Ear Infections

dashofreality

I have been super fortunate and we just now have our first ear infection. What am I supposed to do? Last night was MISERABLE. DS (2.5) was up pretty much the entire night screaming his head off. Clearly it was his ear (he told me and has all of his teeth). Slept a bit this morning, no fever, still a bit off but not acting horribly sick today. Does have quite a bit of crusty discharge in his ear.

 No doctors appointments to be had today, but the nurse line said we can go to urgent care if we thought it was necessary. Right now he isn't acting too sick, but I know that tonight it going to be bad again. I've seen some research that antibiotics are not actually usefully in ear infections, but it seems that is what most people do. I hate to see my poor guy suffer, and the advil and rice sock didn't help at all last night. Anyone have success with antibiotics?

2chatter

I believe 10000% in antibiotics for ear infections.  Proof: 2 doses in no more bad nights.  Hell, sometimes one does works. 

newenglander71

As someone whose DS had many ear infections, and now has tubes and still managed to get an infection, I also 100% believe in antibiotics to treat them.  I definitely think antibiotics are way over-prescribed now, but feel they are necessary for ear infections. 

dashofreality

Thanks! We will head to urgent care after nap.

[Deleted User]

DS has had tubes twice- tons of EI.  Ear infections can help but isn't always necessary.  Ibuprofen and Tylenol are a must though.

The AAP changed its guidelines last year.

ETA- this is a better article.  Healthy Children is a website for parents created by the AAP.

https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/pages/Ear-Infection-Information.aspx

mcgeeva

2chatter said:

I believe 10000% in antibiotics for ear infections.  Proof: 2 doses in no more bad nights.  Hell, sometimes one does works. 

This! DS has one right now and he is on antibiotics and Tylenol for the pain. Laying down is when it hurts them the most. I don't see how they can get rid of this without the meds. 

[Deleted User]

mcgeeva said:

 

This! DS has one right now and he is on antibiotics and Tylenol for the pain. Laying down is when it hurts them the most. I don't see how they can get rid of this without the meds. 

Some EIs need meds, others do not.  The AAP doesn't change it's recommendations without lots of very sound studies. 

Antibiotics do zero for viral infections.  The overuse of needless antibiotics is a huge issue. 

Don't get me wrong- we have often had to resort to 2 rounds of abx for ear infections.  I am simply saying an ear infection doesn't 100% mean antibiotics are needed.  To need it or not is a conversation to have with your pedi and should be had with every prescription unless you 100% know it needs antibiotics. 

mcgeeva

I agree with the viral infections. I was only referring to Ear infections since both my sons have had a ton and only have gone away with medication. For those who don't need it that's great! 

[Deleted User]

Not all ear infections are bacterial.  Not all ear infections need antibiotics to treat them. 

I am responding to "ear infections 100% mean antibiotics".  That simply isn't the case.  See the article I previously linked. 

I am not anti antibiotics.  I am, however, against using them needlessly.  Doctors are very quick to write prescriptions instead of educating parents.  The onus is on the doctors to be more aware and willing to talk to patients who want something that they may not need. 

[Deleted User]

https://www.npr.org/blogs/health/2013/02/25/172588359/pediatricians-urged-to-treat-ear-infections-more-cautiously

Excerpts of interest...including when antibiotics should absolutely be used. 

In fact, ear infections are one of the most common reasons kids see doctors and the leading reason kids get antibiotics.

But about 70 percent of children get better on their own within two or three days, and about 80 percent are better within a week to 10 days, he says.

But even kids who really do have ear infections don't necessarily need antibiotics. The guidelines say doctors have the option of just watching kids who don't have intense pain, a high fever or other symptoms of a severe infection.

But there are some kids who definitely should get antibiotics, such as those ages 6 months to 2 years who have infections in both ears or any child who has severe symptoms, such as severe pain for several days and a fever of at least 102.2 degrees. Any child who has a ruptured eardrum should also get antibiotics, according to the guidelines.

...they can give parents a "safety net" or "wait and see" prescription and say: "Hold on to this antibiotic. Give some pain medicine the first day or two. And if they're not better after two days, then we do want you to let us know and start the antibiotic," Rosenfeld says. "But if they are better, just throw it out and they'll do fine."

dashofreality

AW man @marlasinger& you are making me second guess the doctor today. I really prefer living in the dream world that maybe antibiotics would make him much better and we could sleep tonight. I also don't feel as bad since neither of my kids have had antibiotics yet. But maybe I should she how tonihht goes. I'm definitely getting out the air mattress though.

[Deleted User]

Oh, no.  That wasn't my intention.  I just couldn't let the notion of it being automatic go unchallenged. 

If it helps, I would have definitely go to the doctor and get the Rx and maybe even fill it especially coming into a weekend.  I've done that many times.  Sometimes we ended up needing it, sometimes not.

What did the doctor say?  Lord knows, he's the professional and I am not.   

But definitely, without a doubt, treat the pain

aglenn

My pediatrician says that in the past any redness in the ear would get a prescription for antibiotics, but not all of those would develop into a true ear infection that needed treatment, and that's the source of the overuse.  Once it's reached a stage where it's swollen and they can see gunk in there, they still advise antibiotics.

dashofreality

MarlaSinger& said:

Oh, no.  That wasn't my intention.  I just couldn't let the notion of it being automatic go unchallenged. 

If it helps, I would have definitely go to the doctor and get the Rx and maybe even fill it especially coming into a weekend.  I've done that many times.  Sometimes we ended up needing it, sometimes not.

What did the doctor say?  Lord knows, he's the professional and I am not.   

But definitely, without a doubt, treat the pain

Oh sorry for my crappy phone typing skills. I meant that I'm second guessing going to the doctor. I had to wait around to see if the doc had any appointments open up. They didn't so the option is to go to urgent care (military). DS is still sleeping so I will make a decision when he gets up.

[Deleted User]

I'd go and get it checked.

shannm

Every time my kids have said his/her ear hurt, we go to the pedi. Every time, it is an obvious bacterial infection (in the docs opinion based on appearance and type of inflammation). Antibiotics have always worked for us.

jtmomma13

Good luck OP! Ear infections can be rough! We've had two- both times LO has been sick and has been teething which is just a nightmare. Antibiotics have worked for us but usually take 24 hours to make a difference.

Both ear infections my LO has had high fevers 104 and in clear pain so I've never questioned the antibiotics.

But I agree they can be over used!

KayteeGee

There's not a snowball's chance in hell that I would not go into urgent care if my child was "screaming his head off" all night and had crusty discharge in his ear.
I don't mean to be a bitch but ... I struggle to understand why popping to urgent care isn't something you did last night.
FWIW once my DS had that crusty discharge - the EI had ruptured his ear drum. Poor dude. We had no idea he was sick. He didn't have a fever or anything he was just kind of a grump until it was too late.
I say go! Tell the doc you're concerned about unnecessary antibiotics and see what s/he says a good doc will know the guidelines and be able to advise you much better than the rest of us.

dashofreality

Sorry for the delayed update. I had been giving him pain relievers and his allergy meds that he usually only needs in the spring. Fortunately, he was able to sleep through the night no problem. We were very lucky, and no antibiotics needed - at least for now as the two kids keep bouncing this cold back and forth.

 

As to my decision to not take him to the ER in the middle of the night for an ear infection with no fever, I am fully confident in that decision, as I didn't/don't think that was necessary.

KayteeGee

Glad things worked out!
For what it's worth I didn't suggest taking him to the ER in the middle of the night. I said I'd take my kids to urgent care if they were - as you said "screaming his head off" all night.. Which a) is not the ER and b) implies that it would be morning (though I probably would've taken them to the all-night pedi urgent care during he night but that's my own issue with not wanting my kids to be screaming in pain. As someone noted - they can give ear numbing drops not just antibiotics).

So ... Yeah. It wasn't the judgement you jumped to. But I'm still glad you're comfortable with your choices. That's really the only thing that matters.

ss265

dashofreality said:

Sorry for the delayed update. I had been giving him pain relievers and his allergy meds that he usually only needs in the spring. Fortunately, he was able to sleep through the night no problem. We were very lucky, and no antibiotics needed - at least for now as the two kids keep bouncing this cold back and forth.

 

As to my decision to not take him to the ER in the middle of the night for an ear infection with no fever, I am fully confident in that decision, as I didn't/don't think that was necessary.

DS had always had ear infections without fever. The only symptom is that he wakes up a lot at night. It's been at least 6 months since his last ear infection and a couple of nights ago, he was waking up at night. Kid was inconsolable and pulled a little at his ear so we suspected an ear infection. He hadn't had any congestion or anything so we weren't sure. The next day he seemed fine and he slept that night with no issues. The following day, DC called because he had pus coming out of his ear and when we brought him in to the pedi, his ear drum had ruptured.  

I felt super guilty that we hadn't brought him in sooner although a ruptured ear drum usually heals up pretty well. While I don't think you need to bring him to the ER or urgent care, I would have him seen as soon as you can by the pedi. He's had maybe 4-5 ear infections and we have always treated them with antibiotics. 

2chatter

Yeah, no way would I ER for an ear infection unless there was blood.

But my kids have never had a viral ear infection, so we always end up with antibiotics.  The only upside of that is at least the meds very quickly resolve it.  I usually wait 2-3 days to take them in.

2chatter

I use Breathe for my oldest - DS really hates it, so I don't use it for him.

[Deleted User]

Never once did I suggest that someone skip antibiotics if they are needed. 

I feel like I've said this eleven times but I was simply pointing out the inaccuracy of every EI needing antibiotics 100% of the time. 

That's old school but the change in determining when to give antibiotics (see @MusicFillsMyHeart post) is rather new (2013).  A lot of parents aren't aware.  As a mom with a kiddo who had a ton of EIs, I liked knowing the clear determination so I could have a discussion with my doctor. 

dashofreality

KayteeGee said:

Glad things worked out! For what it's worth I didn't suggest taking him to the ER in the middle of the night. I said I'd take my kids to urgent care if they were - as you said "screaming his head off" all night.. Which a) is not the ER and b) implies that it would be morning (though I probably would've taken them to the all-night pedi urgent care during he night but that's my own issue with not wanting my kids to be screaming in pain. As someone noted - they can give ear numbing drops not just antibiotics). So ... Yeah. It wasn't the judgement you jumped to. But I'm still glad you're comfortable with your choices. That's really the only thing that matters.

Unfortunately being military in a small town doesn't give me many options. Urgent care here closes at 7, which was prior to him waking up in pain. So, my option was the ER at that point. I called the ped in the morning, but no appointments. I have to get a referral to go to urgent care or I could go to the ER. Nurse wanted me to wait to see if an appointment opened up prior to go to urgent care. That was when I asked the question.

It all worked out, I appreciated the advice. Your post did read a bit judgy, but its ok, I can deal with it.

KayteeGee

dashofreality said:

KayteeGee said:

Glad things worked out! For what it's worth I didn't suggest taking him to the ER in the middle of the night. I said I'd take my kids to urgent care if they were - as you said "screaming his head off" all night.. Which a) is not the ER and b) implies that it would be morning (though I probably would've taken them to the all-night pedi urgent care during he night but that's my own issue with not wanting my kids to be screaming in pain. As someone noted - they can give ear numbing drops not just antibiotics). So ... Yeah. It wasn't the judgement you jumped to. But I'm still glad you're comfortable with your choices. That's really the only thing that matters.

Unfortunately being military in a small town doesn't give me many options. Urgent care here closes at 7, which was prior to him waking up in pain. So, my option was the ER at that point. I called the ped in the morning, but no appointments. I have to get a referral to go to urgent care or I could go to the ER. Nurse wanted me to wait to see if an appointment opened up prior to go to urgent care. That was when I asked the question.

It all worked out, I appreciated the advice. Your post did read a bit judgy, but its ok, I can deal with it.

 Sorry. I really didn't mean to be a bitch (like I said!) but I know sometimes I am one anyway... or sound like one.  I really was just encouraging you to go to the urgent care if he was in pain when he woke from the nap, which was the last post I'd read at that point.

That is a sucky situation that those are your only options, I am clueless about military life.  I can't believe they make you have a referral for urgent care!  I definitely would have done the same thing you did given the situation. 

Maybe next time ask the nurse for the numbing drops - I only know about thse after having gone through these miserable EIs (did I mention DS had them so often we got tubes, so I've been there! I feel you!) and I know you said this is a first.

We are lucky - there is an overnight pediatric urgent care near us, it's awesome and we have been there a bunch.  But as I mentioned, I am really sensitive to my kids and the tears - like I can't even do "cry it out" when I'm quite certain it would be fine and probably get us all more sleep in the long run. I'm not saying it's right, I'm just saying that's how I am.

Glad he's feeling better!

dashofreality

@kayteegee No worries. I do appreciate it and I know that I'm only presenting limited info. As this was our first EI, I am glad to know about the drops.

Yes, one thing I dislike about Tricare is that a lot of times they wind up pushing you to the ER. They are trying to get better about it with retroactive referrals, but a lot of times it is get an appointment on base or go to the ER.

dizzycooks

If you've had a bad ear infection as an adult you would you would go to the clinic in a heartbeat.  Those suckers hurt like hell.  I have been lucky enough to have 4 in the last year and could not control the pain with pain meds.  It was awful and I would never try to get my kid to push through a few days just to see if it passes.  Moreover, daycare wouldn't keep them if they were in that much pain.  We are fortunate enough to have a 24 hour urgent care a few miles from us.  I probably wouldn't do the ER, but I'd be at urgent care ASAP in the morning.

[Deleted User]

Fucking A. I never said don't listen to your doctor or don't take them when needed.

dashofreality

K3am said:

@MarlaSinger& - my post was 100% not directed to you, if that's the one you're questioning. 

I get it, it was me. I promise everyone that I was not ignoring my kid in pain. I called the doctor before he woke up, no appointments, needed to wait. He woke up and was not crying or complaining about pain and was playing and running around. If he had woke up and still been in pain I would've gone in immediately and fought insurance or gone to the ER. Realizing that EIs are usually worse at night I was asking advice.

I do appreciate the advice. I promise I am not some monster making my kid suck it up. Pretty sure we've got this all covered now:

 @marlasinger& was saying go to the doctors, but you may not want to give antibiotics right away.

EI mama's super pro-antibiotics based on experience.

Pain drops good!

EI's = ouch