DrNsouliBy Talal Nsouli, MD
Q: Why does my baby get so many ear infections?
A: Nasal inflammation and congestion spreads easily to the middle ear, causing fluid to accumulate behind the eardrum. If this becomes infected, we treat it with antibiotics. But it’s important to look for the underlying cause, which is often environmental or food allergies. So if a child is congested for long periods of time or has three or more ear infections per year, it’s time to see an allergist.
Q: What happens during the evaluation?
A: We start with a full history to understand the intensity of the symptoms, then a physical exam, looking in the nose and the ears and a test to detect the fluid in the ear. If the symptoms suggest allergy, I move on to allergy skin or blood testing. Contrary to what some believe, babies can be tested for allergies. So when we know what the child is allergic to and how severe the allergy is, we can put together a management plan.
Recurrent fluid buildup and infections can cause hearing loss, so if symptoms continue the toddler may benefit from surgery. Unfortunately, many doctors wait too long to intervene and stop the cause of the congestion.

Talal Nsouli, MD, is director of the Watergate and Burke Allergy Center in Washington, D.C.

Ask the Allergist is sponsored by the American College of Allergy, Asthma & Immunology (ACAAI).