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Ear infections

When to visit the doctor and how to prevent them

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Originally published in Today's Parent June 2010


When two-year-old Isabella began complaining that her ear hurt, mother Natalie Nuys quickly made an appointment with her paediatrician.

“He was kind of abrupt,” says Nuys. “He just gave us antibiotics.” Nuys had heard that new recommendations suggested a wait-and-see approach, so she next took Isabella to a naturopath, who advised waiting three days before filling the prescription.

“Isabella was in a lot of pain,” says Nuys. “It was very hard to just wait and see. We gave her painkillers, which helped, and then by the third day she felt a lot better, and that was it. She hasn’t had an ear infection since and she’s now eight years old.”

The wait-and-see approach to ear infections is currently the recommended approach for most children over six months old. In the past, doctors usually prescribed antibiotics as soon as an ear infection was diagnosed. In some cases, when children had frequent ear infections, they were put on daily doses of antibiotics as a preventive measure. But guidelines now urge a less aggressive approach.

“Not every child needs antibiotics for an ear infection,” says Joan Robinson, a paediatrician at the Stollery Children’s Hospital in Edmonton, and one of the authors of the Canadian Paediatric Society’s statement on managing ear infections (see cps.ca and search “ear infections”). “The child’s body can usually get rid of the infection, and research suggests that fewer than 10 percent actually need the prescription.”

Most ear infections resolve in three days with or without antibiotics, Robinson explains. The difference? With antibiotics, the risk of developing resistant bacteria increases, and the child builds fewer antibodies against repeat infections.

Parents can manage the discomfort by giving over-the-counter medication for pain relief, says Robinson.

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