Ear Infections (Otitis Media) in Children

Description

Alternative Names

Risk Factors

Acute ear infections account for 15 to 30 million visits to the doctor each year in the US. In fact, ear infections are the most common reason why an American child sees the doctor. Furthermore, the incidence of AOM has been rising over the past decades.

Gender and Age

Acute Otitis Media (AOM). About two thirds of children will have a least one attack of AOM by age three, and a third of these children will have at least three episodes. Boys are more apt to have infections than girls are.

It generally affects children between the ages of six and 18 months. The earlier a child has a first ear infection the more susceptible he or she is to recurrent episodes (i.e., three or more episodes within a six-month period).

As children grow, however, the structures in their ears enlarge and their immune systems become stronger. By 16 months the risk for recurrent infections is rapidly declining. After age five, most children have outgrown their susceptibility to any ear infections.

Otitis Media with Effusion. OME is very common in children aged six months to 4 years with approximately 90% of children having OME at some point. More than 50 percent of children experience OME before the age of one, and more than 60% by age two.

Specific Risk Factors in Children

Ear infections are more likely to occur in the fall and winter. Some conditions, including the following, also put children at higher risk for ear infection:

• Allergies.
• Enrollment in day care.
• Exposure to second-had cigarette smoke.
• Being bottle-fed as infants.
• Having siblings with recurrent ear infections.
• Being in lower socioeconomic groups.
• Being Native American.
• Possibly having a higher number of cavities. (The study suggesting this was small. More research is needed.)
• Obesity. One 2001 study found a link between ear infections and childhood obesity. Eardrum abnormalities increased the more the child weighed, which might explain the association. The researchers also suggested that parents may be confusing their childrens fussiness due to the ear infection with hunger and, therefore, overfeeding them.
• Certain medical disorders, including Down's syndrome, cleft palate, Kartagener's syndrome, and immunosuppressive disorders, such as HIV, increase the risk for ear infections.

Parental Behavior

The behavior of parents can increase a child's risk for otitis media.

• Parents who smoke pose a significant risk for both otitis media with effusion (OME) and recurrent acute otitis media (AOM) in their children. (Passive smoking does not appear to be a cause of initial ear infections, however.)
• Pregnant women who drink alcohol put their babies at risk for birth defects that can cause a number of problems, among them hearing loss and OME.
• Babies who are bottle-fed may have a higher risk for otitis media than do breastfed babies. The American Academy of Pediatrics recommends breastfeeding for at least six months.
• Several studies have found that the use of pacifiers place children at even higher risk for ear infections. Sucking increases production of saliva, which is a vehicle for bacteria that can travel up the Eustachian tubes to the middle ear.