Don’t look now, but those adorable little seashells that you call your child’s ears may be threatened by a very common childhood condition. At a recent media event, Pediatric Otorhinolaryngologist and St. Luke’s Medical Center Assistant Professor Gretchen Navarro-Locsin, talked about a condition called Acute Otitis Media, which is basically an infection that occurs in the middle ear, or the space right behind the eardrum. When fluid accumulates behind the eardrum and fails to drain into the eustachean tube or tube that connects the ear to the nose, this fluid may become contaminated with bacteria. The ear becomes infected and pus, redness, and swelling may occur. Children three years old and below are especially vulnerable to this condition because their eustachean tube has not yet been fully developed.

What is very striking about Acute Otitis Media, Navarro-Locsin pointed out, is that 70 to 80 percent of children, regardless of social standing and environment, would have developed this condition within the first three years of life, with a peak occurrence from 6 to 12 months of age.

An ear infection usually comes after a bout with the common cold, because the cold can lead to a swelling and congestion of the lining of the nose, throat and eustachean tube. And since young children are very susceptible to colds, it is not unusual for a toddler to get an ear infection two to three times a year. 

Telltale signs

The biggest problem with small kids is that they are not able to tell mommy if something hurts. The best cues that parents and caregivers should look for are:

• Constant tugging or pulling at one or both ears
• Fever
• Unusual irritability
• Loss of appetite
• Difficulty sleeping
• Fussiness in babies
• Hearing difficulty
•  Fluid draining from ears (luga)

Since most of the symptoms are unremarkable for the most part, it would be best to bring the child to his doctor for a checkup if Otitis Media is suspected. The doctor will peer through your child’s ears with an instrument called an otoscope to check for an infection. Through the otoscope, an infected ear will appear red and bulging with the pressure of the fluid.

The doctor may then prescribe pain relievers and cold and allergy medicine to relieve the symptoms. A warm pack held over the infected ear may also help lessen the pain. 

Clearing the ear

Although Acute Otitis Media can be treated with the use of antibiotics, Navarro-Locsin cautions that the condition may recur, “Otitis Media can be caused by many different types of bacteria, and because the infection can recur (Chronic Otitis Media), there is also the possibility of increased resistance to the antibiotics, leading to treatment failure.” Otitis Media has severe complications, she warns. These include life-threatening conditions such as:

• Mastoiditis (infection in the mastoid region of the skull, located behind the ear. This can lead to brain abscesses)
• Meningitis (an inflammation of the membranes that cover the brain and spinal cord
• Labyrinthitis (an inflammation of the inner ear structure that can affect the coordination between the eyes and the inner ear. This may lead to vertigo, feelings of motion sickness, hearing loss, and tinnitus) 
• Brain abscesses

Navarro-Locsin explained that the hearing loss that may accompany Otitis Media can have a big impact on the child’s quality of life. Hearing problems that result from this condition may manifest as difficulties in speech, language, and reading; lower IQ score in early teens; problems in school performance; and behavioral problems/difficulty with socialization skills. “This is therefore not just a medical issue, but a behavioral issue as well. This becomes a social issue because the child cannot communicate properly,” she adds.

“What is important is to try to prevent or at least delay the first episode,” Navarro-Locsin advises. “Early protection to prevent the first episode of Otitis Media, is key to preventing this recurrent and complicated disease.”

Until recently, little can be done to prevent this ear condition. Studies have shown that breastfeeding for at least 6 months is an effective way of preventing otitis media. Experts also say that it is important to keep children away from secondhand cigarette smoke.

Now, there is also a vaccine that can help eradicate this ear ailment, along with other serious childhood conditions. The GSK next generation pneumococcal vaccine has been found to provide protection against Streptococcus pneumoniae (S. pneumonia) and non-Typeable Haemophilus Influenzae (NTHi), two of the major causes of childhood infections and their complications. In addition to protecting children against invasive pneumococcal disease or IPD, the vaccine shields kids against NTHi bacteria, which, together with S. pneumoniae, causes over 40% of Otitis Media cases.