Keep Your Child’s Ear Health in Check

It’s summer! You’ve got your kids’ sunblock, goggles, hats, towels and floaties, plus a lounge chair in a coveted location near the pool. You are the picture of summer perfection … almost.


While we offer you kudos for hauling all of that gear around in style and protecting your family’s skin and eyes, there’s one thing you may have missed on the summer safety checklist – their ears. Often disregarded until it’s too late, proper ear health is especially important during the summer months as kids are swimming up a storm weekly, if not daily.


“Our ears serve an important role and if they’re not healthy, that can lead to conditions that have a significant impact on our lives,” says Jocelyn Joseph, M.D., M.P.H., chief of pediatrics at MIT Medical, Cambridge. “For example, fluid in our ears can cause hearing loss and, as a result, a child’s speech and language development may be delayed. Also, if fluid is persistent, it may lead to chronic ear infections and continued need for antibiotics.”


What Is Swimmer’s Ear?


No one wants to be sidelined at camp because of swimmer’s ear, but the Centers for Disease Control and Prevention (CDC) report that 2.4 million health care visits are attributed to the infection annually in the United States, resulting in almost half a billion dollars in health care costs.


Swimmer’s ear (or otitis externa if you want to get fancy), specifically, is an infection of the outer ear canal and rears its ugly head when water stays in the ear canal for an extended period of time, offering germs a play area to grow and infect the skin. Common in children who love to swim, symptoms can include itchiness inside the ear, redness and swelling, pain when the ear is tugged and puss drainage. The moral of the story? You want to avoid this at all costs.


Joseph advises parents to prevent swimmer’s ear by wearing a swimming cap or ear plugs, but if your little one simply isn’t having it, drying the ears as best you can after swimming is helpful.


“Use a towel, washcloth or even a blow dryer on the lowest setting,” she says. “Hold the blow dryer about a foot away from the ear.”


Another option, Joseph says, is to use a 1:1 mixture of white vinegar and rubbing alcohol before and after swimming. Pour a teaspoon of the mixture in each ear and let it drain out if, and only if, the eardrum is not ruptured.


In the event your child starts to complain of ear pain, Michael Cohen, M.D., a pediatric otolaryngologist at Massachusetts Eye and Ear, encourages parents to visit an ear, nose and throat (ENT) doctor as soon as possible.


“Swimmer’s ear is treated with ear drops; usually antibiotic or a combination of antibiotic and steroid drops are used,” he explains. “Sometimes the swelling can be so severe that drops cannot get into the ear canal, in which case an ENT doctor can put a small sponge, called a wick, into the canal to help the drops get in further. Several ear cleanings may be necessary to remove infected debris and to facilitate healing.”


Is Your Child Prone to Ear Infections?


If your child swims regularly, particularly in water with high bacterial counts at recreational water venues, chances are he is at increased risk for developing an outer ear infection, but there are other factors to consider as well.


Joseph cites children with small ear canals as an example of kids who are more susceptible to this kind of illness, as well as those who use hearing aids or wear headphones. Even irritants like hairsprays can put a child at increased risk for infection.


When possible, ask pool operators if disinfectant and pH levels are checked twice a day. If the levels are within a normal range (which is 7.0 – 7.6 for pH), the water is less likely to spread germs.

Middle ear infections (otitis media with effusion is the technical term) is when fluid builds up in the middle ear and doesn’t offer any signs of acute infection like pain, pus or fever. According to the CDC, these infections can be caused by viral upper respiratory infections, allergies or exposure to irritants such as cigarette smoke.


“Due to [children’s] anatomy, they may have more dysfunction of their Eustachian tube,” says Joseph as to why children may be more susceptible to middle ear infections. “As they grow, this tube changes its position and allows for better drainage of the fluid that naturally collects into the ear tube to drain into the nose.”


Ear Cleaning 101


Those cotton swabs sure do look inviting to little ones, so first and foremost, keep them out of their reach. The only person who should be in charge of cleaning ears is a grown-up, and even then it should be done gently and not as often as you might think.


“The ears are generally self-cleaning,” says Cohen. “Wax produced within the ear canal is normal and serves a protective purpose as it has both moisturizing and antimicrobial properties. Wax gradually comes out on its own as the skin of the ear canal grows outward.”


So how can you safely and effectively clean a child’s ears? With great care and caution.


“Any visible wax can be gently wiped away with a washcloth, but parents should not try to clean within the ear canal using cotton swabs or other implements as this often pushes wax in further and can damage the delicate skin of the ear canal,” he explains.


Joseph concurs, encouraging parents to avoid sticking anything into the ear, even those seemingly innocent cotton swabs. It’s easy to mistakenly dive too far into the ear, which is delicate and may cause the rupture of the tympanic membrane (the eardrum). And don’t even think about trying to get creative. It should go without saying that pen caps, hair pins and the like shouldn’t go anywhere near the ears.


“Avoid cleaning the ear canal,” she says. “If a parent suspects it needs to be cleaned, please call and make arrangements for your child’s ear to be cleaned at their provider’s office.”


If your child is complaining of ear discomfort or pain, Joseph advises not to ignore it. Also, take note if they are speaking loudly or listening to the TV or radio louder than what you think is normal. These can be signs that their ears should be checked by an ENT.


So as you pack up for the pool this summer and round up all of that gear to keep your children safe for the duration of the season, don’t forget about the ears. Ear plugs and swim caps may not be the most glamorous of accessories, but your kids (and their ears) will thank you.


Kelly Bryant is associate editor of Boston Parents Paper.

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26 May 2015

By Kelly Bryant