Two different sets of parents came to the ED in the middle of the night not too long ago because their infant children were pulling at their ears and the parents were worried that the kids had ear infections.
One was pulling on his ears while he was asleep. Don’t even get me started on why parents are waking their kids from sleep at 2 AM to bring them to the ED.
Here’s some general medical information for you (I can’t call it medical advice because I don’t give medical advice out on this blog): Just because infants pull on their ears does not mean that you have a doctor’s visit in your future.
Ear pulling does not equal ear infection. In fact, ear infections are probably not related to ear pulling at all. If you don’t believe me, read this, then read this, then start reading this. I’m not paying to access the last one, but a summary is that of 100 kids with “ear pulling” as their complaints, not one of them in this study had an ear infection. Zero. Zilch. Nada.
But you may ask “WhiteCoat, what if my child does have an ear infection?” Glad you asked. Continue reading for more general information.
Even if your child does have otitis media, in most instances the recommendations are for “watchful waiting.” In other words, the “infection” goes away on its own most of the time anyway. The word “infection” is in quotes because I personally don’t believe that a large majority of the cases of otitis media are really bacterial infections anyway.
While all you naysayers are rattling off angry responses to me in the comment section, answer me this question first: How is it that a dental abscess or a skin abscess hardly ever causes a fever, yet a glorified zit behind a child’s eardrum supposedly causes fevers of 103 degrees? Give me the pathophysiology behind the “fever phenomenon” first, then bash me for being antiestablishment and an incompetent physician second. Gowannnn. I daaaare ya.
If you have some time to spare and want to read the American Academy of Pediatrics Policy on the Diagnosis and Management of Otitis Media, pull up a cozy chair and click here.
There is also another excellent article on the diagnosis and management of otitis media here.
Finally, there is a comprehensive patient handout on otitis media available on MD Consult. Normally you have to pay to access the site, but as an added bonus to the people who read my drivel every day, I printed out the entire handout in a .pdf format and have uploaded it to my blog here.
If you read all of these materials, you will know infinitely more than almost any physician about the diagnosis and treatment of otitis media – and you might save yourselves a few bucks in doctor visits to boot.