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Ear Infections: Treatment & Medication

At Home: For immediate relief, experts recommend age-appropriate doses of acetaminophen or ibuprofen (never aspirin -- it’s been linked to Reye’s syndrome, a rare but serious condition that causing swelling in the liver and brain) for pain and fever.

To ease some of the pressure, keep your child’s head elevated by raising one end of the crib or mattress. If he’s over 2 and no longer sleeps in a crib, it’s fine to use a pillow when he lies down. Keep a baby upright in a car seat. Once he’s begun to feel better, put him to sleep in his crib again. Never use a pillow with an infant.

A warm (not hot) compress against the ear can also help.

Swallowing opens the eustachian tube and drains the fluid from the middle ear, so you can try having older kids chew sugarless gum. Have babies drink plenty of liquids. In fact, both of these may also help prevent a cold from turning into an ear infection in the first place.

Wait-and-See Approach: Because about 70% of all ear infections clear up on their own, many doctors now prefer to hold off prescribing antibiotics. This makes sense as long as the baby's symptoms (fever, pain) don't progress and you're in touch with your pediatrician. The principle reason for this wait-and-see approach is to avoid antibiotic side effects, including rash, allergy, diarrhea, upset stomach, and drug-resistant strains of bacteria. Ear infections are most likely to resolve on their own in children with only one ear involved and with no visible drainage or pus coming out of the ear canal.

Eardrops: You can also ask your pediatrician for pain-relieving eardrops, such as a benzocaine ear solution. Do not use these drops if the ear drum has ruptured or is perforated.

Antibiotics: Ear pain and fever should be improved after 24 hours and be much better by 72 hours, and children are usually symptom-free within seven days. Nevertheless, it's extremely important to complete the full course of medication to eradicate all the infecting bacteria and prevent a recurrence.

Tubes: If your child suffers from ear infections repeatedly, or if an infection lasts longer than three months, talk to your pediatrician about whether tympanostomy tubes are a good option. These tubes are implanted surgically and are designed ventilate the ear and promote drainage. Tubes will prevent ear infections as long as they remain open, which is usually 9 to 15 months, after which they fall out on their own. In some cases, they need to be removed by the doctor. Your child may be a candidate for tubes when chronic ear fluid is present for more than four to six months, or when there’s more than three ear infections in six months or more than five in one year.

As with any surgery, there are risks to being under general anesthesia, though they are small. The tubes may lead to calcium deposits in the eardurm (white patches), though this also occurs in children without tubes and no long-term consequence seems to result. Some children continue to get ear infections with tubes, but they are usually painless (because they drain out the tube) and can be treated with antibiotic ear drops, which have minimal side effects and do not lead to resistant bacteria.

Laser: Laser myringotomy may offer an alternative for some ear tube candidates. Using a hand-held laser, the doctor creates a tiny hole in the eardrum, allowing it to drain. Unfortunately the hole usually closes up within a few weeks and recent well-designed research studies have shown that tubes are much more effective in the long term.

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