December 1st, 2008
03:39 PM ET

Will antibiotics help the ache?

By Shahreen Abedin
CNN Medical Senior Producer

I'm typing this blog entry while sitting on an airplane.  Haha, just kidding.  I'm a mom of a now 1-year old who got off a plane a few days ago when I flew home to Dallas for Thanksgiving.  I couldn't imagine tap-tapping on a laptop while also trying to feed and keep the little one calm and happy in that a cramped little airplane seat! 

Along with being near-impossible, it would've been one more thing to push me towards the edge of losing it altogether.  There is just SO much to worry about when flying with baby – are his bottles ready? How do I time lunch and what's he going to eat? Did I bring enough toys that are entertaining enough but won’t disturb others? And oh yeah this is a fun one: Is he going to get sick this time too? 

See, the last two times we flew with the munchkin, he ended up getting an ear infection.  I don’t know if it’s because, like many adults, the re-circulated air in the cabin during cold and flu season, along with the close quarters with so many sniffly, coughing people allowing the virus to cling to trays and seats– just makes him more susceptible to getting a cold?  That stuffiness from his cold (a viral infection) can lead to fluid backing up in a child’s ears, thereby setting the scene for an ear infection, which is bacterial (those infections are usually only treated with antibiotics if they last a few months).

Or is it something else about the experience of flying to a different house, surrounded by different people, sleeping in an unfamiliar bed, etc., that makes his immune system go wonky? 

Nevertheless, I know my kid isn’t alone in his bouts with ear infections.  It’s the most common bacterial illness in children, according to the American Academy of Pediatrics.  Young children are more likely to get these pesky infections because their Eustachian tubes are shorter, narrower, and more horizontal than for the rest of us, so they don’t drain as well.  Every year, over 5 million kids get ear infections, leading to over 30 million doctors’ visits, according to the American Academy of Pediatrics. 

The first time it happened, I saw the telltale ear tugging, usually a sign of pain or discomfort, and then took him to a drug store clinic while I was still in Dallas, where he was prescribed antibiotics by a nurse practitioner.  The second time, we came home and his pediatrician said we could put him on antibiotics or just wait it out and see how he does.  See, the AAP (and I) are both concerned about antibiotic resistance.  Which is why the organization actually now recommends that doctors give parents the option of letting the kid fight the infection on his own for the first two or three days, observing how he does, and then prescribing antibiotics only if the symptoms don’t improve.  The academy says that about 80 percent of cases actually get better even without antibiotics.

On top of that, a study from this February, published in the Archives of Otolaryngology-Head & Neck Surgery, found that antibiotics don't really work to get rid of the fluid that accumulates in the ear due to infections.  When I asked her about this, Dr. Laura Jana, spokesperson for the American Academy of Pediatrics and author of “Heading Home with Your Newborn,” said that yes, for 2 or 3 year olds, the trend is now for doctors to hold off on the antibiotics and let the child fight off the infection naturally.  But for babies under age 1 like mine, because their ability to hear is so intrinsically tied to the critical language skills that they develop during this period, doctors will still give them the amoxicillin to fight off the underlying bacterial infection if there's fluid buildup and inflammation, even if the drugs don’t work for fluid reduction.

For the pain, though, the academy still recommends ibuprofen or acetaminophen.  Dr. Jana also stresses the importance of follow up visits for the little tykes, to make sure that the fluid has indeed finally drained from the ears.

So I’m wondering – how many of you out there have chosen to wait it out and let your baby’s body duke it out alone, and how did that go for you? How many of you, like I was the first time, are more willing to put the baby on antibiotics if it could help, when they're in their first year?  Did you have any problems with antibiotic resistance later on?  And do you also deal with ear infections related to when you travel?  What was your experience?  And what are your most useful tricks for getting your small child to stay healthy and sane on a plane?

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