Most parents are familiar with childhood otitis media firsthand. Eight out of ten newborns and infants under one year old had hearing inflammation at least once. Why the smallest children are more likely to suffer from this disease and how to help a child, we will tell in this article.
What it is
The inflammatory process in one of the sections of the human ear is called otitis media. Accordingly, with inflammation of the outer ear, they talk about otitis externa, middle ear - about middle, inner - about otitis media or labyrinthitis.
In children of the first year of life, it is otitis media that is more common.
In babies, this disease is usually acute. Chronic otitis media can be talked about when episodes of inflammation are repeated from 5 times a year.
The inflammation can be either catarrhal (common inflammation) or purulent or exudative (inflammation with accumulation and separation of pus).
The main reasons that cause inflammation of the hearing organs are pathogenic and opportunistic bacteria (cocci, Pseudomonas aeruginosa, moraxella, and so on). Many of them live quietly in the nasopharynx without causing disease.
With any infection, cold, under the influence of other external factors, bacteria mechanically penetrate into the auditory tube and middle ear. There are excellent conditions for microbes to reproduce - warm, humid. This is how the inflammation begins.
The causative agents of otitis media can enter the organs of hearing when sneezing, improperly blowing your nose, sniffing, and coughing. Through the bloodstream, microbes enter the ear much less frequently.
Viruses sometimes cause illness, such as during measles. In any case, otitis media is not considered to be an independent disease. In 99% of cases, it is only a complication of previous diseases of the upper respiratory tract, viral or bacterial infections.
The main danger of otitis media lies in the possibility of hearing loss. This can happen with purulent inflammation, when the structure of the hearing organs is disturbed, with labyrinthitis.
Purulent otitis media in severe form can also cause inflammation of the meninges if purulent masses break through not outside, but inside. Most acute inflammations without pus do not lead to hearing loss.
Age features
The first six months after the birth of a child, innate immunity protects from viral infections - antibodies that the baby's mother passed on during pregnancy. Therefore, severe viral diseases at this age are rather rare than the rule.
After six months, the baby becomes vulnerable to hundreds of various viruses, to which the child's immunity is not ready to meet. When faced with microbes and viruses, the immune defense “learns”, produces its own antibodies, and this takes time. That is why so often even mild forms of diseases in young children are complicated, including otitis media.
As for children under six months, they have otitis media - also not uncommon. But the reason lies not even in the state of immunity, but in the physiological age-related features of the structure of the hearing organs.
Babies have a short and wide auditory tube.
It is located almost horizontally. That is why breast milk, water, nasal mucus can easily penetrate into it, along with bacteria that existed peacefully in the nose, and in the ear they quickly become activated and begin to multiply.
Nasal mucus in babies is produced more actively, in addition, babies often cry and excess tears flow down the nasolacrimal canal into the nasal cavity. When sniffing, they can easily end up in the auditory tube.
Do not worry, because as the child grows, his auditory tube grows. It lengthens, becomes narrower, its location in space changes to a more vertical one. The risks of getting into the tube of the contents of the nose and mouth is sharply reduced. That is why in children after 5-6 years, the number of otitis media is rapidly decreasing.
Causes
Thus, the most common causes of ear inflammation are:
- hypothermia;
- mechanical injury (for example, when cleaning a child's ears with cotton swabs);
- bacterial contamination;
- viral infection and its complications;
- getting into the middle ear cavity of fluids (milk, tears, water, nasal mucus);
- allergic reaction.
Symptoms and Signs
Otitis externa usually manifested by the formation of boils on the auricle and behind the ear. The ear turns red, swells, hurts badly. Diagnostics of labor does not constitute, since the source of pain is immediately noticeable. With otitis externa, the temperature rises, the general condition of the child worsens.
Otitis media it can be more difficult to detect. It is accompanied by severe shooting pain in the ear, which is worse when moving the head. The temperature does not always rise. The child develops a noise in the ear, congestion. If not only the auditory tube becomes inflamed, but also the eardrum, then the temperature rises, other symptoms, including pain, also become stronger.
Purulent otitis media always accompanied by almost unbearable pain and high fever. The child will feel relief only after the pus begins to drain. Purulent masses press on the eardrum and eventually break through. After the pus comes out, the pain recedes, the temperature decreases, and recovery begins. A breakthrough of the tympanic membrane is gradually scarred, it is restored. Perforation of the membrane does not affect the state of hearing.
Internal otitis media - the most difficult and severe among all inflammations of the auditory analyzer. It rarely ends without consequences for the hearing and the organs of balance located in it, but one cannot but rejoice at the fact that such otitis media rarely occurs in children.
The symptoms of labyrinthitis, as it is also called, are: sweating, lethargy, refusal to eat due to dizziness and nausea, too pale or, conversely, reddened skin, increased or slowed heart rate.
After a while, parents may notice hearing loss. The kid stops responding to voices to which he previously responded with a smile or a turn of his head, does not turn at the noise of a rattle, does not flinch if the door suddenly slams.
Then there are severe pains in the ear, which become more intense with a change in the position of the head, body position. Attempts to roll the child onto its side will be accompanied by a loud and shrill roar.
How to recognize otitis media in babies?
With the diagnosis of otitis media in children over two years old, problems usually do not arise, because such babies are already able to tell their mother what and where they hurt. With babies, everything is much more difficult, they do not talk, do not indicate the source of pain.
By the nature of crying, many mothers are able to determine that the child is in pain. Such crying is characterized by harshness, anguish, the child literally starts screaming. The scream is almost constant.
A hungry baby greedily takes a breast or a bottle of formula, but after a few seconds he stops sucking and starts screaming loudly again. This is due to the fact that sucking and swallowing movements only increase the pain in the ear.
The child's behavior changes dramatically, he becomes moody, lethargic, sleep is disturbed, he may refuse food after realizing that it hurts to suck. If such signs are found, the mother must definitely measure the temperature of the child and examine the ears for discharge from them.
To confirm suspicions, the method of pressing on the tragus is used. The tragus is the cartilage located centrally at the entrance to the auditory opening. He's performing, it's hard to miss him. With the index finger of the hand, the mother gently presses the cartilage-tragus. If there is an inflammatory process in the ear, then such an effect increases the pain, the child begins to cry.
The diagnostic test is best done when the baby is at rest. If he roars without a test, then it will be difficult to distinguish a change in the nature of pain and crying.
First, the left ear is checked in this way, then the right one. Then press simultaneously on both tragus. This will make it possible not only to establish whether otitis media at all, but from which side it develops, or is bilateral. Usually children have unilateral inflammation, but anything can happen.
It is somewhat easier to understand a child who is already 9-10 months old. Such a kid will rub a sore ear, fiddle with it. If the movement is repeated often and combined with temperature, a positive reaction when pressing on the tragus, then we can safely say that the child has otitis media.
It will be easier to recognize otitis media if you know that ear inflammation in young children usually manifests itself in the evening or at night. It all starts with a sharp pain. Therefore, if the baby woke up and suddenly screamed, this is also a reason to check if he has signs of otitis media.
If the baby has purulent or bloody discharge from the ear, there can be no doubt - there is inflammation, and only a doctor can determine its exact location and degree.
At the first signs of otitis media in a child under one year old, it is imperative to call a doctor. Self-medication and experiments with folk remedies at this age and with such an ailment are absolutely unacceptable.
Diagnostics
The doctor examines the ears visually using an otoscope. Determines the presence or absence of pus, as well as the degree of inflammation. Visual inspection allows you to conclude whether the eardrum is intact.
If purulent exudate is found, take a sample for bacteriological analysis to establish the type of microbe that caused the inflammation. This is required in order to select antibiotic drugs for the treatment of otitis media.
If bacteria and viruses are not detected, blood tests do not show antibodies to viral ailments, and bacterial culture does not show the presence of microbes, then the doctor may suggest allergic otitis media. In this case, a completely different treatment is prescribed.
If you suspect otitis media, a study of auditory function by the method of tone audiometry for babies is mandatory.
First aid
If a child from 2 years old can call a doctor at home, and an older child can be taken to an appointment at a polyclinic, then delay is unacceptable for children of the first year of life, because purulent otitis media from karatal one can develop in them in just 5-7 hours.
It is best for parents to call an ambulance, especially if the baby has a fever.
While waiting for a doctor, you should not bury anything in your ears, since there is no certainty that the eardrum is intact.
Drops can be dripped only if the membrane is intact, and this integrity can be assessed only when viewed with an otoscope with a light bulb - a special instrument. Therefore, first aid should be that the child should be taken in his arms, and put his sick ear down - so the little one can calm down at least for a while.
It is also not worth making warming compresses as part of an emergency, since at home there is no way to find out if pus is formed inside the inflamed cavity.
With purulent otitis media, warming up only aggravates the already severe inflammation. A compress is a good treatment, but only after the doctor has examined the child.
The only thing parents can do is to give the baby an antipyretic agent if the temperature exceeds 38.0 degrees. It is better to give preference to paracetamol-based drugs.
For the smallest patients, there are antipyretic drugs in the form of rectal suppositories and syrups. It is also allowed to drip vasoconstrictor drops "Nazol" or "Nazivin" into the baby's nose to relieve puffiness in the auditory tube. This will somewhat reduce pain for a while.
Treatment
Otitis media in infants is treated at home. The only exceptions are otitis media (labyrinthitis) and severe purulent otitis media, in which there is a real risk of inflammation of the meninges. Such children are hospitalized and treated under the supervision of pediatricians and ENT doctors.
After examination and analysis, the doctor gives detailed recommendations. With purulent otitis media, antibiotic ear drops are always prescribed. For an allergic form of ear ailment - drops with corticosteroids.
If the cause of inflammation is viruses, the doctor may advise osmotically active drops with anesthetic and anti-inflammatory effect.
Purulent otitis media and catarrhal otitis media with severe course may require the use of antibiotics inside - babies are most often recommended "Amoxiclav", "Amosin". Ear drops such as "Otinum" and "Otipax" have proven themselves most well as a medicine for an infant.
With allergic otitis media, as well as with severe inflammation with general sensitization, antihistamines, for example, "Suprastin", can be recommended.
If otitis media is accompanied by nasal congestion and rhinitis, then vasoconstrictor nasal drops are prescribed in a course of no more than 3-5 days, since their longer use can lead to persistent drug dependence.
Ear drops are usually instilled 3-4 times a day, 2-4 drops in each ear canal. Nose drops - morning and evening. The dosage and frequency of antibiotics is determined by the doctor based on the weight of the child.
In addition, vitamins and iron preparations can be prescribed, since against the background of otitis media there is often a decrease in hemoglobin.
With catarrhal otitis media without a purulent complication, the child may be allowed to make warming compresses. To do this, parents will need:
- cotton wool;
- bandage;
- gauze;
- compress paper;
- heated vegetable oil.
A vertical slit is made in the gauze for the auricle. The size of a piece of gauze is 10x10 cm. It is moistened with warm sunflower oil and applied to the sore ear, passing the auricle through the slot. Then a layer of paper for compresses is applied, its size is 12x12 cm.Then a dry gauze measuring 14x14 cm is applied and the compress is carefully fixed with a bandage so that it does not let air through.
The compress is applied for 4-6 hours. You should not do the procedure at night. Vodka and alcohol cannot be used for such treatment. The compress can be applied only when the child's temperature is at normal values.
With a competent and thorough approach, treatment of otitis media in infants and newborns will not take more than five to six days. In this case, acute pain can usually be “overcome” in a day or two.
In severe cases, the doctor may suggest a puncture of the tympanic membrane. This is done if the pus cannot come out. To avoid breaking it inward, a small incision is made in the membrane. This is not dangerous. After the discharge of the purulent contents, the incision is healed, the integrity of the membrane is fully restored.
After the course of treatment, you should definitely visit a pediatric otolaryngologist with your baby, who will examine the baby's ears and find out if the auditory function has been affected.
Otitis externa is treated with antibiotic ointments, turunda with antimicrobial drugs, and warming compresses. If an abscess or furuncle forms, surgical opening may be indicated.
What you can't do:
- You can not warm up the ears if the child has a purulent form of otitis media.
- Breast milk, which is an excellent breeding ground for bacteria, should not be instilled into the baby's nose and ears.
- Do not stop taking antibiotics at the first sign of improvement. The course (it is usually 5-7 days) must be completed.
- Do not bury homemade homemade drops in your child's ears.
- Do not use alcohol to treat an infant.
- Do not apply warming compresses at elevated body temperature.
Doctor Komarovsky will tell you when you need to treat otitis media with antibiotics in the next video.
Prevention
The risk of injury to the ears can be reduced by using turunda made from gauze for hygienic cleaning.
If you quickly and correctly respond to nasal congestion, to snot in a child, to treat rhinitis correctly, then this significantly reduces the likelihood of developing such a complication as otitis media.
To prevent nasal mucus from thickening, including after getting into the auditory tube, the child must breathe sufficiently humidified cool air. The best parameters for children under one year old are air temperature from 18 to 21 degrees, humidity - 50-70%.
When collecting a child for a walk, it should be remembered that it is not necessary to wrap him up, but it is also impossible to allow drafts and wind to blow through his head and ears. Beanies should be chosen in such a way that they cover the ears even in summer. At the same time, it is not at all necessary to choose a warm hat if it is already warm outside. If the wind is strong outside, it is better to postpone walking with a baby.
After feeding the baby, it is imperative to hold it in an upright position so that what is regurgitated does not fall into the auditory tube.
