Step into a pediatricians waiting room, and you're likely to find that one of every three children under the age of three is there because he or she has an ear infection. Some one-third of all children have more than three middle-ear infections (the medical name is otitis media) during the first three years of life, resulting in 30 million doctor visits a year.
Of course, children arent the only ones who get ear infections. But they are, by far, the most common victims. Adults are more likely to get an infection of the outer ear, which is aptly referred to as swimmers ear because it usually gets its start when water containing bacteria or fungi seeps into the ear and gets trapped in the ear canal.
In order to understand how middle-ear infections develop, it helps to know how healthy ears function. The outer ear is connected to an air-containing space called the middle ear. The eardrum, a thin membrane, is stretched across the entrance to the space, and three sound-conducting bones are suspended within it. The pressure within the middle-ear space is equalized with the atmosphere through a narrow tube called the eustachian tube. The eustachian tube opens into a space behind the nose where air or fluid may enter or escape. The air pressure in the middle ear is equalized more than one thousand times a day every time you swallowusually without your noticing it. The eustachian tube also carries fluid away from the middle ear.
When a cold or an allergy is present, the eustachian tube swells and air is absorbed by the lining of the middle ear, creating a partial vacuum. The eardrum then gets pulled inward, and fluid weeps from the lining of the middle ear. Bacteria or viruses from the nose and throat can travel up the eustachian tube and infect the stagnant, warm fluid in the middle ear, which provides a perfect
environment for them to live and multiply. When this happens, an infection is underway.
Children may be more prone to middle-ear infections for a variety of reasons. For example, their eustachian tubes are shorter and straighter, which may make it easier for bacteria and viruses to penetrate. Children also get colds and sore throats more often than adults.

TREATING AN EAR INFECTION
It is most important that a child showing signs of ear infection be taken to a doctor immediately, advises Daniel Kuriloff, M.D., associate director of the Department of OtolaryngologyHead and Neck Surgery at St. LukesRoosevelt Hospital Center and associate professor at Columbia University College of Physicians and Surgeons, both in New York. If a middle-ear infection is treated promptly, it is not serious. If not treated right away, your child might suffer hearing loss and, as a result, a delay in learning and speech development. Once your child has seen the doctor, however, there are some things you can do to help make your little one more comfortable.

Follow through on the doctors instructions.
Your job doesnt end with a visit to the doctor. You will need to be sure that your child receives the medication prescribed by the doctor. The one medication that the pediatrician will almost certainly prescribe is an antibiotic. You must be sure that your child takes the medication for the full time prescribed usually 10 to 14 days, says Kuriloff. Read the label on the prescription bottle carefully and follow directions. The doctor may also prescribe an antihistamine and/or a decongestant if your child has a cold or allergy. If you have any questions about the proper use or administration of the medication, call your doctor or pharmacist.

Keep your childs chin up.
If your child is lying down, prop his or her head up on pillows. Elevating the head will help to keep the eustachian tubes draining into the back of the throat.

Try mild heat.
Applying a heating pad set on warm not hot may make your child more comfortable.

Give acetaminophen.
Try giving your child acetaminophen to help relieve pain and fever. Do not, however, give your child aspirin. Aspirin use in children with a viral illness has been associated with Reyes syndrome, an often-fatal condition characterized by severe, sudden deterioration of liver and brain function.

PREVENTING EAR INFECTIONS
As a parent, there are some things you can do to decrease the chance that your child will develop a middle-ear infection.

Steer your child clear.
The entire process starts with a cold, allergic reaction, or infection of the tonsils or adenoids, says James Stankiewicz, M.D., professor and vice-chairman of the Department of Otolaryngology Head and Neck Surgery at Loyola University Medical School in Maywood, Illinois. If you can keep your child out of contact with children who have colds and other respiratory infections and make sure that allergies are under control, then there is a better chance of avoiding ear infection. If you are in the process of choosing a day-care facility for your child, check into the centers policy for dealing with children who are ill.

Teach proper nose-blowing technique.
Once your child is old enough, teach him or her to blow his or her nose softly rather than with excessive force, so as not to drive infection into the ears. And teach your child not to stifle a sneeze by pinching the nostrils, since this, too, may force the infection up into the ears.

Dont smoke.
Heres another reason not to smoke: Children who live with smokers seem to be more susceptible to middle-ear infections than are those who live in smokefree homes. Cigarette smoke irritates the linings of the nasal passages and middle-ear cavity, which interferes with the normal functioning of the eustachian tube. If you cannot quit, at least take your habit outside.

Be careful with bottle-feeding.
Avoid giving a bottle of milk or formula to a baby who is lying on his or her back, because the milk can flow into the eustachian tube during swallowing and initiate a middle-ear infection.

Stay alert to the signs.
It is essential to get your child to the doctor as soon as you suspect an ear infection, but to do that, you need to be aware of the symptoms that can signal an ear infection. An older child who has an ear infection may complain of ear pain or aching or a stuffiness in the ear. In a younger child who cannot yet describe an earache, you need to be alert to other signs that may signal an imminent ear infection. One of the first signs is that the child pulls or rubs his or her ears frequently. This is before real pain sets in but indicates that something is amiss, says John W House, M.D., associate clinical professor in the Department of Otolaryngology, Head and Neck Surgery at the University of Southern California at Los Angeles. You may also notice that your child does not seem to hear you. Then come the real signs of infection: fever, crying and other signs of pain, nausea, and vomiting.