Otitis media in children:

Ear infections are one of the most common conditions seen by pediatricians, with statistics showing that one in three children will have at least one ear infection by the age of three.
Middle ear infections, known as otitis media, usually occur when the middle ear, which is normally filled with air, becomes blocked with mucus and fluids due to inflammation, affecting hearing.
Middle ear infections are typically caused by bacterial infections following upper respiratory tract infections or colds (which are usually viral), creating a conducive environment for germs to multiply and cause secondary middle ear inflammation.

*Children are more prone to middle ear infections than adults, although they can occur at any age. Children's immune systems are less effective than adults' because they are still developing, making them more susceptible to infections. Additionally, the Eustachian tube, which connects the middle ear to the nasopharynx, is smaller and more level in children, reducing its ability to drain fluids effectively. When it becomes swollen or filled with mucus due to infections in the upper respiratory tract or colds, it does not allow for proper fluid drainage.

mptoms of otitis media:

A mother may not be able to know if her child is in pain if the child is unable to speak or describe their pain fully. By observing the child's movements, a mother can often tell if her child is in pain. Children suffering from ear infections often exhibit the following:

1. Pulling at their ears.
2. Sleep disturbances.
3. Increased crying.
4. Fever

Additionally, if a mother notices fluid coming out of the ears or observes balance difficulties while her child is walking or playing, or if she feels that her child is not responding well because they cannot hear properly.

Types of otitis media:

*Acute Otitis Media (AOM): In this type of middle ear infection, the middle ear becomes infected, leading to swelling and fluid buildup behind the eardrum, which impairs the transmission of sound vibrations and can result in hearing loss. This type of inflammation typically causes ear pain and may be accompanied by fever. Acute otitis media is one of the most common types affecting children.
*Otitis Media with Effusion (OME): Often occurring after acute otitis media, fluid remains accumulated behind the eardrum. Symptoms may not be present, but a doctor can diagnose effusion through clinical examination.
*Chronic Otitis Media with Effusion (COME): This type occurs when fluid remains in the middle ear for an extended period or when fluid returns and accumulates in the middle ear. Symptoms may be absent, but it can lead to hearing problems or difficulty in facing new infections.

Diagnosis of otitis media:

If you suspect your child may have otitis media, it is essential to consult a doctor. The doctor will typically rely on the child's medical history of exposure to colds, respiratory tract infections, or throat infections before the onset of symptoms. Inform the doctor if your child is experiencing sleep difficulties or if they exhibit behaviors like pulling at their ear. The doctor may use an otoscope to examine the eardrum (which may appear swollen and red in case of infection). Sometimes, the doctor may use a pneumatic otoscope to blow air into the ear to check for fluid in the middle ear. In a normal condition, the eardrum vibrates freely without any obstruction for sound transmission. However, in cases of middle ear infections where fluid impedes the movement of the eardrum, the doctor may perform this procedure if the diagnosis is not entirely clear.

Treatment of middle ear infection in children:

• Once the diagnosis is confirmed, the doctor will prescribe an antibiotic (such as amoxicillin) for a period ranging from a week to ten days. They may also recommend pain relievers like ibuprofen or acetaminophen, or ear drops to help reduce fever and pain (do not give your child aspirin unless prescribed by the doctor).
• If the diagnosis is uncertain, the American Academy of Pediatrics issued general guidelines in 2013 encouraging doctors to monitor children who may have middle ear infections but are not entirely confirmed, especially in the absence of symptoms such as fever and severe pain in children between 6 months to 2 years old. If symptoms do not improve within three days to 42 hours from the onset of symptoms, antibiotics should be initiated.
• It is important to ensure that your child completes the full course of treatment, especially regarding antibiotics. Symptoms may improve rapidly after taking antibiotics, but this does not mean the infection is gone. The antibiotic should be continued until the infection is completely eliminated to prevent bacteria from becoming resistant and causing recurrent infections in your child.
• Regular follow-up visits with a pediatrician are necessary to ensure complete resolution of the infection.
• Contact the doctor if your child does not improve within 2-3 days after visiting the doctor, as the antibiotic may not be suitable for your child and may require a different type. Fluid in the ear may persist for up to 3-6 weeks.
• If recurrent infections occur (more than 6 times a year), the doctor may recommend a surgical procedure to insert a small ventilation tube in the eardrum to improve airflow and prevent fluid accumulation in the middle ear.

Some tips to protect your child from middle ear infections:

• Keep your child away from smoking areas, as most studies have linked exposure to smoking with recurrent middle ear infections.
• Ensure your child receives annual flu vaccinations (consult with the doctor for more information).
• Wash your hands thoroughly to prevent the spread of germs.
• Keep your child away from other children with respiratory infections and colds.
• Do not let your child sleep with a milk bottle as it may become contaminated and reintroduced into their mouth, causing infection.
• Ensure your child receives pneumococcal conjugate vaccines (consult with the doctor to ensure your child receives all age-appropriate vaccinations).