otitis media

Acute otitis media is infection of the middle ear (the cavity that lies just behind the ear drum), with the accumulation of pus, inflammation, pain, and often fever. Otitis media is usually caused by bacterial germs, chiefly Pneumococcus, Haemophilus influenzae, and Moxarella catarrhalis. It usually begins as a consequence of congestion and blockage of the eustachian tube, the drainage canal from the middle ear to the oral cavity. It is differentiated from serous otitis media, a more chronic condition in which bacteria may or may not be found in the middle ear fluid. Antibiotics are generally considered to be effective in the treatment of acute otitis media and are routinely prescribed. (They are ineffective for otitis media with effusion, which means simple fluid residue behind the ear which often is found after an acute infection.)

Some points:

  • Statistically, parental smoking is the single biggest preventable cause of ear infections. "But I don't smoke around him!" Doesn't matter, the correlation is 30% more infections whether you smoke in the house or at work - the smoke on your clothes is enough.
  • Wind or water in the ear have nothing to do with middle ear infections (unless the eardrum is perforated or has a ventilating tube in it). Wearing a hat will not prevent ear infection.
  • Bottle feeding is associated with more ear infections, especially if the child is allowed to lie in the crib while sucking his bottle. Breast feeding appears to be protective, either by differing position while nursing, or by direct immunological protection.
  • Pacifier use beyond about 6 months of age is probably pretty well established in several studies as a risk factor for otitis media. For this reason (and pacifier associated sleep disruptions in older children) my enthusiasm for pacifiers has waned in recent years.

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