DEAR DOCTOR,

Is it normal for a child to suffer from ear infections often? My daughter is four years old, and time and again, she gets ear infections. Sometimes I even notice pus in her ear. How can I stop this permanently?

BONITA

DEAR BONITA, 

Ear infections occur when bacteria or viruses enter the ear. This results in pain, swelling, itching and redness within the ears, with or without pus discharge. There may be fever and or pain on touching. Recurrent infections can lead to swelling of lymph nodes around ear and can affect hearing. Severity of symptoms depends on severity of infection, i.e. load of microbes present and immunity of the person. Rupture of ear drum can occur as complication of severe or long standing infection.  

Small children are more vulnerable to ear infections due to multiple reasons. The size of Eustachian tube (tube connecting middle ear to back of throat), is smaller in children, thus making it easy for germs to enter the ears from the throat. Immunity of a small child is not strong enough to protect him/her from being infected after exposure to infectious germs. Passive smoking (being exposed to smoke when somebody is smoking in the child’s presence) also makes a child more susceptible to ear infections. If not watched, children tend to put needles, pins, foreign objects in the ear, resulting in trauma as well as infection. Water entering the ear particularly in swimming pools also can result in infection due to dampness.  Play groups and nursery classes become one of the greatest sources of recurrent throat and ear infections, as affected children affect other kids.

Ear infection is easily diagnosed by the symptoms of pain and inflammation within the ear. If pus is present, it can be examined under the microscope to know the kind of infection. Culture of the pus can lead to precise identification of the microbes. Treatment is by use of specific antibiotics either orally as syrups or tablets or put locally as ear drops. Anti-inflammatory medicines are used to reduce pain and inflammation. In case of perforation of ear drum, surgical intervention can be done if needed.

After treatment of one episode of infection, preventive measures are needed to prevent relapse. Immunity needs to be enhanced by feeding the child more green vegetables, citrus fruits and nuts. Discourage the child from eating high sugar junk food. Be vigilant to see that the toddler does not put pins, needles or any foreign objects in the ear. Do not use ear buds to clear excess wax in the ears, as they can push any dirt or microbes present outside, within middle ear, thus cause infection. Keeping the ears clean and dry,   helps in reducing risk of infection.  In case of any nose or throat infection occurring, it should be treated without delay as it can lead to ear infection.

Dr. Rachna Pande is a specialist in internal medicine

rachna212002@yahoo.co.uk