Pearls of Wisdom: Your Baby and Ear Infections

At some point or another, most babies and children will suffer through the pain and discomfort of an ear infection. The telltale signs may be all you need to know what’s happening… crying, tugging at her ear(s), and temperature are all indicators. In children that have learned to talk, you may hear complaints of throbbing pain or that your child is having trouble hearing. You’ll need to get baby to the pediatrician for treatment and relief of an ear infection.

Middle ear infections, or “otitis media,” is the most prevalent disease of childhood, second only to respiratory infections. There are an estimated 25 million yearly visits to the pediatrician resulting from ear infections.  Accurate diagnosis and treatment of otitis media are important not only because it affects a lot of our children but also because left untreated, it can lead to serious complications like meningitis or brain abscess. Middle ear infections that lead to fluid in the middle ear, known as effusions, could also affect a child’s hearing and subsequently, his speech and language development.

Nearly 86% of children have at least one episode of otitis media by 3 years of age, with peaks occurring from 6-36 months and 4-6 years of age. Available medical data shows that the occurrence of ear infections tends to decrease with age but is higher in the following groups: male children; kids belonging to lower socioeconomic groups; black children, and among those with craniofacial anomalies. Incidence is also higher during winter months and early spring.

Ear InfectionWhen an ear is infected, the “eustachian tube” or the canal connecting the middle ear and the back of the throat gets clogged. During healthy periods, this canal is filled with air; however, during cold weather, when other respiratory infections are present, or when a child also has allergies, this tube can get blocked. When the eustachian tube is blocked, fluid accumulates in the middle ear and attracts bacteria that thrives. As this condition progresses, pressure increases on the eardrum, impeding its ability to vibrate properly. This can affect hearing and cause a great deal of pain.

It is wise to see your pediatrician so he can examine your child’s ear with an instrument called and “otoscope.” After diagnosing him with an ear infection, he may prescribe an antibiotic such as amoxicillin to kill the bacteria and prevent more fluid accumulation. Many times, an antibiotic is not necessary and relief can be attained just by giving acetaminophen or ibuprofen. Antihistamines and decongestants may also be prescribed depending on your child’s symptoms and a physical exam. However, in instances where fever persists and pain worsens despite these medications, he should be re-examined to rule out any other serious concurrent infections. Occasionally, if a child has recurrent ear infections, your doctor may suggest insertion of ear tubes to aid in draining trapped fluid from the middle ear.

It’s important to note that ear infections are not contagious and oftentimes, a child may return to school or daycare after the symptoms abate; however, it is always important to finish the course of antibiotics prescribed. All patients should be re-evaluated 2 weeks after the start of treatment to ensure that inflammation has resolved and the mobility of the tympanic membrane is back to normal.

Periodic follow up is highly recommended for patients with recurrent ear infections. Your pediatrician will also perform a hearing test on your child to ensure that there are no residual effects on his hearing after the infection.

Recurring medical conditions can be very trying for both children and parents. Trust me, I know it sometimes seems as though you see your pediatrician more than you see your best friend! But hang in there… some of my best friends today are parents that were in my office with their kids once a month of more ;)    Silver linings, friends. Silver linings!

I hope you are all having a wonderful, safe, and happy summer!

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All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

Dr. Pearl CenonDr. Pearl

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: Infant Nutrition

Infant FeedingWhen it comes to infants and children, basic nutrition choices have a lifetime impact on overall health and are key for satisfactory growth and avoidance of deficiency states. Adequate nutrition helps in the prevention of acute and chronic illnesses; maximizes physical and mental potential and provides reserves for stress. During infancy, it’s all about milk, whether breast milk, formula or a combination of the two. Breast milk and formulas contain enough nutrients needed by babies in the first year of life. Around 4 -6 months of age, most babies can start consuming solid foods like iron-fortified cereal, mashed fruits and vegetables, and pureed meats. As you introduce more foods, keep in mind that a healthy amount of fat is important for the babies’ brain and nerve developments – unless advised by your doctor for particular health reasons, low-fat options can be avoided.

The feeling of ease between infant and mother is essential to successful infant feeding. When mom can establish a comfortable, satisfying feeding practice, the result is usually emotional well-being of both the mother and infant. Remember that mom’s feelings are readily transmitted to the baby and greatly influence the emotional setting in which feeding takes place. Hence, a tense, anxious, and emotionally labile mother is more likely to develop a difficult feeding relationship with her baby. It’s helpful if she receives appropriate guidance and support from an empathetic family member, friend or physician.

Infant FeedingImmediately after birth, the infant can safely tolerate feedings to ensure a smooth transition from fetal to extrauterine life, to promote maternal- infant bonding and prevent hypoglycemia and electrolyte imbalances. It is critical that your infant receives enough fluids so he will not develop dehydration. Moms who wish to initiate breastfeeding in the delivery room are definitely encouraged to do so. Subsequent feedings either by breastfeeding or bottle feeding are given every 3-4 hours a day and at night. That’s a lot of eating! This is based on the time it takes for the infant’s stomach to empty and varies from 1-4 hours. Do not expect your baby’s feeding schedule to be consistent immediately after birth.  However, by the end of the first month, 90% of babies will establish a more regular feeding schedule. Majority of healthy formula-fed infants will want 6-9 feedings per day by the end of the first week of life. Some babies are satisfied with every four hour feedings, while others who have a faster gastric emptying time will want to eat every 2-3 hours. Interestingly, most breast-fed babies get hungry quicker and require more frequent feedings with shorter intervals. This just reinforces the fact that individual feeding needs vary and one infants’ feeding would not be expected to fit the pattern of another. The best parameter of successful infant feeding is weight gain by the time the baby reaches the second week of life.

Infants cry for various reasons and babies do not need to be fed every time they cry. Usually, sick babies are not interested in feeding and if an infant refuses food, this should act as a red flag to see your pediatrician. If your baby is constantly waking up every 1-2 hours, he may not be receiving enough milk at each feeding or be suffering from infantile colic. This can be addressed during your doctor’s visit and may involve discussions about formula choice and feeding practices. It is important to know that babies cry for reasons other than hunger. Some may just need to be picked up and held, others may continue to cry even after feeding so it’s important to carefully evaluate your infant’s health and behavior for other potential causes of distress. Try to discourage the habit of frequent small feedings, holding and feeding to pacify crying as he may become too reliant on you to calm him.

Infant FeedingThe post-partum period is oftentimes a period of much anxiety and insecurity for first-time parents who may be overwhelmed by the responsibilities that comes with having a new baby. The questions are endless: Am I feeding her enough?  Is she having diarrhea? Should I switch formulas? The list goes on and on. This is why anticipatory guidance sessions should be scheduled between you and your pediatrician. During each office visit, your doctor is already tracking your baby’s weight gain and monitoring whether her weight is steadily increasing. Normally, babies in the first four months of life gain 1 ½ lbs-2 lbs per month and grow 1-1 ½ inches. By the time he is a year old, he would have tripled his birth weight.  Breastfed babies also tend to be chubbier than formula-fed babies in the early months of life however they become leaner by nine months to one year of age.

Parents need to understand the goal of infant’s “self- regulation.” Once the infant establishes a regular feeding schedule, other family members are able to resume their normal daily routine with minimal disruptions. It doesn’t take long to achieve the confidence and calm of an experienced parent. Your baby will give you enough signals and clues as to how she likes to be treated, talked to, held and comforted.  This very special bond, once established will guide you through this challenging stage and the next.

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

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Dr. Pearl

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.