To ask about treatment for recurring toddler ear infections?

[WhyamIBoredathome]

Hi all, hoping someone with experience of this might offer some sage advice.
My DD is 21 months. This evening her ear had started discharging gunk with another ear infection. This is her third infection in 5 weeks. It's only 5 days since she finished a course of oral antibiotics for the last infection which was in both ears.

She has had ear infections a lot since about 8 months old. It used to be predictable, every time she got a cold, about 5 days later it would turn into an ear infection. Now they come out of nowhere with no cold or other symptoms preceeding them. She does suck her thumb, which I believe makes kids more susceptible to it.
I reckon her infections average about one every 6-7 weeks (more in winter, less in summer)

Has anyone had a similar situation and been referred to ENT? I asked the doctor when we went in last week about this and she said no, she doesn't think it's necessary.
But how often does she need to have them before they will do something? I'm starting to worry that her hearing will be damaged.

I'd be very grateful for any experience of this that anyone can offer.

Lots of experience with this. Eldest daughter had hearing difficulties (very low poor hearing) but no discharge from ear. Had grommets done privately as waiting list long and advised to have them done due to hearing affecting performance at school. Fast forward 2 years later, grommet caused mastoiditis and a cholesteatoma and this perforated ear drum which now requires an operation to repair in her case.
Youngest daughter had recurrent ear infections from age 1-5 year old. The ENT doctor refused to put grommets in. Private doctor offered but I refused as wanted to see if things improved. Daughters ear improved on its own without the need for surgery. See how things go and decide for yourself.

I'm surprised the Pp children have had grommets after eardrum bursting twice, my DD must be on her 6th or 7th perforation by now.

I'm in the US. We don't have to get a referral to an ENT, we just go. Also, you don't have to have a perforation at all to get tubes; you just have to have 3 ear infections in 6 months.

3 in 6 months? Blimey, in 6 months over winter last year we were up to 7 or 8.
This Autumn /winter she's on 5 and it's only December 1St!

I'm going to make an appointment for a gp I know and like and push for referral. I'm also going to buy an otovent and try and get her to use it. She can blow her nose so it's worth a go. If not I will use it on myself, for years I've had a bubbling noise in my right ear and I'm pretty sure I've got some hearing loss (but never tested) and I wonder now if that bubbling noise is stuck fluid.

Absolutely ask again for an ENT referral. I've had a brief scan through the comments -so apologies if I've missed anything- but repeated otitis media with perforation at such a young age is a clear ent referral. It sounds as though the background history may have been missed or not been taken fully into account, Purely based on the information you've given if your child saw me I would be referring. Without examination and direct history taking it's not really possible to say if the infections are exacerbated by Eustachian tube dysfunction, I wouldn't try an oto vent unless it's been recommended by someone who has seen your daughter.

Please also bear in mind that the US have a very different healthcare system which is payment based. Unfortunately this can and does have an impact on treatment options (I've worked in the UK and US)

Niccyb luckily your experience of mastoiditis and further complications secondary to grommets are very rare, your daughter has been incredibly unlucky. Grommets and t tubes work incredibly well for many children but like you said it can also be a 'wait and see' situation. I would urge anyone with concerns over repeated 'glue ear' to have a specialist referral to discuss treatment (or non treatment!) options

If you have no luck with the GP, try going through the HV. I asked our HV about ENT because of recurrent ear infections and suspected hearing loss in my DS and she sent it straight through. Also if you have a Nurse Practitioner at your GP practice (not the Practice Nurse - that's a different role) try going to see them instead. Personal experience rates our NP for "everyday" stuff and they can prescribe and refer.
Good luck. Ear infections are horrid and it's so hard to see DC in so much pain from them.

Bizarrely homeopathy worked for us. In France there are homeopathic doctors. And ear infections and allergies are 2 areas I would/have used them. Successfully. I can’t really remember but I think she had silver drops in her ears. And some other stuff.

Ds has had problems with his ears since he was a toddler. He's had grommets twice which worked while they were in place but the infections came back as soon as they dropped out. He is now 12 and down to 4 infections with perforation a year. We always now have any discharge tested to make sure we get the right antibiotics because he has more problems with continuous discharge than the acute part of the infection which sometimes is not obvious. We have been told he will likely grow out of them in the next year or so.

DD had grommets fitted at 18 months after constant ear infections and burst ear drum. They never checked her hearing at all! It was like a miracle cure though. No side effects and no trouble ever since. Push to see ENT

ENT problems are dealt by a single specialist because they are interlinked. Any problem in one spreads to other. Toddlers due to poor personal hygiene tend to suffer frequent ENT infections. The golden advice here is look at the environment in which the toddler is growing. You can't do anything about the nursery if she is going to one. But if she is not, then it is definitely picked up from home. Have an OCD for a clean house until the toddlers are 5 years old. You only confessed that your child has the habit of sucking her thumb. There you go all the more reason to be more hygiene conscious. Educate other members of the family about home hygiene. No pets, no carpets, no mess and definitely no outdoor footwear in the house. ANTIBIOTICS ARE NOT AT ALL NECESSARY FOR ENT INFECTION IN 90% IN CHILDREN. THEY ONLY WORK SO LONG AS THE CHILD KEEPS TAKING THEM.

grommets for us. DC had ear infections since 6 months old. In the space of a year we had 8 courses of ABs which did not help. DC was having high temperatures with the ear infections and impaired hearing. GP refused to refer to ENT. We saw an ENT who works at the local hospital privately. He was appalled that we weren't referred by our GP. He referred DC back to NHS and we had a surgery to insert grommets 3 weeks later. Surgeon said DC had one of the most gunky ears he had seen in a very long time.

Once grommets were in, all ear infections stopped. It made such a huge difference.

I think grommets is one of the things that gets often rationed on the NHS and is used as a last resort. Can you afford to see an ENT privately - it may give you a better idea how to proceed (grommets may not be the way).

Toddlers tend to suffer ear infections because of the geometry of the physical structures of the ears/nose in young children.

My dd out of the blue started getting tonsillitis, ear infections when she turned 2. After ten weeks, almost being refused getting on a flight cos of a burst eardrum, numerous trips to gp and AB’s, the gp started saying she would need her tonsils out.
My reply was along the lines of ‘your fucking joking, she was never sick before 3 months ago’ that there had to be something else. Gp said it had to be bacterial or viral and I pressed and said so there is definitely no other cause.

She said in rare cases, it’s allergy related.
It then dawned on me, 12 weeks previously..... I had stopped breastfeeding and started her on dairy.
Stopped dairy, now she only gets sick if I let her have ice cream and she now self limits herself.

It’s worth restricting dairy for just 2 weeks to see if it makes a difference before you go into surgical solutions.

I would absolutely second this comment made by Baaaaaaaaaaaa:-

"My dd presented with ear infection after ear infecrion, with ab’s apparently clearing it up, only for it to recur a short while later.

After the 4th or 5th time in succession she was referred to ent where it was discovered she was suffering from cholesteotoma. Whilst choleseotoma is rare, it can be serious is left undiagnosed.

I only add this to make you aware not all ear complaints are straight forward ear infections. If it prolongs/recurs please ask for 2nd opinions/possibility of this."

My oldest ds had constant ear infections and burst eardrums from the age of 11 months. It took until he was 2 and a half until he got the grommets in and that solved the problem. I had to really push to get the grommets. Same problems with second ds but managed to get the grommets in a lot earlier with him and again solved the problem. Keep going back to doc and pushing for a referral.