Ear Infections 101 - A Parent's Guide to Avoiding Swimmer's Ear
If only my friend Nici had a dollar for every time I’ve texted a medical question, she’d never have to work another day (or enunciate “otolaryngologist” at another cocktail party). But since she lives states away from Colorado, I’m reduced to texting her frantic questions for advice and parental peace of mind.
For example, there was the time we went to Iowa for a family event: “Nici! I accidentally slammed poor Colin’s pinky in a door (with photo). Does it look like he needs urgent care?” Or when a neighborhood friend’s son took a knee to the face: “How do you know if his nose is broken?”
And then there’s the most prominent topic: my boys’ ears (mostly Brody’s): “Is it ok to let Brody go to the pool? He seems fine after his ear drum burst three weeks ago.”
Inevitably, these texts come during or immediately after a swimming-intensive vacation.
No coincidence, Nici says, because the ear canal is already full of bacteria and yeast, not to mention shedding skin cells. Then you throw in moisture.
“That’s an opportunistic scenario for the yeast and the bacteria that’s already in there,” she says.
Add in the fact that children’s ear canals are smaller than those of adults—and that most kids would swim all day if given the option—it’s typical for them to develop swimmer’s ear. An infection of the ear canal that does not pass through the eardrum, it’s painful enough that most kids can articulate the affected ear(s).
“There are some kids who can swim in the pool all summer and not get an ear infection,” she says. “But if your child gets one from just looking at the pool, you can take preventative measures.”
If your children are like mine and vulnerable to ear problems, here is a simple precautionary checklist that I’ll be following before the next pool season or snorkeling adventure begins:
- Use an ear rinse. Add a 50/50 mixture of water and vinegar to a squeeze bottle; squirt in ear and gently massage the outer-ear area; allow liquid to trickle out. The mixture is benign enough that parents shouldn’t worry about overuse. But at a minimum, Nici says, it’s best to rinse ears before or after water activity.
A concoction that is slightly anti-bacterial and anti-fungal, she says, the rinse provides protection and cleansing without side effects. “If you use it 50 times a day, it’s not going to hurt anything.” In fact, if Nici sees the same patient every 6 months for this same ailment, she recommends implementing ear rinses as a regular hygienic practice. “I say, ‘Put the rinse in your shower or bath, and irrigate the ears as part of your bathing routine,’” she says. “Squeeze it in, squish it around and let it rinse off. Then you don’t smell like salad dressing the rest of the day.”
Or try an over-the-counter alternative, Domeboro, available at most pharmacies.
- Respect the earwax. Most adults by now have heard the dangers of removing earwax, especially from children’s ears. Not only is this sticky substance critical to the ears’ health because of its pH (slightly acidic), which keeps the canal’s natural bacteria and yeast in check, but also because it guards the canal itself. “Parents who remove the wax are taking away a protective barrier and can actually scratch the skin, which is another way to invite infection,” she says
You can still use cotton swabs, she says, but only to remove wax that is visible around the opening of the ear canal. “Don’t go farther than what you can see,” Nici says. In other words, she says, “Don’t insert the swab or device into the ear, or you’ll risk wedging the wax against the eardrum, which can cause other problems.”
- Supplement aquatic activities with water-drying drops. I’ll be honest: I get confused between the condition called “swimmers ear” with water-drying aids like “Swim-EAR.” Because, if you think about it, the product—alcohol-based drops that remove excess water from the ear—isn’t used to treat actual swimmer’s ear, an infection of the outer ear.
Bottom line, Nici says, is to use products like these after water activities only. “Put it in the ear canal to dry up water so it doesn’t get trapped in the ear wax and set up the ear for infection,” she says. These products are also safe to use in concert with an ear rinse. (Visit product links below.)
- Watch for contraindications. If after any of these treatments your child experiences pain, redness or swelling around the ear canal, muffled hearing, or abnormal discharge, contact your health-care provider.