How Ear Infections Stress the Family
By Duncan Postma, M.D.
If baby ain’t happy, Momma ain’t happy; and if Momma ain’t happy, the family will be a mess of stress. It’s 2:00 in the morning and your two-year-old child is hot, screaming and has another ear infection. Or you’re at work and you get the same story from the daycare center, who wants you to pick your child up. You think “where is my spouse” or maybe you don’t even have a spouse to fall back on. Stress abounds in the family with a child having significant recurrent ear infections.
What can be done? Stop any smoking in the household if that is occurring and get a special vaccination from your child’s primary care physician. Unfortunately these measures often do not work, especially in young daycare children in the centers with groupings of more than five children. Compared to homecare children, daycare children have ten times the number of upper respiratory viral-type infections, which are not treatable. On average, a child will get one bacterial infection for every two viral infections. This is just an average: some children do better and some do worse. Furthermore, there are more resistant germs in children who attend daycare centers.
What more can be done? First of all, don’t panic. There are options. Remember this is an infectious process, and allergies are not the issue. Some parents are lucky enough to have access to grandparent care or a smaller daycare center. Furthermore, things improve over time with about a 15 percent drop in the number of infections each year and, by age 5, daycare children actually have less infections than children who were in homecare. We just need a 1 to 3 year “fix”.
For most parents, the larger daycare is the only reasonable option for their child. While the child suffers pain and has a small risk of a serious complication from these infections, the parents’ suffering is often overlooked and underappreciated. There is the stress of your “baby” suffering, the loss of sleep, the missing of work, the distraction at work, and even a feeling of guilt.
Physicians are appropriately trying to limit antibiotics to the more severe cases when they have been shown to be most beneficial. With the child that still has too many infections (variably defined, most of the children we see in our practice have had an infection almost once every one to two months by the time we see them). With these especially sick children, surgery becomes an alternative that affords relief for the entire family. This common procedure is called tympanostomy or ventilation tube insertion. This is a five-minute out-patient procedure where an incision is made in the eardrum and a “grommet” or tube is inserted to “ventilate” the space on the other side of the eardrum where the infection occurs. The usual tube stays in an average of about one year and reduces infections substantially. There are other benefits of the tubes. Since ventilation tubes keep fluid from accumulating, the infections that occur are much less severe. They are easy to diagnose because the tubes allow drainage of infection. The infections are easier to treat because you can use eardrops, which are curative in about 85 percent of the cases.
Your child is happier and so are you. You know that if your child is in a daycare, he will still have infections after tubes, but they are much less frequent, less severe and decreasing every year. So, don’t despair. Most children will need just one set of tubes. And time cures all. Knowing that the cause is daycare and that things will get better with time helps both the physician and parent to be patient. Sometimes another procedure that is called an adenoidectomy may be helpful along with ventilation tube insertion, but that’s another story.