Risk factors | Inflammation of the middle ear in the baby

Risk factors

In addition to the infectious causes of otitis media that are difficult to control, there are a number of risk factors in babies that can contribute to the development of otitis media. These include all types of immune deficiency in the baby, but also allergies. Large almonds or a cleft palate are also among the risk factors. Passive smoking and the uninterrupted use of pacifiers increase likewise the risk of an inflammation of the middle ear, however decreases several months of breastfeeding proven the risk.

Symptoms

Since babies cannot communicate and show very unspecific physical symptoms, middle ear infection is difficult for parents to detect. The infectious overpressure in the middle ear can be very painful and uncomfortable because it causes the eardrum to tighten. As a result, the infant is very restless and cries a lot.

When a middle ear infection begins, affected babies often grab the ear or throw their head back and forth. If the disease is already advanced, the ear is no longer touched and touching by the parents is not tolerated because the pain is now very severe. As with other diseases, sick children often refuse to eat.

Other unspecific symptoms such as fever, diarrhea and vomiting also occur frequently. If bloody secretion starts to run from the baby’s ear, the eardrum has already ruptured (ruptured). However, since the excess pressure in the middle ear can now be compensated for by the resulting opening, the pain is significantly reduced. A rupture (rupture) of the eardrum occurs after an inflammation of the middle ear lasting about 1 – 2 weeks.

Diagnosis

Symptoms of any kind that persist for several days should always be clarified for babies.After the doctor has asked about the symptoms and a subsequent orienting physical examination, the diagnosis of a middle ear infection in the baby is finally made, as in the adult, by an ear examination (otoscopy). When the eardrum is examined in this way, it is possible to make a diagnosis as well as a good assessment of the extent of the disease. In a healthy condition, the eardrum should be pearly and a reflection of the examination lamp should be visible on the eardrum.

In the case of middle ear infections, however, the eardrum appears dull and without reflection. It can also be tense and visibly reddened if the eardrum is also affected by the inflammation. One of the most important and at the same time simplest means of treating inflammation of the middle ear, both in babies and adults, is a decongestant nasal spray or nose drops.

This is available especially for children in lower concentrations than those used for adults and works mainly by decongesting the mucous membrane of the ear trumpet. This ensures ventilation of the middle ear. However, they should only be used for a limited period of time.

Ear drops, on the other hand, do not help with middle ear inflammation, as their active ingredient cannot enter the tympanic cavity through the eardrum. Ear drops are only useful for inflammation of the external auditory canal. Furthermore, mucolytic preparations can also help speed up recovery.

Antibiotics are only indicated and helpful if the inflammation is really a bacterial infection; antibiotics have no effect on viruses. The antibiotic of first choice is usually a penicillin (e.g. amoxicillin) if there is no penicillin allergy. The pediatrician can easily determine whether antibiotics are necessary.

Homeopathic preparations can also be helpful under certain circumstances, but their effects are very controversial. Paracetamol in the form of suppositories or juice is particularly suitable for relieving pain. Paracetamol can be administered in the first months of life and has a good pain-relieving effect.

However, this analgesic lacks an anti-inflammatory effect. In any case, the recommended maximum dose should be strictly adhered to, otherwise a dangerous overdose can quickly occur. Ibuprofen is approved from about 6 months of age and has both analgesic and anti-inflammatory effects.

If the baby or toddler is affected by middle ear infections several times within a year, the insertion of a tympanic tube into the eardrum for tympanic drainage should be considered. This usually has a diameter of 1 – 1.5 mm and is made of plastic. To enable the tube to be inserted, the eardrum is opened first (paracentesis).

This is usually done under general anesthesia in children. Since water can now enter the tympanic cavity through the auditory canal, the auditory canal should be closed during bathing in order to avoid infections occurring in this way. This can be done with special plugs. After about 9 – 12 months, the tube is spontaneously rejected or sometimes removed by the doctor. If the eardrum is torn (ruptured) as a result of the inflammation of the middle ear, a hearing test should be performed immediately.