Middle Ear Infections

Middle ear infections result from a buildup of fluid in the middle ear that gets infected. Fluid buildup is caused by congestion that blocks the natural channel (eustachian tube) that allows air and fluid to go in and out of your middle ear. Once the fluid is infected with bacteria, a middle ear infection develops.

Colds or allergies are almost always to blame for the congestion and fluid buildup. This is why ear infections often occur on the second or third day of a cold.

Symptoms of Middle Ear Infections

When children tug at their ears, act irritable, or have a fever after a cold, suspect an ear infection and seek medical attention.

Treating Middle Ear Infections

Ear infections may require regular treatment with low doses of antibiotics. However, your doctor may recommend that an ear infection not be treated with antibiotics because of problems with resistant bacteria. Some ear infections will get better on their own. Your child’s doctor may recommend ear tubes to drain fluids from the ears if your child has fluid that does not go away or is not responding to treatment.

Preventing Middle Ear Infections

There are several steps you can take to prevent ear infections in children:

• Encourage breastfeeding.
• If using a bottle, feed child upright.
• Avoid exposure to passive smoke.
• Limit exposure to large numbers of children as much as possible.
• Wash hands carefully—both adults and children.
• Limit exposure to viral upper respiratory infections.
• Avoid pacifier use in children older than 10 months of age.

Caring for Middle Ear Infections

• If your doctor has prescribed antibiotics, take as directed to reduce the risk of recurring problems. That means not skipping doses, measuring doses carefully, and taking the medication exactly the way it is prescribed. Store the antibiotic as directed; some require refrigeration.
• Follow your doctor’s recommendations for follow-up exams or other measures to prevent future ear problems.
• For relief from pain or help with sleep, use acetaminophen (Tylenol or a generic) instead of aspirin.
• Ask your doctor if swimming is okay. Avoid diving, because the pressure change could cause ear pain.

Swimmer’s Ear and Earwax Buildup

Swimmer’s ear is an infection of the skin in the ear canal and is often caused by water trapped in the canal. Earwax is normally protective; however, it sometimes becomes impacted. This makes it hard to remove and makes the ear feel plugged.

Symptoms of Swimmer's Ear and Earwax Buildup

The symptoms of swimmer’s ear and wax buildup are an itchy feeling, redness of the outer ear, and pain from simply wiggling the earlobe.

Preventing Swimmer's Ear and Earwax Buildup

To prevent swimmer’s ear, dry your ears after swimming. Use a clean towel or hair dryer set on low. You may also want to use drying ear drops if your doctor recommends them.

Caring for Swimmer's Ear and Earwax Buildup

• If earwax has built up, do not probe in the ear with cotton swabs. They can push earwax farther into your ear, causing even more problems. Instead, direct a warm (never hot) shower at your ear to loosen the wax, and then wipe it out with a clean towel. Sometimes, gently squeezing warm water into the ear using a soft, rubber-nose syringe helps. Don’t try to wash your ear if you think you have ruptured your eardrum or if you have ear drainage. (Symptoms of a ruptured eardrum are earache, partial hearing loss, and slight bleeding or discharge from the ear.)
• A heating pad or warm cloth on the ear may provide pain relief.
• Ask your pharmacist for over-the-counter earwax drops, which help soften the wax for easier removal.

If earwax can’t be easily removed or if you still have ear stuffiness, muffled hearing, or blocked ear passages after 3 days of self-care, call your doctor.

The pilot says, “We will now begin our descent,” but your ears have already told you there’s something going on. Sound is muffled and there’s a painful, uncomfortable feeling in your ears. You have barotitis, commonly called “airplane ears.” As the plane descends, the air pressure inside your ears is lower than the pressure outside your ears. This creates a vacuum inside your ears, pushing your eardrums inward and making your ears feel full or stuffed up.

If you have allergies or a cold when traveling by plane, descent can cause real pain. Your doctor may advise you to postpone a trip by air if you have an upper respiratory or ear infection.

Airplane ears usually cause temporary discomfort. They may cause fluid to
accumulate, which can make your ears feel like they are plugged. Airplane ears can also cause an infection.

Preventing Ear Stuffiness/Airplane Ears

• Don’t sleep during descent. You don’t swallow as often when you’re asleep. Ask the flight attendant to wake you.
• For children too young to chew gum, give them something to drink to make them swallow.
• If you must fly when you have an upper respiratory infection, ask your doctor about using decongestant (such as Sudafed) about 2 hours before you expect to land.
• Use a nasal decongestant spray such as oxymetazoline (Afrin or Sinex) an hour before landing and then again 5 to 10 minutes later. Don’t use nasal decongestant sprays if you have high blood pressure or angina, and never use them for more than 3 days.

Caring for Ear Stuffiness/Airplane Ears

• Clear your ears by swallowing, yawning, or chewing gum.
• Try the ear-clearing technique pilots use. Squeeze your nostrils shut, take a big gulp of air, and tightly close your mouth. Then try to blow the air out against your closed mouth and nose. If you’re successful, you’ll feel your ears pop.