Does Your Child Need Ear Tubes?

Seeing your child in pain is enough to make any parent break down in tears. Unfortunately, a common malady among young children is ear infection—something that can cause intense discomfort. Most children between the ages of six months to three years will suffer from ear infections at some point.

If ear infections recur often, parents might need to consider a temporary solution: ear tubes. Dr. Anthony Sheyn, Division Chief of Pediatric Otolaryngology at Le Bonheur Children's Hospital, provides helpful information parents and caregivers need to know about this decision and its potential benefits.

What Causes Ear Infections?

Ear infections arise from varying circumstances. One is age-plus-anatomy.

“The ear is actually the organ that's the closest to adult form when the child is born, about 80% formed. Even so, it still has a very short approximation. Anytime you get any kind of virus, it can stay there and cause fluid, which can turn into a bacterial infection,” states Dr. Sheyn.

Then, two of the largest contributing factors to ear infections are being in a daycare setting and family history. Children who are in daycare are over two and a half times more likely to develop ear infections than those who aren't. “That's just because they've not been exposed to other children and their immune systems are ramping up. So, they're going to spread bugs from child to child when they're in daycare,” explains Dr. Sheyn.

In respect to family history, the closest indicator is a sibling who has had severe ear infections. The further away from relation, the more the risk reduces (e.g. parents, then grandparents).

Additional factors include secondhand smoke exposure, as well as laying a baby flat in a crib with a bottle or pacifier. “We advise parents never to put their babies down to sleep with a bottle or using a pacifier. Quitting a pacifier is much like quitting smoking. You can't force somebody to do it. Just know when they're ready, they'll give it up,” notes Dr. Sheyn.

When Are Ear Tubes Appropriate?

Per Dr. Sheyn, there are two primary guidelines physicians follow when considering ear tubes. The first is three or more ear infections within a six-month period, accompanied by an abnormal hearing test. Second is the occurrence of middle ear fluid lasting three months or longer. This can impact the child’s ability to hear and develop language.

“If the fluid does not go away within three months, we would recommend putting ear tubes to drain it and to prevent any further accumulations, regardless of how many ear infections.”

What Does Ear Tube Insertion Involve?

The procedure to insert ear tubes is simple and quick—about three minutes to perform. It can even be done without anesthesia, via a device called the Hummingbird. This device pierces the eardrum, deploys the tube, and removes fluid.

“There is a little bit of screaming involved, but not necessarily because of pain. More because of the child; it's a baby and they don't want anybody messing with them. They don't really realize what's happening. So, they would cry just as much, even if we were just looking in their ears,” assures Dr. Sheyn.

Tubes ultimately help improve ventilation of the middle ear and equalize the pressure between the inside and the outside of the ear. By doing so, it decreases how many ear infections a child has. “That's not going to stop them completely, but it will allow us to put eardrops in—which are a thousand times more powerful than oral antibiotics—if a child gets future ear infections after the tubes are in place,” he adds.

This solution is not designed to last forever. Typically, tubes last about six to 18 months. They can stay inserted longer, but there is quite a bit of evidence they should be removed if in more than two years after age five. In many cases, tubes fall out by themselves. However, if they don’t, physicians remove them while the child is under sedation.

What Should Parents Watch For?

Ear infection symptoms can mimic those of teething. For instance, ear tugging, headshaking, or butting their head up against a pillow or mattress. Fever is also common, which may also accompany an upper respiratory infection.

“An ear infection is just a symptom of an upper respiratory infection. It's not the cause of all these other symptoms of runny nose,” clarifies Dr. Sheyn.