Sunday, January 6, 2013

Sleepless Nights and Infant Ear Infections

If you've ever had a baby with an ear infection, you know it's just as miserable for Mom and Dad as for Baby.  Which leads to this post.  There are other places on the internet you can find information on ear infections, signs and symptoms and treatments.  However, since both my sons have suffered from chronic ear infections, I feel the need to address it here.  (My daughter, luckily, did not go through them, and has only ever had one ear infection in her 4 1/2 years.)

Dragon Boy had his first ear infection when he was about 6 or 8 weeks old, and kept getting them for the first two and half years of his life.  Every other week or so, he had another one, alternating ears, or sometimes both ears.  I think the grand total was somewhere between 34-40 in those two years.

Chunky Monkey, who is not quite 7 months old (he will be 7mo in a few days) has also had more than his fair share of ear infections, starting at 7 weeks old.  Same deal: alternating ears and double infections.  The latest has been either a never-ending infection for the last 4-5 weeks, or just back-to-back infections with little to no relief in between.

In our case, the solution for both is tubes.  DB got them at about 2 1/2 years old, and has only had one mild ear infection since.  My monkey baby will be having the same surgery in a week and a half, and I am seriously hoping for similar results. 

Like I said above, when Baby has an ear infection, it's miserable for everyone.  Since they can't talk to tell us what's wrong, it's often a guessing game and a matter of ruling out all other possibilities to figure out what's wrong.  And then, you have to try and figure out some way to help Baby find relief.  I hope this helps someone.

Signs/Symptoms of an Ear Infection include (but are not limited to!):
  • Unusual fussiness/crankiness
  • Excessive crying - especially when lying down
  • Pulling or tugging on ears (mine never did this too much, until after being diagnosed)
  • Refusing to nurse or take a bottle; diminished appetite if eating baby food
  • Cannot be calmed using usual methods
  • Fever can be associated with ear infections
  • Restlessness; not sleeping
Of course, most of these symptoms can be caused by other things, such as a cold, teething, gas, tiredness, hunger...  So before jumping to the conclusion that your little one is suffering from an earache, it is a good idea to try treating other potential problems.

Treatments for Ear Infections:

Non-medical
  • Warm compress on the ear
  • Massage at the base of the ear to relieve pressure
  • Keep Baby propped up at 30-90 degrees, even when sleeping
  • Apply a couple drops of warm olive oil in ear, and place a bit of a torn cotton ball in the ear
  • Walking or driving Baby around
  • Cover Baby's head with a light blanket
  • Keep the noise level around Baby as low as possible
At-home medicines
  • Tylenol and/or Motrin (dosage as directed by your pediatrician)
  • Teething tablets - believe me, this works!
  • Earache drops
  • Cold tablets - this works especially if the earache is related to a cold, and has the bonus of working on the cold symptoms, too
  • Benadryl might help, if the earache sets in around the same time as seasonal allergies start being a problem
Medical treatment, when at-home remedies simply aren't enough
  • Your baby's pediatrician can determine if s/he has an ear infection or just an earache.  There could be other factors causing ear pain, such as a wax build-up, which the doctor can clear out 
  • While sometimes ear infections will clear up on their own, there are other times when you might want to consider an antibiotic.  Amoxicillin, Cephalexin and Supprax are common ones, among others.  Be sure to tell the doctor if Baby has any known allergies.  And, if Mom or Dad has any allergies, be aware of giving Baby those or related meds and watch her/his reactions.
  • The pediatrician may also prescribe a steroid to boost Baby's immune system and their ability to fight off the infection
  • Recurrent, or chronic, ear infections might require a trip to an ENT (ear, nose & throat) doctor.  The ENT will likely monitor your baby's health, and number of infections, for a couple months, and will then discuss the best treatment options.  These can include having a relatively simple surgical procedure done to insert tubes into the ears; adnoidectomy (removing adnoids that may be blocking the eustachian tube and not allowing proper drainage); and, in rare instances, tonsillectomy - though it is generally not thought that having tonsils removed actually makes a difference to chronic ear infections.
Causes and Contributing Factors to Ear Infections:
  • Ear infections can be viral or bacterial.  Many times, an ear infection will come along with a cold, but sometimes, they'll come on their own
  • An under-developed eustachian tube that prevents proper drainage allows fluid to collect which then invites bacteria to grow causing the infection
  • Boys are more susceptible to chronic ear infections, according to some research.  Also, having a family history of ear problems is a good indicator whether you can expect it in your children.
  • Allergies, asthma or other respiratory-related problems can contribute to ear infections
  • Teething.  Not sure why, and some experts deny it, but there is a connection between teething and ear infections.  Possibly, it is the excess saliva babies produce that pools in the back of their mouths and gets "stuck".
  • Being around cigarette smoke has been shown to increase the likelihood of developing ear infections
  • Bottle-fed babies tend to be more likely have recurrent ear infections; I'm not sure why, but research shows breastfed babies tend to be less susceptible (though this certainly isn't the case in my family, here it's all genetics)
  • Some literature also claims that pacifier use can lead to increased risk of infections
  • Children who go to daycare or school are also more likely to get them, probably due to the unrestrained germ-swap they engage in with the other children
Risks from Chronic Ear Infections:
  • Possible ear drum rupture - would be very painful, though it should heal on it's own.  Carries an additional risk of infection and more medical treatment.
  • Scarring, either from a ruptured ear drum or from the inflamed and irritated tissue caused by the infections
  • Hearing loss
  • Speech delay
  • Other developmental delays
  • Balance or sensory problems may be related
  • Early weening for a breastfed baby
Prevention tips:
While these haven't worked for my boys, they might work for someone else.
  • Avoid exposure cigarette smoke if at all possible
  • Cover Baby's head and ears when it is cold, windy or rainy outside
  • Try to have baby sit up a little bit when nursing or drinking from a bottle to prevent the liquid from pooling in the back of their mouth
  • Try not to send Baby to bed with a bottle or sippy-cup
  • Try to limit exposure to known seasonal or animal allergies
Just a few more things:
  • As miserable as you are, Baby is feeling worse.  S/he is tired and in pain, and can't understand why. 
  • You will have to experiment with the different relief options to see what works best for you and Baby. 
  • Rocking, walking and/or driving with Baby really do help.
  • If Baby won't sleep on her/his own, take them to bed with you, even if you don't, as a rule, co-sleep.  The closeness may provide the extra comfort s/he needs to fall asleep, and stay asleep.
  • Try having Baby lie on your chest, and sit/lie supported by pillows or the back of a couch or chair.  Get comfy - you will probably sleep in this half-sitting up position for as long as Baby will sleep.
  • Stay calm.  As tired as you are, getting frustrated that you can't settle your baby won't help you, and it won't help Baby.  Try calling a family member or friend to come sit with the baby so you can get a little break, if you need to.
  • Nap when Baby naps, if you can
  • and, Good Luck!

(Anyone who has other questions about babies and ear infections, I'd be happy to try and give you an answer that will help.)

2 comments:

  1. Gosh my little guy is one his third ear infection in two months. He is 1 year recently and is miserable. He seems fine till its time to lay down. Nap time and bedtime is a screaming ordeal. Just walking into his room he starts. Any suggestions? I put a pillow in his crib to prop him up for reflux reasons and thought it may help here too but he doesn't sleep on it.

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  2. I'm talking medical journals and reports, not blog posts and mother forums - then you have something to fall back on! headphones and tinnitus

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