rapidly accumulating pool of warm fluid that can no longer drain into the back of the nasal passages.

These bacteria can grow without fear of being flushed out, and soon the middle ear fluid turns to pus. Classically, this occurs after a few days of congestion.

Infants are more prone to otitis media because their Eustachian tubes are shorter, floppier and more horizontal. Infants’ immune systems are not as strong against certain bacteria, and they catch a lot more viruses (especially if in daycare).

Symptoms of otitis media include irritability, pulling on ears, sometimes a fever, clumsiness, trouble hearing and trouble sleeping.

Actions that can help prevent or reduce ear infections include brestfeeding, delaying solids until 4-6 months of age to help prevent allergies, avoiding daycares, and getting your children immunized against pneumococcl bacteria and influenza.

In the U.S., ear infections are usually treated with antibiotics. For older children, there is also the option to wait a few days to see if they go away on their own.