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Otitis is a common disease in infancy and early childhood. This regularity results from lower immunity than in older children or adults, and from some distinctness of the structure of children’s ear.
There is a connection between the throat and the middle ear called Eustachian tube. Its primary function is to equalize pressure in the middle ear. We experience it while driving a car in mountainous terrain or while flying by plane – then we feel characteristic “gobs” in the ears.
The Eustachian tube is short and wide in an infant. For this reason, it is a “gateway” to the middle ear, through which secretions from the respiratory tract can get here, and during vomiting or belching – food content.
In the case of a young child, the term “earache” is very imprecise. The so-called indirect symptoms: pain during pressure on the patch of the ear or pulling the auricle. However, these symptoms are not certain. Strong pressure on the patch of the ear and the sudden release of pressure causes pain also in a healthy person and is by no means indicative.
Therefore, when confirming ear pain in children, we rely on indirect symptoms, such as anxiety, irritability, crying in the initial stage of sucking, the presence of other features of a viral infection (runny nose, cough), low-grade fever or fever, and rubbing the auricle with a handle or nodding by a lying child head to the sides.
It should be remembered that the appearance of purulent discharge from the ear brings great relief to the child. Mothers usually describe the situation as follows: “for half the night the baby screamed, could not calm down, then fell asleep, and in the morning I noticed a small yellow spot on the pillow.” Such a situation is – contrary to appearances – a cause for the greatest concern – it means that the tympanic membrane has been perforated, and gases and inflammatory secretion pass through the resulting opening.
Ear pain is not always caused by an underlying disease process. It is also accompanied by the pain of molars, inflammation of the mastoid process of the temporal bone, and parotid gland inflammation in the course of common parotitis (mumps).
A child with earache requires a medical consultation with a pediatrician, and even better – an examination by an ENT specialist. Often, to see the eardrum, you need to clean the ear of any residual earwax. In the case of a restless child, it is not easy and requires a lot of practice. Often, the doctor is not able to immediately assess the appearance of the eardrum – he must first “dissolve” the earwax by applying softening preparations to the ear, and repeat the test the next day.
There is a belief in some families that ear pain treatment is helpful in inserting potted plant fragments with alleged anti-inflammatory effects. It is absolutely forbidden! Parents can help their child with earache by administering painkillers by mouth and, if the child refuses to drink fluids, in the form of suppositories. Sometimes, sedative medications are also indicated, the administration of which will allow the suffering child to sleep through the night. However, do not give your baby any of these measures on your own – this can only be done after consulting your pediatrician.
Finally, it should be mentioned that, in addition to infections, earache can also be caused by the child inserting various small objects into the ear canal. If this happens, their removal should be dealt with by an ENT specialist. I advise against trying to remove them on your own, as it often happens that – instead of extracting them – parents push such items deeper, which results in damage to the eardrum.
Text: lek. med. Grażyna Słodek – pediatrician