May 13, 2014 — Ear infections are the most common reason parents bring their child to a doctor. Most young children get ear infections, but reoccurring infections can lead to problems. Ear, nose and throat specialist Dr. Jeremy Meier talks about how to avoid ear infections in children. He also discusses some solutions for children who keep getting infections.

Interview

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: They cost the healthcare system nearly $3 billion a year. Ear infections also rank as the number one reason for a pediatric appointment. I'm going to find out about ear infections right now with Dr. Jeremy Meier. He's an E.N.T. specialist with University of Utah healthcare. Is it normal for kids to get lots of ear infections? It seems like parents are always talking about them.

Dr. Meier: Yes, well, "lots" is relative. But nearly every child will get an ear infection by the time they're three years of age.

Interviewer: All right. And how many a year would you expect in a normal child?

Dr. Meier: Two to three, especially during the winter months is not unheard of.

Interviewer: Okay.

Dr. Meier: That can mean several nights of no sleep for both the parent and the child.

Interviewer: Yeah.

Dr. Meier: And when you start to get four ear infections over six months or six in a year, that's quite a few.

Interviewer: That's when you should get concerned and maybe talk to a pediatrician.

Dr. Meier: Right. Well, yeah, your pediatrician may start recommending that you think about tympanostomy tubes.

Interviewer: Okay, from an ear, nose, and throat specialist.

Dr. Meier: Right.

Interviewer: Let's talk about that in a second. Is there anything that can be done to lower this number? Both the $3 billion or the number of ear infections a kid gets.

Dr. Meier: Ear infections typically will start after a cold, and kids are going to get colds. You can try to avoid and reduce the number of colds by not smoking around the child and also avoiding exposure to other kids with colds. So kids that are in daycares with lots of kids are at higher risk of getting ear infections, yeah. Choosing daycares with fewer kids would be one way to try to avoid more ear infections.

Interviewer: Any other tips as far as how could you avoid ear infections in kids?

Dr. Meier: Hand washing is always good, whether it's your own child and yourself, but washing their hands and the typical hygiene to prevent the spread of germs.

Interviewer: Now, tell me about the tubes. So if somebody has more than three or four a year, what do these tubes do?

Dr. Meier: So if a child's had four ear infections in six months or six in a year, you might want to consider tympanostomy tubes. And those are small tubes through the tympanic membrane or the eardrum, which then help to prevent the buildup of fluid. So when a child gets an ear infection, fluid builds up in the ear, and that causes the pain and the infection. Those tubes help air come through the eardrum so that that fluid will not build up. And if they do get an ear infection, you can treat it with eardrops.

Interviewer: Oh, okay, because those tubes will allow the medication to get in there.

Dr. Meier: Exactly, exactly.

Interviewer: So is there a downside to having the tubes put in?

Dr. Meier: About 2% of the time a child will be left with a small hole in the eardrum after the tube was placed, or the tube will stay in for too long. Those are the biggest risk factors.

Interviewer: When you talk about a number like $3 billion a year, should every child get these tubes? I mean . . .

Dr. Meier: No, because the tubes are not inexpensive themselves, and we don't want to do something on a child that they're not needed. So it's important to realize that kids will get ear infections; however, the newest recommendations suggest it's okay to wait on placing a child on antibiotics.

Interviewer: Oh, okay. So it used to be right away antibiotics.

Dr. Meier: Exactly. So they're encouraging a wait and see approach. If a child can go 48 hours and starts to get better, then you don't need antibiotics.

Interviewer: Okay. What about some sort of pain relief though?

Dr. Meier: Yes, many of these children will have a sleepless night, so using Tylenol and ibuprofen to help with the pain is recommended.

Interviewer: So it sounds like a good rule of thumb, if your child gets an ear infection before you contact your pediatrician, wait 48 hours. See if it plays out, and if it doesn't then let them know.

Dr. Meier: You can make the decision of whether to see them or not, especially if they're younger. Sometimes we'll start them right away with antibiotics, but it's not something you necessarily have to go in right then.

Interviewer: Okay. Any final thoughts on ear infections?

Dr. Meier: Just try to keep your kids as healthy as possible. In the winter time that's difficult, but washing hands and cleaning the toys after your child and their friends have played with them are steps that would go a long way towards keeping your kids healthy and infection free.

Announcer: We're your daily dose of science, conversation and medicine. This is the Scope, University of Utah Health Sciences Radio.