What Parents Should Know About Acute Otitis Media

Otitis Media: inflammation of the middle ear. Otitis means inflammation of the ear; media means middle. This inflammation often begins with infections that cause sore throats, colds or other respiratory problems, and spreads to the middle ear. These can be caused by viruses or bacteria, and can be acute or chronic. - medicinenet.com
(Photo from Medicinenet.com)
I was privileged to have been invited to the recently-concluded regional conference for the prevention of acute otitis media (AOM), which was attended by professionals and delegates from Malaysia and Singapore. So for this post, I'll focus on what I've learned about AOM.
Acute otitis media is a viral or bacterial infection caused by fluid accumulation in the middle ear which leads to inflammation. AOM is usually of rapid onset and short duration, often with build-up of purulent material (pus), which causes pain, redness and fever. It is not contagious.
Acute otitis media (AOM) is a common childhood illness where up to 85% of children will experience by age 3.

Common symptoms:
  • Fever
  • Cough and colds, with or without ear pain
  • Decreased appetite 
  • Dizziness
  • Nausea
  • Vomiting
  • Ruptured eardrums
  • Sensation of the ear being ‘full’ or ‘popping’
  • Sleep problems
  • Hearing difficulties
Unfortunately, most cases are either misdiagnosed or left untreated since parents like myself, would not know about it until their child is stricken by it.  This is exactly what happened to my daughter several weeks ago after she went through recurring cycles of coughs and colds since the holiday season! She just turned 4 last month.

At first, we thought it was just the usual colds, and her jaw pain was caused by a cavity on her left molar.  Then she showed signs of discomfort on her left ear. It was not the jaw after all.  After two days, she was down with a fever.  We noticed excessive earwax too. I cleaned it and there was build up again the day after.  Luckily, the fever subsided but we still decided to bring her to our pediatrician since we already felt it was ear infection as soon as she had fever. As expected, the cause was having prolonged colds with fluids crossing from the nasal passage to the ear canal. We were prescribed an antibiotic and to lightly clean the outer ear for comfort. I was able to clean up to the external part of the ear canal and, thankfully, everything went back to normal after a couple of days.

So why do young children tend to have ear infections?

Young children has a shorter and more horizontal eustachian tube than older kids and adults, which makes them at greater risk of getting infected by microorganisms that can easily enter the tube. The eustachian tube is a canal that runs from the middle ear to the back of the nose and throat.
Illustration from Kidshealth.org
Other causes include:
  • Age (those below 3 are more susceptible)
  • Exposure to cigarette smoke
  • Exposure to other children with virus (i.e. in day care centers, schools, swimming pools, playgrounds)
  • Gender (more common in boys than girls)
  • Genetics (family history of ear infections) 
  • Bottle-feeding increase risk in babies
  • Colds and other upper respiratory tract infections
  • Allergy affecting nasal passage
Dr. Eng Soh Ping, Director & Consultant ENT Surgeon (Singapore)

My attendance was very brief, yet quite an eye-opener for me especially since we have just gone through the condition with my little girl. After learning all about AOM, I will now be more vigilant in spotting the signs and preventing this from happening again. Since I was not able to finish the conference that day, I am sharing you the literature provided so you can be more informed about acute otitis media and be advocates in educating more parents about this serious condition.
Why should parents and the public be concerned about AOM?
AOM is the most common childhood condition prescribed and given an antibiotic by doctors and even by parents who may not realize that AOM is the root cause of most of the signs and symptoms shown by the child.  As such, use and misuse of antibiotics can lead to high resistance of the bacteria causing AOM, thereby impacting on the high burden and poor outcome of treatment of many childhood diseases. Preventing the occurrence of AOM has great benefits to the quality of life of the child as well as to the economic costs of medical treatment.
On a more intimate level, the disease can hinder a child’s intellectual development by causing learning disabilities. Children can become fussy, difficult to feed, frustrated, and unable to concentrate when they are unable to communicate the reason for their condition, or when the condition persists untreated. The early years of a child’s life are crucial to his or her future health, and it is imperative to secure their health at this stage. 
Left untreated, AOM can lead to permanent hearing loss. In turn, hearing loss can affect children’s speech and language development, and even their performance in school.
Finally, acute otitis media is a pneumococcal disease (PD). PDs include the potentially fatal diseases bacteraemia, meningitis, and pneumonia. The less severe, more commonly diagnosed PDs are bronchitis, otitis media, and sinusitis. Pneumococcal diseases, even in their milder forms, can impair a child’s future quality of life with long-term effects that include learning disabilities, hearing loss, and even mental retardation and paralysis. Ignorance should not place a child in danger, which is why there is a need to educate the public on AOM.
Other references:

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