Month 23 Worry: Why All These Toddler Ear Infections?

What the Docs May Do

The docs will tell you that exposure, anatomy, and family history are important to your child's risk of developing an ear infection, but there are a few things that are not important:

Bath water, for instance, cannot cause a middle ear infection in a normal ear. Water that goes in that cave of an ear canal has only one way to get out: the way it came in. And we know that bacteria get into the middle ear cavity via the back of the throat.

Failure to wear a hat or coat in colder weather does not cause ear infections. (Mom, are you reading this?) Again, it is caused by a viral infection that is complicated by bacteria creeping up the Eustachian tube. (And, Mom, throw out the going-outside-with-wet-hair theory as well. It's bunk.)

How about the way your child eats, sleeps, and fails to blow his nose? All are meaningless when looking at your child's risk of otitis media.

What your doctor does know is that the fewer antibiotics your child is exposed to, the better. Bacteria living in your child (good and bad bugs) are waiting to learn from experience. Multiple exposures to multiple antibiotics teach bacteria the concept of resistance. And they learn it quickly. The American Academy of Pediatrics (AAP) has guidelines for kids over six months of age which recommend holding off on antibiotic treatment for 48 to 72 hours if your child is reasonably comfortable. (Read more about this here.) The risk to your child (in withholding antibiotics) is low, while the benefits (in reducing your child's antibiotic exposure) are significant.

Your doctor will send you to a specialist (otorhinolaryngologist or ENT) if your child's ear infections are too frequent or if there is inadequate clearing of fluid within three months of an acute infection. If your child has Down syndrome, cleft palate, or immunodeficiency, a specialist may need to be involved, as well.

More 23nd Month Help

Even the most confident parent has concerns about her child's health and wellness from time to time. Learn more about which medical issues are most common at each age, here. (If you have any pressing concerns or questions about your child's health, please check with her healthcare provider.)

• What was last month's most popular health worry?
• Learn which medical question you might have next month.
• Here's what else is happening with your child's health and development this month.