How to manage ear infection in children

A three-year-old boy recently convulsed and a diagnosis on him showed that he had febrile convulsion. After receiving treatment for two days, the fever reduced and so the hospital asked him to go home.

Three days later, the boy had fever. He became irritable and so complained of pain on the head. His parents later returned him to another hospital after he had another convulsion. He had developed Meningitis (Infection of the brain).
After thorough examination, it was found that the fever was caused by ear infection and this got to his brain, causing him meningitis.
The import of this is that children with fever must have their ear, nose and throat checked for infection, in addition to the other examination.
Otitis media is commonly called ear infection. This simply is an infection of the middle ear. It is very common, especially in children between six months and three years of age.
It is usually not serious, nor is it contagious if well managed. Most cases of Otitis media occur during cold and are accompanied with fever.
Risk factors
Babies born prematurely, children, who have frequent colds, those with allergies or those exposed to cigarette smoke, as well as children not breastfed, among others, are prone to the sickness.
Causes
Viruses or bacteria (germs) cause middle ear infection. The Eustachian tube connects the middle ear with the back of the throat. Germs can travel from the back of the throat when the Eustachian tube is damaged, causing middle ear infections. This is why children with cold or throat infections may also have ear infections. The cause is mainly by bacteria and poor skin hygiene.
Signs and symptoms
Otitis media: Older children will complain of earache and, often, fever. Younger ones might not say they have an earache, but might have an unexplained fever, be cranky or irritable. They may also have trouble sleeping, tug or pull at their ears, and have trouble hearing quiet sounds. Fluid may also drain out of their ear (ear discharge). It may be clear or pus-like. This fluid could contain germs.
Doctors diagnose middle ear infections by looking at the inner ear to see the ear drum (tympanic membrane) with a special lighted instrument called an otoscope.
Doctors take ear swab and send it to the lab for culture and sensitivity test. The result will guide on the type of antibiotics to prescribe.
Treatment
• There is the antibiotics prescription for children less than six months of age or for children with other serious medical problems.
• Paracetamol (aceta-minophen) or ibuprofen is also given to reduce pain. Doctors do not give ibuprofen to babies under six months, though.
• Children usually feel better within a day of starting an antibiotic course. Parents should use antibiotics only as directed, and they should keep giving the child until the drug finishes, even if the child feels better.
• Topical antibiotics and ointments are used for otitis externa.
• The pus/discharge coming out from the ear is cleaned with a swab.
• The doctor sees the child again to be sure the infection has cleared up completely
• If the child has frequent ear infections, or if s/he has trouble hearing because of repeated ear discharge fluid, an Ear Nose and Throat Surgeon review will be needed.
See the doctor if your child has an ear infection and vomits over and over; if he has fever for more than 48 hours, or swelling behind the ear or if the ear is tender, if the child is very sleepy, irritable, has a rash on the ear, is not hearing well or at all.
Prevention      
Wash your hands and your child’s hands often to reduce the chance of getting a cold, breastfeed babies exclusively, avoid bottle-feeding when baby is lying down, discourage the use of a pacifier (soother), don’t smoke in the same room as the child, have your child vaccinated with the pneumococcal vaccine, which is available in Nigeria. It reduces the incidence of Otitis media and should be given to all babies less than two years of age,
In conclusion, when a child develops ear infection:
• Don’t put cotton balls (cotton wool) to block the ear when there is infection, as this will harbour the growth of organisms called anaerobes
• Don’t put antibiotics eardrop in babies’ ear. Indiscriminate use of antibiotics eardrop will lead to bursting of the eardrum (tympanic membrane) and the child will have ear discharge throughout life
• Don’t clean the child’s ear with cotton bud to get rid of wax. Earwax is protective, but when impacted or prodded too much, it may be dangerous. There is an eardrop specifically for this purpose. Some may have ear syringing to remove the wax, often done in an ENT clinic.