Summer Ear Infections
As a pediatrician, I looked forward to the summer. There is of course more time to spend with family and friends, but specifically, I look forward to report to all those patients with persistent ear infections that finally their ears look “crystal clear”.
Children ages six months – two years of age are especially prone to get ear infections. There are a few contributing factors to point out:
Eustachian Tubes – These tubes are the functional “drains” of our ears. They connect the middle ear chamber with the back of our throats. When working properly, these tubes will drain out all the fluid that accumulates in the ear. Therefore, their proper function is instrumental to prevent ear infections. Unfortunately, it takes a few years until these tubes are wide enough and angled downward to work properly. Most kids attain good Eustachian tube function when they are about two years old.
Exposure to Illnesses – Most children start day care when they are about 4-6 months old. There they are exposed to other children’s colds, and when they develop those colds, they are at risk of developing ear infections.
Colds – Almost invariably, ear infections are accompanied by at least a few days of congestion and/or wet sounding coughs. These help push the mucus up into the Eustachian tubes and lead to the ear infection.
In my practice, if a child presents with an ear infection, I try to take a conservative approach and not immediately treat with antibiotics (unless the child looks extremely ill or was not immunized in the past). In the winter months, ear infections can take anywhere between ten days to two months to resolve without antibiotics. This is due to the persistent runny noses and congestion that children have in the cold winter months.
In the summertime however, many of the germs that cause colds do not survive in the warm temperature and the ears finally get “their day in the sun”.
But just when you thought that you will finally rest at night without hearing your children holler in pain from their ears, comes the bad news – swimmer’s ear.
What is it?
Swimmer’s Ear is an inflammation or swelling in the external ear canal. It is usually caused by water irritating the skin lining the ear canal, which becomes infected with bacteria or fungus. The different level of acidity in pool water harms the protective barrier that lines our ear canal and hence the name Swimmer’s Ear.
Signs and Symptoms of Swimmer’s Ear
Ear pain is the most common sign of swimmer’s ear. However, unlike the pain of an inner ear infection which usually is preceded by a cold or cough, the ear pain from swimmer’s ear is made worse by a simple tug on the outer ear. When I look inside the child’s ear, I usually would see redness, swelling and some discharge in the ear canal.
Treatment of Swimmer’s Ear
Once your pediatrician has diagnosed your child with swimmer’s ear, your child will get antibiotic or antifungal ear drops with or without steroids (which reduce the inflammation more rapidly).
If there is considerable swelling in your child’s ear, you may soak an ear wick with the medicated drops and place them in your child’s ear. Tylenol or Motrin could be used for a few days until the ear drops start working.
If your child only has mild symptoms of pain, ask your pediatrician if you can first try a solution of half strength white vinegar ear drops (half water/half vinegar) twice a day. This is a common home remedy that many parents try prior to using medicated ear drops.
How to Prevent Swimmer’s Ear
You can prevent swimmer’s ear by keeping water out of your child’s ears. That doesn’t mean that your child should stop swimming and enjoying the water. You can also create your own home made ear solution by mixing equal parts of rubbing alcohol and white vinegar and putting five drops in each ear after your child swims. Alternatively, you could use an over-the-counter ear drying agent that contains isopropyl alcohol such as Auro-Dri or Swim Ear.
The use of Ear Plugs is controversial. Therefore, ask your pediatricians if they feel that ear plugs are a good idea for your child.
Q Tips are never a good idea for you kids, especially when it comes to swimmer’s ears. Your child’s wax actually protects against the changes from the pool water and removing it may predispose your child to develop swimmer’s ear more readily.
I truly hope that you enjoy the rest of the summer.
David E. Simai M.D