Month 23 Worry: Why All These Toddler Ear Infections?
The most common medical concern for parents of children this age
Second, your child’s middle ear cavity is the perfect anatomic set-up for bacteria to brew. Looking down the ear canal is like looking into a cave. The far wall of the cave is a thin membrane of skin called the eardrum. Behind that translucent drum is the middle ear cavity. That is where all the ear infection “action” takes place.
So how do bacteria get in there and set up shop? It is not through the eardrum. There is a secret opening to the back of that cavity called the Eustachian tube. This tube connects the back of the throat to the back of the middle ear cavity. You have felt evidence of your own Eustachian tubes if you have ever driven up a steep hill or taken off in an airplane. The “popping” of your ears that you feel in these instances is your Eustachian tube equalizing pressure between your throat and your middle ear cavity. Bacteria can get up this tube, get in the middle ear cavity, and start to multiply. This is an ear infection.
Your toddler’s middle ear cavity and Eustachian tubes are dysfunctional in a number of ways (keep reading) that make bacterial ear infections (usually a complication of a bad viral head cold) much more likely.
Third is family history. Did you have lots of infections as a child? Well, consider this one more thing you can take the blame for. Anatomy, like eye color, is inherited. Your toddler may not have gotten your blue eyes, but that upward slanted, slightly kinked, easily blocked Eustachian tube? That’s all your doing.
Classic Symptoms of Ear Infections
Diagnosing an ear infection is not like a pregnancy test, either positive or negative. There is judgment and interpretation involved. So, too quick a trip to your doctor may lead to a well-meaning but ill-founded diagnosis and possibly an unnecessary course of antibiotics.
I look for these few key signs and symptoms in kids over six months of age:
- ongoing cold symptoms,
- and disrupted nighttime sleep.
These are the classic signs that I find most helpful. A bulging eardrum on exam clinches the diagnosis. How about fever? Ear tugging? Red external ear? These are all notoriously useless or at least less useful. And if you’ve thought about purchasing an otoscope (the ear checker thingy the doctor uses), forget it. It only took me about 300 ear exams to really learn how to diagnose an ear infection. And after more than 10 years in practice, I still have occasional difficulty.
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