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Common Childhood Ear Problems

Swimming and traveling are great ways to spend time with your children. But the time spent splashing in the community pool or traveling with the family can actually result in two of the most common causes of ear problems: swimmer's ear and middle ear barotrauma, the earache caused by pressure changes while flying.

Swimmer's Ear
Swimmer's ear is a painful infection in the delicate skin of the outer ear canal. Your budding Olympian's frequent exposure to water moistens the canal skin and provides an ideal environment for bacteria and fungi to grow. The resulting irritation may cause itching at first, followed by swelling of the skin of the ear canal and drainage. Finally, there is severe pain that is worsened when the ear lobe or other outside parts of the ear are touched.

Treatment
Your child's doctor will probably prescribe ear drops containing antibiotics and/or corticosteroids. These medications will help fight the infection and reduce the swelling in the ear canal. The drops are usually given several times a day for up to 10 days. Your child's doctor may also suggest over-the-counter pain relievers until the antibiotics begin to work.

If the ear swelling is severe, the doctor may place a cotton wick into the ear canal to help the medication get carried into the ear. And for more severe infections, oral antibiotics may be prescribed, and a sample of ear discharge may be sent to a laboratory to determine exactly which germ is causing the infection.

In addition to the course of medicine, your child must not go swimming until the infection is cleared up, generally 10 to 14 days. Your child's doctor can tell you when your child can put her head under water again. The restriction may also include showers and shampoos. The doctor can advise you on ways to keep the ears dry with a shower cap or a cotton ball coated with petroleum jelly.

Prevention
Fortunately, there are ways to avoid swimmer's ear. Acid alcohol drops, which are available as an over-the-counter preparation, are an effective way to prevent the problem. At the end of the swimming day, three or four drops should be put into the ear canal while the child is lying down on her side. Gently massage the area in front of the ear canal to allow the drops to penetrate the ear. Have your child remain in that position for a full minute or 2 before having her roll over for drops in the other ear.

For a child with normal ears, ear plugs are not as effective as the drops in preventing swimmer's ear. For the child with a hole in the eardrum or ear tubes, however, ear plugs are useful. Ear plugs work best for surface swimming only; the effectiveness of an ear plug can't be guaranteed underwater.

Middle Ear Barotrauma
Another kind of earache can result when your child is on board an airplane. Called middle ear barotrauma, it is related to abnormal pressure changes in the air space behind the eardrum (the middle ear).

Even in a pressurized aircraft cabin, there is a decrease in the cabin air pressure as the plane climbs. As the plane descends, there is increased air pressure. It is during descent when children are most likely to experience the discomfort of middle ear barotrauma.

When a plane descends and the pressure in the cabin increases, the air pressure in the middle ear must be equalized. If it isn't equalized, the increased cabin air pressure pushes on the eardrum and causes pain. Normally the eustachian tube, a passageway that leads from the middle ear to the nasal passage, will open to equalize pressure. This happens when your child yawns or swallows - and the result is that well-known "popping" sensation in the ear. In children, however, the relatively smaller eustachian tube may not function effectively and pain is the result.

Prevention
There are several measures that will help your child more effectively ventilate the middle ear and equalize the air pressure in the ears.

Good hydration is very important. Airplane air is dry and will thicken nasal mucus, making it harder for the eustachian tube to open. A glass of a noncaffeinated beverage (water is best) for every hour of air travel will help overcome the drying effect.

Judicious use of nasal decongestant sprays before takeoff and before descent will also help open the ear and nasal passages.

Avoid medications that include antihistamines, such as those for colds and allergies. Antihistamines may worsen the problem by thickening secretions and making your child drowsy. The exception may be if the child is using an antihistamine for an allergy.

Finally, your child should be awake for takeoff and descent. An older child may benefit from chewing gum or sucking on hard candy. A bottle works well for infants, but the child should be upright and not lying down while drinking from it.

Children with ear tubes don't have to worry about equalization, since, thanks to the tubes, that happens automatically.

With these precautions in mind, there is only one thing left to do - enjoy traveling and swimming with your children!