Children have weak resistance, narrow, short and horizontal Eustachian tubes, when swimming, they are susceptible to infected water stagnating in the ear causing otitis media.
Swimming has many health benefits, but also carries the risk of otitis media. Master, Doctor Nguyen Duc Minh, ENT Center, Tam Anh General Hospital Hanoi, explains that the ear has a closed structure, the pressure inside and outside is always kept in balance by the Eustachian tube – a small tube connecting the middle ear cavity and the nasopharynx. This part also has the function of draining secretions from the middle ear to the nasopharynx, preventing secretions from the nasopharynx from going up to the middle ear causing inflammation.
Normally, the Eustachian tube is always closed. When swimming, diving, or diving, the change in water pressure is too high, causing the pressure between the outer ear and the inner ear to become unbalanced, the eardrum is stretched, and movement is limited. If the Eustachian tube does not open in time or is blocked, it will cause acoustic trauma to the middle ear, manifesting as earache and tinnitus.
Water entering the ear while swimming causes itching and discomfort. Children often have the habit of picking their ears, scratching the skin of the ear canal, which can lead to swelling, making it easier for bacteria to enter and cause otitis media. Children have a shorter and more horizontal Eustachian tube structure than adults. When swimming, water easily accumulates in the ear, changing the pH in the ear canal, creating an opportunity for microorganisms, bacteria, viruses, and fungi in the water to enter the middle ear, leading to infection.
The Eustachian tubes in children are also narrower and more prone to blockage. Abnormalities in the Eustachian tubes such as swelling, congestion, and blockage prevent the Eustachian tubes from closing or opening when needed, making it difficult for secretions from the middle ear to drain into the nasopharynx. Secretions from the nasopharynx can travel up to the middle ear.
Children’s resistance is weak, susceptible to upper respiratory tract infections, rhinitis, sinusitis, otitis media… At this time, the nasopharyngeal mucosa is swollen, blocking the Eustachian tube, preventing fluid from flowing out of the ear, leading to fluid accumulation in the middle ear, which can lead to infection. Soaking in water for too long can also easily cause children to catch a cold with symptoms of runny nose and sore throat. If not treated promptly, these conditions can easily lead to complications of otitis media.
Like 8-year-old An, who went swimming for three days, got a runny nose, headache, sore throat, and cough. Her mother, Thuy, thought her child had a common cold, so she just rinsed her nose and gargle with saline. On the 5th day, the child was restless, had a high fever of 39 degrees Celsius, and had an earache. When she went to the Pediatrics Department of Tam Anh General Hospital in Hanoi, she was diagnosed with otitis media, swollen eardrums, fluid retention, and congested mucous membranes in both ear canals.
Ngoc, 10 years old, had a sore throat and runny nose but still went swimming. After 4 days, she had a high fever, diarrhea, earache, and yellow fluid coming out of her left ear. Doctor Minh diagnosed her with otitis media due to nasal discharge and dirty water from the swimming pool flowing back into her ear but not being cleaned properly.
These are two of many cases of otitis media after swimming treated at the ENT Center, Tam Anh General Hospital, Hanoi. In the past two weeks, the hospital has received about 30 children with otitis media due to swimming, an increase of nearly two times compared to the same period last year.
The narrow structure of the Eustachian tube makes it easy for water to accumulate in the child’s ear, causing infection. Photo: seagulls
According to Dr. Minh, children with a history of otitis media, perforated eardrums, abnormalities in the anatomy of the ear canal… are at high risk of otitis media when swimming. The disease can appear alone or after an upper respiratory tract infection with symptoms of fever, headache, runny nose, fatigue, poor sleep and appetite. In addition to specific ear symptoms such as pain, discharge, hearing loss, children with otitis media may vomit, have abdominal pain, and diarrhea.
If not diagnosed and treated promptly, children are susceptible to complications such as perforated eardrum leading to hearing loss, acute mastoiditis, meningitis, brain abscess, cavernous sinus thrombosis and lateral vein thrombosis. In young children who are just learning to walk and talk, complications of otitis media can cause hearing loss, delayed development of speech and social communication skills.
Treatment for otitis media depends on the cause. Children may be prescribed pain relievers, anti-inflammatory drugs, antibiotics, decongestants, or ear medications (rinsing, ear drops, or ear sprays) if pus is draining.
Dr. Minh recommends that parents choose a swimming pool with a limited number of bathers, a clean water source, and no harmful chemicals. Avoid letting children swim in ponds, stagnant rivers, lakes, or polluted water sources.
Before swimming, check your ears. If you find earwax, clean it by pulling it out or spraying it with a specialized spray. Provide your child with a cap, goggles, and earplugs. The cap should be made of soft, waterproof material to prevent bacteria, fungi, and dirt from seeping into the ear with water.
Summer is hot but the water in the swimming pool is quite cold in the morning. Parents should avoid letting children jump into the water and swim immediately, but should guide them to warm up or participate in some games on the shore, warming up their bodies before going into the water. Absolutely do not bathe or swim when the body is sweating, has just sunbathed or has eaten a full meal.
Teach children not to urinate in the pool, and to avoid water getting into the ears, nose, or throat. If water gets into the nose, cover one nostril and gently blow the other. If water gets into the ear, tilt the head and pull the earlobe back to let the water flow out.
Children under 5 years old should only swim for no more than 30 minutes and children over 5 years old should swim for no more than 60 minutes. After swimming, you should bathe with clean water and soap, and place a clean cotton swab in the outer ear canal for about 3-5 minutes to absorb water. Do not clean your child’s ears with unsanitary tools. Clean eyes, nose, and throat with saline.
Children with otitis media or signs of respiratory tract infection should be treated before going swimming. Children with fever, runny nose, sore throat, itchy ears, earache, or yellow discharge from the ear canal should see a doctor. If the doctor prescribes antibiotics for the child, they should take the full dose and on time. Do not self-treat with antibiotics at home, put unknown drugs into the ear, or use tools to dig deep inside the ear to avoid worsening the infection.