Sick baby care

• Call your baby's provider if you think your baby is sick.
• Keep medical supplies on hand at home.
• Ask someone to take care of your baby if you're sick.

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Otitis media is an infection behind the eardrum (middle ear). In most cases, ear infections develop in a child who has had a cold. Your child can't catch an ear infection from another child who has one. But he can catch the cold that caused the child's ear infection. About two out of every three children have at least one ear infection before their second birthday.

Ear infection is caused by viruses and bacteria. Babies and preschool-aged children are especially likely to get ear infections for several reasons, including:

• The tubes that connect the back of their throats and middle ear are small. (These tubes are called the eustachian tubes). The position of these tubes also increases the risk of infection.
• Their immune systems are still developing.

Your child may have an ear infection if she:

• Complains of ear pain
• Does not seem to hear normally
• Pulls on her ear
• Has a fever (above 100.4° F)
• Cries during feeding

Call your child's health care provider if you suspect an ear infection. Providers can diagnose an ear infection by looking inside a child's ear canal. They do this with an instrument called an otoscope.

Some ear infections clear up without treatment within a few days. Others require antibiotics. Providers usually treat babies under 6 months of age with antibiotics. If the child is older and has mild symptoms, the provider may suggest waiting a few days before starting antibiotics to see if the infection clears up by itself.

If your child's provider recommends antibiotics, be sure your child takes them for the recommended length of time (even if she feels better sooner). If antibiotics are stopped too soon, the ear infection could come back, and then require stronger antibiotics.

The provider also will suggest treatment for ear pain, such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil), and sometimes ear drops.

After treatment, some children may have fluid in the ear that can affect hearing for three weeks or more. Hearing should return to normal when the fluid clears.

Some children are prone to repeated ear infections. In these cases, the provider may recommend low-dose antibiotic treatment to help prevent the infections. If this doesn't work, some providers recommend inserting tiny tubes in the eardrums to help drain the middle ear. The tubes may help prevent speech and language problems that may result from hearing loss from repeated or long-lasting ear infection.

You may be able to help prevent some ear infections in your baby by:

• Breastfeeding your baby. Breast milk has antibodies that help protect a baby from many infections, including those that can cause ear infections.
• Holding your baby in a partially upright position during bottle-feeding. This helps prevent formula from dripping into the eustachian tubes. Avoid keeping your baby's bottle in the crib after feeding.
• Keeping your baby or young child away from cigarette smoke. Smoke appears to increase the risk of ear, as well as respiratory, infections. Minimizing dust in the home also may help.
• Making sure your baby gets all the recommended immunizations. The pneumococcal vaccine may help prevent ear infections caused by certain bacteria.

July 2006