Ear infections plague many kids in their first years of life, and the pesky infections are becoming more common. In fact, medical studies suggest a 300 percent spike in clinical visits for ear infections in the last two decades -- totaling a whopping 30 million annually.
So what's driving the increase? And what can parents do about it?
Henry Morgan, in many ways, is a typical 2-year-old -- he's busy. But for the past year, the Cedar Falls boy has been dealing with chronic ear infections.
"I'd always thought ear infections were pretty easy to diagnose," said Rachel Morgan, Henry's mom. "The child would pull at their ear or would run a fever or something like that. But Henry didn't present with any of those symptoms. He wouldn't sleep through the night and he would sometimes be tough to console and just really need a lot more attention and comfort during the day."
Many kids take antibiotics and the infection clears up. But that wasn't the case for Henry. He developed allergies to several common antibiotics, and the ones he could take didn't work.
"He'd get on the course of an antibiotic for seven to 10 days. Then we'd go back in for a re-check and it hadn't cleared," Morgan said.
The Morgan's dilemma is not unique.
"The underlying problem is the Eustachian tube dysfunction," said Dr. Dov Rotenberg, Covenant Clinic Ear, Nose and Throat Specialist. "And it's the Eustachian tube immaturity, as well as their frequency to have upper respiratory infections -- whether due to viral illnesses or adenoids or sinus issues. By and large, anything that kind of affects the nose will also affect the ear."
Each year, an estimated 30 million kids are treated for ear infections, up from just 9 million in the mid-1970s.
So what's behind the huge spike? Some experts say we're just getting better at recognizing ear infection symptoms. Others blame increases in allergies and daycare use.
"I don't think living in sort of a germ-y daycare necessarily means you'll have an ear infection," Rotenberg said. "But I think, living in a crowded daycare where a bunch of what we call 'snot-nosed kids' are running around all the time, we see much more of the cross transference where kids pass upper respiratory infections to each other and then secondarily cause ear problems."
There's a typical cycle of treatment to resolve chronic ear infections.
"Where it appears to be a viral respiratory infection, all of us will tend to just spin wheels for a while and reassure the parents," Rotenberg said. "But in those cases where there's puss appearing in the upper respiratory passages or middle ear infection, we'll treat that with an antibiotic.
"Now it's what happens afterwards that's the question," he added. "The majority of them will get better. But there's a significant number that simply do not get better."
That includes Henry Morgan. After months of antibiotic failure, his ears are still full of fluid. His parents are eager for a solution to help their son feel better and give them a little relief from coping with a sick kid.
"As his doctor put it, we've now had three antibiotic failures, so this is a procedure that he needs," Morgan said.
That procedure: myringotomy and tube insertion.
"Myringotomy (is) a small incision done with a microscope in the ear drum, sucking out the fluid that's there, and inserting a tube," Rotenberg said. "People tend to think of the tubes as drainage tubes, but they're really not. They're pressure-equalizing tubes. What we're really giving them is an artificial Eustachian tube that now equalizes pressure from the outside world to the middle-ear part of the body."
Henry's parents hope the tube procedure will be the end of his chronic infections. The surgery does require general anesthesia, but it only lasts about 10 minutes.
Not only does the operation help heal the child's ears, it prevents serious complications from leaving infections untreated, including speech and language delays.
"I think that's very realistic," said Dr. Rotenberg.
Still, some question whether the operation is over-used. Historically, many doctors have just let kids grow out of ear infections.
"That's something some people are advised," Rotenberg said. "But as a now-grandparent, but before that a parent, it's not easy to be a parent and be up night after night after night with a child screaming and yelling and rubbing at the ear,"
The Morgans hope the operation is the long-term solution they've searched for.
Experts suggest some simple preventative steps before it gets to that point for other children.
"If parents can decrease the use of bottles and pacifiers, that decreases the negative pressure in the back of the throat, causing fluid to go into the middle ears and constantly re-infecting the fluid," said Dr. Benjamin Davidson, Covenant Clinic pediatrician. "But it's good to take a really good history to make sure there's no extra contributing factors, like allergy or cigarette smoking or chronic inflammation in the back of the throat from tonsils, adenoids, or reflux."
Chronic ear infections are primarily a problem in children under age seven. But the condition can, and does, impact many adults, who can also undergo the ear tube procedure. For adults, though, it's an in-office visit, since they won't squirm as much during the procedure.
Alternative treatments for ear infections can also be considered. These include allergy and chiropractic care.
After the operation, Henry Morgan is doing quite well. He's learning to say more words and speak more clearly, he is sleeping better at night, and is infection free.