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healthy baby isn't so tough to care for but a sick baby is a
nightmare. It's time to get Mom involved and ask for help.
As the primary caregiver, it is our responsibility to take care of
our child when they are sick so that mom is available to work. Don't
be scared to ask mom for help. She will be more than happy to
comfort the child and may even stay home to help you out. It doesn't
mean you failed. A sick child is very tough to care for and two
caregivers can only make their recovery that much faster.
Ear infections occur when fluid gets trapped in the middle ear (an
air-filled space located behind the eardrum) and becomes infected by
bacteria or a virus. This is most likely to happen when the eustachian
tube (a narrow passageway that connects the throat to the middle ear)
becomes blocked. Typically, this blockage is caused by swelling or
congestion from a cold, which is why an ear infection often develops on
the heels of a cold. Allergies can also cause inflammation that
obstructs the eustachian tubes.
Anatomy is a contributing factor as well. A child's eustachian
tubes are shorter, less angled, and floppier than an adult's, which
means that both fluid and germs are more likely to get trapped in the
middle ear. In addition, a child's immune system is still developing, so
she has a tougher time than an adult in fighting off viruses and
Because infants and
toddlers don't yet have the language skills to let you know how they're
feeling, detecting an ear infection is especially hard. "Older kids will
come to you and say, 'My ear hurts",an infant obviously isn't going
to be able to do that." So what can parents be on alert for? In
general, a fever above 102 degrees F. is one of the hallmarks of an ear
infection in a nonverbal child. Ear tugging is not a
reliable sign, but ear infections are painful, so your child's tears or
increased irritability may be a symptom. Also, if your baby becomes more
upset when she's lying down, an ear infection may be to blame, because
that position puts pressure on the eustachian tubes. Other indicators of
an ear infection can include difficulty sleeping, diminished appetite,
vomiting, or diarrhea. And you may notice that your child doesn't hear
well; she may not respond to sounds around her as she normally would,
for example. Rest assured -- her hearing will come back once the
infection is gone and her ear is free of fluid.
A definite red flag: fluid or pus draining from your child's ear.
This can signal a perforated eardrum, a condition that can develop if
the fluid in the middle ear puts so much pressure on the eardrum that it
bursts. Although a burst eardrum may sound scary and can be very
painful for your child, the hole is not serious and will usually heal by
Though antibiotics are very often used to treat ear infections, the
latest thinking is that doctors needn't immediately whip out their
prescription pads. In some cases, a watch-and-wait approach may be
appropriate. "The science is now showing us that 80 percent of the time,
kids will get better without an antibiotic," says Ellen M. Friedman,
MD, author of My Ear Hurts! A Complete Guide to Understanding and Treating Your Child's Ear Infections
(Fireside). That's because one-third of ear infections are caused by
viruses, which don't respond to antibiotics. And some of the infections
caused by bacteria will improve on their own. Moreover, repeated doses
of antibiotics that may be unwarranted can spur the development of
resistant bacteria, which is another big problem, Dr. Friedman says.
Whether your child takes antibiotics is based on several factors,
including his age and the severity of his symptoms. It's common to
prescribe antibiotics for babies and toddlers who have an ear infection.
"With children younger than 2, almost everyone agrees on giving
antibiotics," Dr. April says. "Kids that age aren't verbal enough to
tell you, 'My ear really hurts. It's getting worse.' Plus, they're more
prone to complications from ear infections, such as hearing loss or
other rarer problems."
for kids older than 2, watchful waiting is an option if the
symptoms are mild and if the doctor is uncertain that the child has an
ear infection. So if your preschooler is otherwise healthy, doesn't have
a high fever, and isn't extremely irritable, and if you're a family who
will definitely follow up, your doctor may decide to wait 48 to 72
hours to see if the problem will get better on its own, Dr. Friedman
explains. Dr. Casselbrant adds, "Your child doesn't have to be perfectly
back to normal within two to three days, but his symptoms should have
improved." If they haven't, your doctor will ask you to come back or
will simply give you an antibiotic prescription.
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