Ear infection

How can I tell if my baby has an ear infection?
The easiest way to tell if your baby has an ear infection (also known as acute otitis media) — or any other illness, for that matter — is a change in his mood. If he turns fussy, or starts crying more than usual, you should be on the lookout for a problem. If he develops a fever (whether slight or high) you have another big clue. Ear infections tend to strike after a common cold or sinus infection, so keep that in mind too. You may also notice the following symptoms:

• Your baby pulls, grabs, or tugs at his ears. This may be a sign he's in pain. (However, babies do pull on their ears for all kinds of reasons or for no reason at all, so if your baby seems fine otherwise, he probably doesn't have an ear infection.)

•  Diarrhea . The virus that causes ear infections can also affect the gastrointestinal tract.

• Reduced appetite. Ear infections can cause gastrointestinal upset. They can also make it painful for your baby to swallow and chew. You may notice your baby pull away from the breast or bottle after he takes the first few sips.

• A yellow or whitish fluid draining from the ear. This doesn't happen to most babies, but it's a sure sign of infection. It also signals that a small hole has developed in the eardrum. Don't worry — this will heal on its own once the infection is treated.

• A foul odor emanating from the ear.

W hat causes ear infections?
An ear infection results when fluid and bacteria build up in the area around your baby's eardrum. Normally any fluid that enters this area leaves pretty quickly through the Eustachian tube (which connects the middle ear to the back of the nose and throat) when your baby yawns or swallows. But if the Eustachian tube is blocked — common during colds, sinus infections, even allergy season — it traps the fluid in the middle ear. Bacteria like to grow in dark, warm, wet places, so a fluid-filled ear becomes the perfect breeding ground. As the infection worsens, so does the swelling in and around the eardrum, and, as a result, the pain. Fever develops as your baby's body attempts to fight the infection.

Babies are particularly susceptible to ear infections because their Eustachian tubes are short (about 1/2 inch) and horizontal. As they grow to adulthood, the tube triples in length to 1 1/2 inches and become more vertical, so fluid can drain more easily. Ear infections are one of the most common childhood illnesses. Although there are no statistics on how many babies get them, the American Academy of Pediatrics expects that most children will have gotten at least one ear infection by the time they turn 3.

When should I call the doctor?
Call the doctor at the first sign of an ear infection. She'll ask you to come in so she can take a look in your baby's ear with an instrument called an otoscope. An eardrum that's red, bulging, and possibly draining is likely infected. She may also look to see whether the eardrum moves in response to a device called a pneumatic otoscope, which releases a brief puff of air into the ear. If it's not moving, you have one more clue that fluid is collecting in the middle ear and it may be infected.

What can I do to prevent ear infections in the future?
Babies who attend daycare or playgroups with other children are more prone to getting ear infections because they're exposed to more germs. That doesn't mean you should keep your baby home all the time. That's not fun or practical and even if you managed to do it, your baby would still catch an illness here or there. Instead, wash your hands (and your baby's hands) often, and try these prevention ideas:

Keep your baby up to date on his vaccines. They help prevent certain illnesses that can lead to an ear infection. For example, the Hib vaccine has helped tremendously in reducing the number of ear infections in babies, and the new pneumococcal vaccine can help prevent them as well. If your baby has suffered repeated ear infections, especially after bouts with the flu, you may want to consider an annual flu vaccine , but talk to your doctor first. Only children over 6 months old can get a flu shot.

Breastfeed your baby for a minimum of six months. A recent study from the Centers for Disease Control and Prevention and the Food and Drug Administration, which appeared in the journal Pediatrics , showed that children who are breastfed for the first six months of life are less likely to develop ear infections. In fact, the risk of ear infections was 70 percent greater in formula-fed babies. Practitioners believe that mothers transfer certain immune-building antibodies to their babies through breast milk. However, those antibodies seem to decrease after the six-month mark.

Limit your baby's exposure to tobacco smoke. Even a weekend spent in a house with a smoker can significantly harm a baby and increase his chances of getting an ear infection. Tobacco smoke seems to suppress the immune system, making it more difficult for your baby to fight off infection.

Are ear infections ever serious?
They can be. A severe or untreated infection can rupture your child's eardrum. Ruptures don't happen very often and they generally heal quickly, but it's important to see your child's doctor for a follow-up to make sure that the infection has cleared and that the eardrum is healing well. Repeated ear infections can sometimes lead to hearing loss and scarring. In very rare cases, untreated ear infections can lead to an infection of the skull behind the ear (mastoiditis), or meningitis .