Q. My son is prone to ear infections. Could that make him more susceptible to swimmer's ear?
A. Happily, the answer is no. Otitis media (middle ear infection) and otitis externa (swimmer's ear) are two different problems. Middle ear infections typically occur behind the eardrum when bacteria and fluid from the child's nose and throat collect there, most often after a cold or flu during the winter months. Swimmer's ear is an infection on the other side of the eardrum -- the lining of the outer ear. This lining contains glands that normally secrete a waxy coating that is both water-repellent and too acidic for invading germs to survive. Frequent swimming, however, may wash away this protective coating.
Suspect swimmer's ear if your child's ear canal first itches, then rapidly becomes painful. If he winces when you try to pull on the earlobe or press down on the small flap of tissue that covers the ear canal, it's also likely to be swimmer's ear. As with middle ear infections, temporary minor hearing loss can occur.
A doctor will need to examine your child to confirm the diagnosis and will probably prescribe antibiotic eardrops to treat it. It's best to keep water away from the ears until the infection has cleared, which usually takes from four to seven days.
To prevent swimmer's ear, have your child tilt his head to one side and shake it after swimming to help the water drain out; then roll a small piece of tissue between your thumb and forefinger and gently insert it a short distance into the ear to absorb the remaining water.
My favorite home prevention for a child prone to swimmer's ear: Mix equal parts white vinegar (which contains a germ-fighting acid) and rubbing alcohol (which helps dry out the ear). After each swim, dry your child's ears thoroughly with a towel, then have him lie down. Gently pull the auricle (the outer rim of the ear) up and back to straighten the ear canal, and apply at least five drops to the ear. Wait five minutes or so, then repeat on the other side.
Pediatrician William Sears, M.D., is the author of 25 books on childcare.