How many ear infections are too many?

Aamnda in the topics thread asked,What is a reasonable amount of ear infections a child should have in a year’s time span before parents should see an ENT or ask their pediatrician about tubes?”

There isn’t a one-size-fits-all answer, but I can tell you there are things that you and your doctor should look at that will influence this decision.

Factors that would encourage me to refer for tubes sooner:

· Younger child. A child who’s six months old and has already had four ear infections is already in trouble.

· Ear infections that always occur in both ears simultaneously. These affect hearing more.

· Ear infections that need more than one course of antibiotics to cure.

· Ear infections in a child with hearing problems or speech delays.

· A child who has multiple antibiotic allergies, making ear infections harder to treat.

· Ear infections that are occurring at the beginning of the winter. You do expect more ear infections through the cold season, so if you know you’re heading into a time with more ear infections, you should consider tubes more seriously.

Factors that lead me to watch-and-wait longer include many things that are the opposite of the above: an older child, or a child who only has one ear infected at a time, or a child who quickly responds to antibiotics. If it’s already the end of winter, I’m often temped to wait to see if ear infections continue in the warmer months before referring.

If you want to start with a number, I’d say that more than 5 ear infections a year is too many, and most children who are having this many ought to be at least considering visiting the ENT for tubes. (There are other worthwhile ways that families should consider for preventing ear infections in this circumstance, but that’s a subject for another post!) The absolute number that means tubes are necessary depends on your child’s individual circumstances.

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2 Comments on “How many ear infections are too many?”

  1. Kim Says:

    Two Questions:

    My 20 month old has had 4 double ear infections, 1 single ear infection and strep throat in the last 7 months. So a total of 5 ear infections in the last 7 months. The last double she was switched from amoxicillin and placed on augmentin. This last ear infection they placed her on omnicef. Her tonsils and adenoids are very large. We find her constantly in her crib rocking back and forth w/ tears streaming down her face and not getting much sleep. She has passed numerous hearing tests. 6 weeks ago she was diagnosed w/ Speech and Language Impairment. She completely understands language although her weakness is in the area of expressive speech as she says “muh-muh” and has a high pitched shriek most of the day. Occupational Therapists through the county think she has a few sensory issues. That investigation is in the early stages. Pathologists stated she appears Apraxic. She currently receives services through our county Early On (40 minutes in a group setting) and next week will be evaluated for individual therapy in addition to her group sessions which her pathologists stated is critical at this stage of development. She will return to the ENT next week. Do you think she needs her adenoids and tonsils removed and tubes? If so at what age is appropriate? My poor little girl has been in such pain and has enough struggles w/ her expressive language I do not want to see her struggle w/ her ear trouble any more. Every time an ear infection is suspected the doctor’s grimace at how bad her infections are and that she has tolerated the pain for that long. Shorty I will have completed my master’s in special education and I know of the possible struggles speech impaired children possibly face due to their weakness and possible learning disabilities. Any advice is greatly appreciated as I am a concerned mom at whit’s end w/ all of this.


  2. Dr. Roy Says:

    Kim, Your questions and case are too complex to address in a forum like this. Without knowing your daughter better I could not give you a good answer. I suggest you discuss this with your pediatrician and ENT. Best of luck to you.


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