Posted tagged ‘tympanostomy’

Ear infections: How many are too many?

November 7, 2011

The Pediatric Insider

© 2011 Roy Benaroch, MD

For November, I’m concentrating my writing chops on National Novel Writing Month. Fun! So I’m re-running revised versions of some classic posts. And by classic, I mean “old.” This one was originally from April, 2008. Enjoy!

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. The absolute number that means “tubes are necessary” depends on your child’s individual circumstances.

If your child is heading for “too many” ear infections, consider some other ways to prevent them. Ask yourself:

  • Can I take my child out of group care?
  • Is my child fully vaccinated (some vaccines protect against at least some ear infections, though not nearly 100%)
  • Is my child exposed to second-hand smoke?
  • Does my child have chronic nasal allergies that haven’t been treated?

Some kids are prone to ear infections, and sometimes tubes really are the best way to get off the one-antibiotic-after-another train. Review your child’s specific history with your pediatrician to see if it’s time to head to the ENT.