Treatment of otitis media in a child

August 12, 2017 17:51 | Child Health

One father, who, together with your child often visited my office about otitis media, during a recent visit began like this: "The ears of my child - the most expensive for me part of his body."True, have to pay for treatment a lot, but if you think about the fact that healthy ears - a pledge of normal hearing and speech, the price of a good care of them does not seem like such a high.

What parents should know about

children's ears if you get into the anatomy of the ear and what the baby's ears are different from adult human ears, it will be easier to understand why infants are vulnerable to inflammation of the ear, and why it is important to carry out an adequate treatment.Let's go with the germs to travel from the nose or mouth to ear to see how there is otitis media.The microbe gets into the nose and throat and then up the Eustachian tube to the space called the middle ear.Eustachian tube connects the middle ear with the pharynx and serves to equalize the pressure on both sides of the tympanic mem

brane.Without this tube, your ears would always be painful, they would be weighed and you would seem, they are laid, as it happens for some time, when you climb to a higher altitude or flying in an airplane.Besides the fact that it provides equal pressure, this pipe also protects the middle ear, opening and closing, when it is necessary to provide an outlet for unwanted accumulations of fluid and microbes.

reason that infant ear infections occur more frequently than in older children, lies in the small tube.


symptoms suggestive of otitis media:

• more dense and viscous nasal discharge;

• discharge from the eyes;

• moodiness and irritability;

• frequent nocturnal awakening, or a sharp change in sleep patterns;

• unwillingness to lie;

• cry or shriek against the backdrop of the symptoms of acute respiratory disease;

• discharge from the ear;

• sudden deterioration in the cold.

Not only that it can not adequately function (open and close), a baby's Eustachian tube is short, wide and extends substantially on the same plane with the pharynx - all you need to pathogens and mucus easily penetrated into the ear ofthroat.As the child grows, the Eustachian tube is extended, narrows and bends down, lying is now a large angle to the throat, and mucus to reach the ears, already has to climb up the hill.

With a cold or during allergy attacks in all respiratory tract and middle ear fluid accumulates.The same mass that fills the child's nose, and it turns out his eardrums.That's what the doctor has in mind when he says to you: "The kid behind the eardrum fluid."The medical term for this condition - serous otitis media (secretory otitis media).At this stage, colds child can behave like a completely healthy.However, a feeling of heaviness in the ear can cause sudden awakening and irritability.

child may even not good enough to maintain balance while walking, since the liquid splashing in the middle ear, violates the sense of balance.But usually at this stage, children under one year are behaving as if they were just cold.The liquid may ottech itself, due to the fact that the immune power of the body to cope with all the microbes present in the liquid, and then the child would recover.This is a good end of the story.

Often, however, there is obstruction of the Eustachian tube is closed and fluid in the middle ear.There is a main principle of the human organism: any liquid stagnant wherever it was, usually infected.This stagnant fluid serves as a breeding ground for microorganisms, which multiply in this liquid, making it as thick as pus.This thick liquid presses on the eardrum, causing pain, especially when the child is lying.That's why so otitis wrong time makes itself felt at night when the baby is lying horizontally, and in the afternoon

child's condition sometimes improves.The pain, moodiness and insomnia - the usual initial symptoms, sometimes (but not always) accompanied by fever, thick secretions from the nose and vomiting.You may notice less obvious signs, such as the child who receives the chest begins to suck anyway, and the child refuses to lie in a horizontal position.If a child pulls his ear - this is not a reliable sign.Babies play with their ears, and most often are drawn to him while teething.

Sometimes pus under pressure breaks through the eardrum, and then you point out that of the auditory canal of the child implies a thick liquid.This can occur during the night, and the liquid may be confused with nasal secretions.After the rupture of the eardrum child usually feels better, because the severity of ear was gone, but still take your child to the doctor for treatment.(At a time when there was no antibiotics, doctors in the usual manner pierced eardrums to release the tension and excruciating pain.)

Meanwhile, the doctor

doctor's office looks the child in the ear, and sees the red bulging tympanic membrane, which givesasked why no one slept last night.The pediatrician prescribes antibiotics for at least ten days;type and dosage depend on the severity of inflammation and reaction on antibiotics of the child in the past.Then the doctor says is very important phrase: "And we see the ears of your child in ten days or two weeks."Remember to be three important points: comply with the instructions, follow the instructions, follow the instructions.

field one or two days of antibiotic treatment, the child should be a little better.If, within forty-eight hours there has been no improvement, please contact your doctor, and even earlier if the child's condition worsens.When you first look at an ear infection in your child's doctor tried to pick up an antibiotic according to the type of infection, but only a reaction to the body of the child will tell whether this is the right choice was.But do not expect an instant effect: to antibiotic has an action may be required from twelve to twenty-four hours.And the temperature, if any, can survive even a day or two.Antibiotics do not lower the temperature.They kill bacteria and germs when disappear, the temperature drops.

Suppose your child began to feel much better, almost completely recovered after three days of antibiotics.Tempted to finish a course of treatment right now?Do not

How to help small lugs in flight

Here are some ways to prevent or minimize the discomfort in your ears when you are traveling with your baby in the air.During takeoff and landing, give your child the breast or a bottle or something else to suck or drink.If baby sleeps during takeoff, no need to wake him.When taking off the ears lays not so much as when landing.That's when the plane lands - it is the only case where you need to wake a sleeping baby.During sleep, the Eustachian tube is not so effectively equalize the pressure.If a child has a cold or has clogged nose, give him oral decongestant or a drip nose (drops your doctor will recommend) half an hour before takeoff.To moisten the air in the cabin over-dried, put the nose of your child a sponge dampened with warm water to provide moisture small airways.

this!The microbes most likely are still in the body and cause a new inflammatory process, if you stop treatment too early.Being conscious of their parents, you would bring the prescribed antibiotic treatment until the end.Now one of two things is possible.The child may be better, but it has not completely recovered, and again you go to the doctor for re-examination of the ear, and possibly even one course of treatment.Or it seems that the baby is completely healthy.You look at the calendar.He reminds you that today you have scheduled a visit to the doctor for a re-examination of the ear.But you start to argue: the child seems to have completely recovered, the doctor visit is so expensive, and you have plenty of other things.Busting tempted to cancel the visit to the doctor and still check the child's ears.That's why.In most cases, otitis media can not be cured completely after the first course of treatment with antibiotics.If you nedolechite inflammation, which may lead either to the fact that nothing bad will happen and the ear recover completely by itself, without further treatment, or to the fact that in the remaining stagnant in the middle ear of the infected fluid flash inflammatory process again, and youagain I have to go to the doctor.

another, more frightening option is the possibility that nedolechennaya infection can remain in the ear for weeks, even months, despite the fact that the child may feel perfectly healthy.In some cases, if the child is lucky, the liquid may leak out months later.But in most cases the infected fluid with slow current inflammatory process, which remains in the middle ear without treatment for months, it becomes sticky - the medical term for this situation adhesive (slipchi-st) otitis - and

removal is required it surgically (drainage).If you would bring to the end of treatment, achieving what the child's ears become completely clear, thus you reduce the risk of hearing loss and the need for drainage.

On subsequent visits to the doctor is not always easy enough to examine the child's ears.Today, research has become a mandatory procedure eardrums after suffering otitis using the tympanogram: rubber probe that painlessly included in the external auditory meatus of the child, measures the vibration of the eardrum and sets the presence or absence of fluid in the middle ear.Only a doctor can announce that the child fully recovered after suffering otitis.

prevention of otitis

assume this situation is repeated with increasing frequency and severity over the next year, as often occurs in young children.Here ways to prevent otitis media, or at least reduce the frequency and severity of inflammation of the middle ear.

Breastfeed for as long as possible. In children receiving breastfeeding, otitis media occurs rarely.

Fight allergens. Allergens cause the production of liquid, which serves

breeding ground for bacteria and other pathogens, and can be in the middle ear.Get your child to private detective to search for allergens to identify the effects of which allergens your child may be subjected to the highest degree of probability.The most common are the nasal allergy (or respiratory allergies) on cigarette smoke, dust, animal dander.Particular attention to the release of the room where your baby sleeps, from the fluffy and soft toys that collect dust (see. Advice on how to clean the child's bedroom from soft toys and dust).Food allergies, especially in dairy products, also contribute to otitis media.

Change the immediate environment of the child. Maybe your child spends a lot of time with a cold child?Children in the kindergarten pick up colds more often.Think about how to transfer the child to kindergarten with fewer people in the group or in the garden at home, in which the teacher is strictly isolate sick children from healthy or sends patients home.

Feed your baby in an upright position. If your baby is bottle-fed, feed it in a vertical position, or at least an angle of

How to prevent otitis

• Breastfeed.

• Get rid of allergens.

• Minimize contact with sick children.

• Feed upright.

• Treat acute respiratory infections as early as possible.

• Keep your nasal passages clean.

• Assign frequently repeated examinations.

• Try to give preventive antibiotics daily.

• resort to surgery.

forty-five degrees.This reduces the risk of leaking in the throat in the Eustachian tubes or milk mixture which can cause the pipes or in the middle ear inflammation.Breastfeeding supine rarely causes otitis, since swallowing mechanism in this case other than breast milk, and has a less irritating to tissue of the middle ear.But if your baby receives breast often repeated otitis media, never feed lying down.

Begin to treat a cold as soon as possible. Note that the sequence in which the common cold usually goes in your child's otitis.If the typical pattern of events is as follows: from the nose flowing watery liquid and child having fun playing, then in the nose are formed thick discharge and the child becomes moody, which eventually develops a few days later in acute otitis media - it makes sense to consult a doctor as soon as possiblebefore cold moved in otitis media.

Keep nasal passages clean.

Treat nose steam and rinse to ease the removal of thick secretions.

Recurrent otitis

Suppose you have resorted to all the above preventive measures, and your child

still now and then dropping in a doctor's office with recurrent otitis media and begins to show signs of deteriorating behavior, such as chronic irritability.Such changes in behavior - a common occurrence in children with frequent ear infections, simply because they do not feel or hard of hearing, and therefore behave badly.After you manage to cope with the constant ear infections, especially parents notice that the child began to lead to better themselves.

whole set of preventive measures, including support courses of antibiotics and surgical intervention is aimed at simply buying time until it will get stronger and the child's immune system does not develop Eustachian tube

.Most of the children coming out of age, is fraught with inflammation of the ear, to the three-four years.

Long-term treatment with antibiotics

A recent breakthrough in the prevention of recurrence of otitis media was the use of soft antibiotics in small doses once or twice a day for one to six months, especially in the winter months.

Parents peculiar reluctance to give your child antibiotics for such a long time, but consider the alternative.Weak antibiotics in small doses tolerated by the body of the child is easier than periodic courses of antibiotic treatment with increasing dosages, because over time the child may receive resistance (immunity) to common antibiotics.Antibiotics are used for prevention, like those taking some children daily for twenty years for the prevention of rheumatic fever, do not give dangerous side effects.Without these preventative measures in a child with chronic otitis may occur temporary hearing loss at a time when a good ear is required for optimal development of speech.Inflammation of the ear that happen too often or for long

sequence of medical interventions in recurrent otitis

for proper treatment and prevention of inflammation of the ear is important to take each stage on time.If the first three steps completed correctly, the majority of children with recurrent otitis fourth step, surgical treatment is required.

Stage One.Treat every ear infection as soon as it appears

Continue treatment and timely come repeated medical appointments until the inflammation completely disappear and the child does not become a normal tympanogram.If otitis media will become more frequent, continue to the next step.

Step Two.Take preventive measures

As mentioned above, the resort to preventive measures, consisting in breastfeeding, anti-allergens, reduction to your child's contact minimum with sick children, feeding in a vertical position, the early treatment of colds and washing the child's nasal passages.If otitis media is still repeated, proceed to the next step.

Stage Three.