It’s ear infection season
When Emily Beatty started sending her infant daughter, Olivia, to day care about a month ago, “I knew she was going to be bringing home all kinds of gunk,” she said. So she wasn’t surprised when Olivia, now 7 months old, came home with congestion and a runny nose.
But last Friday night, that changed. “She was super fussy, and then she started grabbing her ear,” said Beatty, who lives in the North Hills. And Olivia had a fever, at one point going as high as 103. That can be especially worrying for parents of a young baby who “can’t vocalize what is giving her issues,” said Beatty, who is a senior public relations analyst for Highmark and AHN.
“We just tried to manage through the weekend with Tylenol,” she said.
On Monday, a doctor confirmed that the baby had an ear infection and prescribed the antibiotic amoxicillin, but when Beatty went to fill the prescription, “My pharmacist said, ‘sorry, we’re out – you’re going to have to go get it somewhere else.’”
They did find it elsewhere, and by Tuesday afternoon Olivia seemed to be doing better, but the antibiotic may be in high demand because many young children are getting ear infections.
The National Institutes of Health defines an ear infection (otitis media) as inflammation of the middle ear, usually caused by bacteria, that occurs when fluid builds up behind the eardrum.
“This goes back to that we are seeing unprecedented amounts of respiratory syncytial virus infections. The ear infections result from a complication of the viruses,” said Dr. Alejandro Hoberman, president of UPMC Children’s Community Pediatrics.
While RSV and flu are typically seen later in winter, both started earlier this year, across the country. When combined with COVID-19, “it’s a triple threat that you don’t want to see,” said Dr. Hoberman, who is also director of general academic pediatrics at Children’s.
“The outbreak we are seeing this year is larger than it has ever been,” he said.
Dr. Joseph Aracri, the system chair for pediatrics with AHN Pediatric Institute, said that AHN doctors are seeing a lot of ear infections as part of the current surge in respiratory viruses, which have been crowding doctors’ offices and emergencyrooms for weeks.
“RSV is there, flu is there, and a side effect can be ear infections,” he said.
Dr. Hoberman said that the social distancing and masking of the first two years of the COVID-19 pandemic cut down on the rate of viruses in young children. “These kids, over the last two years, they have what is called an immunity debt because they haven’t been exposed,” he said.
Because of the high number of sick children, he said “we are overloaded with sick appointments in every setting now,” and if patients cannot get in to see their primary care doctors they could try UPMC’s after hours Express Care service. But he said that ear infections cannot be diagnosed over telemedicine, because the patient has to be examined to determine if there is bulging of the tympanic membrane.
“Young children under 24 months with a bulging eardrum definitely need to be treated,” he said, usually with antibiotics.
However, both doctors said it is not necessary to take a child to the emergency department for an ear infection. “It’s not a lifethreatening diagnosis,” Dr. Hoberman said.
“Ear infections are really not an emergency,” Dr. Aracri agreed. In the short term, parents should give children the appropriate dose of acetaminophen or ibuprofen and the pain will usually subside after a few hours. And Dr. Hoberman suggested that it might help to slightly elevate the head of the crib to help a child sleep — though never with pillows inside the crib.
If your child isn’t old enough to say, “My ear hurts,” here are a few things parents can look for:
“Not all ear pain is an ear infection,” Dr. Aracri said. “Sometimes in the little ones it could be referred pain from teething or just from having congestion.”
Manydoctors today tend to be more cautious than in the past about prescribing antibiotics, in an effort to prevent the development of bacteria that become resistant to antibiotics. Dr. Aracri said “We still treat ear infections with antibiotics, but it has to be a true ear infection.”
For home management, in addition to acetaminophen or ibuprofen, Dr. Aracri also recommended soothing the ear with a compress, like a warm washcloth.
With older children, he said, parents can sometimes wait to see if the problem improves on its own. “If it goes on for more than three days you should definitely see a doctor,” he said.