EAR INFECTION

More than 10 million children are treated each year for ear infections, and chances are, your child is one of them. If an ear infection clears up quickly, it's no more of problem than the common cold. In many cases, however, ear infections become chronic, which can cause permanent hearing loss in small children.


The first two years of life are critical for the development of language skills and obviously hearing function plays the pivotal role in this achievement. Hearing impairment is thus a fundamentally important issue, as it is related to significant delays in speech and language development, both of which affect academic performance as well as social and emotional growth. It's also important to note that children with hearing impairment often demonstrate emotional and behavioral problems that, in and of themselves, can result in poor academic performance.


Despite the fact that ear infection are so common and that they often lead to hearing problems, hearing impairment is generally not recognized until a child is between 2 and 2.5 years old. But is imperative to identify hearing loss much earlier. As many as 80 percent of children get middle ear infections , technically known as otitis media, by the age of three. These middle ear infection can affect a child's hearing when they become chronic, or when fluid builds up behind the eardrum. A middle ear infection that includes fluid buildup behind the eardrum is called otitis media with effusion (OME). These middle ear infections, especially OME, are the most common causes of inadequate hearing in children.


Smarter Child Tip A recent study showed that infants who used pacifiers had a 40 percent increase in the risk of ear infections; interestingly, when parents were counseled to reduce use of the pacifiers, the study demonstrated a 29 percent decrease in the rate of ear infections. They added that since ear infections are so common in childhood, even a slight change in habits that reduces their frequency would be extremely beneficial in preventing infections. But don't throw out the pacifier yet. A recent study sugested that babies who sucked on pacifiers while falling asleep were at a dramatically reduced risk of sudden infant death syndrome (SIDS). So the sensible solution seems to be reserving the use of pacifiers to calm your baby at bedtime.


It is also important to recognize that most middle ear infections (about two-thirds of uncomplicated infections) will clear up on their own within twenty-four hours, and in more than 80 percent of uncomplicated infections, symptoms will diminish or disappear within one to seven days. Since many middle ear infections are caused by viruses, antibiotics, which fight bacterial infections, do not help to clear up the primary infection, nor they eliminate middle ear fluid. Antibiotics, which are widely overused in treating ear infections, are thus frequently unnecessary, and can even be harmful in some cases, as overusing antibiotics can breed antibiotics-resistant strains of bacteria. Perhaps even more important is the fact that frequent use of antibiotics in children has been linked to a higher incidence of attention deficit hyperactivity disorder (ADHD). Of course, it's up to your doctor whether or not  to prescribe an antibiotic, but all too often, doctors succumb to the pleading of anxious parents who feel that an antibiotic will solve the problem quickly. The reality is, it makes better sense to monitor the problem for a week or so to see if it resolves on its own. As noted earlier, in most cases, it will. Save the antibiotic for the rare ear infection so severe that it doesn't clear up on its own.


As for removing the adenoids of children suffering from recurrent ear infections, recent has shown the benefit of this procedure with respect to reducing frequency of ear infections to be so small that many doctors now do not recommend this approach as a primary treatment in children up to 2 years of age.

A SAFER DRUG

In my opinion, a much safer medication choice than steroids for treating asthma is montlukast (Singulair). This new medication is safe for 2-to 5-year-olds, and the dosage is one milligram chewable tablet each evening. While I am not a big proponent of medication, especially in children, Singulair is highly effective and well tolerated, especially in exercise-induced asthma.


The best approach is for parents to help their child manage his or her asthma so that it doesn't become a major problem. Try to keep your child away from the environmental triggers that cause the attacks whenever possible. Reduce your child's exposure to stress. Key factors that increase stress in young children include inappropriate television prgograms, interaction with violent children and exposure to family conflict.