That’s a question we hear quite a bit, especially during the summer months. So we thought we'd ask one of our experts.

In general, swimming with a middle ear infection (while under treatment) is not a problem, according to Natalie Roberge, M.D., an Ear, Nose and Throat (ENT) specialist at Cook Children’s.

However, a child should stay out of the water for some time while experiencing swimmer’s ear, also known as otitis externa.

Unlike the common middle ear  infection, swimmer’s ear is inflammation and/or infection of the ear canal.

Symptoms

The symptoms of swimmer’s ear usually start as itching of the ear, and quickly progresses to ear pain (especially if you pull on the earlobe). You may even notice a discharge or foul smelling odor from the ear. Swimmer’s ear is predominately seen in the summer months, mostly in children older than 2 years and often only affects just one ear.

“Swimming with an otitis externa is discouraged until three days after the pain and drainage have stopped,” Dr. Roberge said.

How do you get swimmer's ear?

There's a reason why your mother used to make you dry your ears when you got out of the pool or shower. Water sitting in your ears is the perfect environment to allow bacteria and fungus to grow. Wax prevents water from pooling in our ears and changes the acidity of our ear canals to stop microbial growth. Therefore children with little to no ear wax are at risk of developing swimmer’s ear. Conditions that trap water in the ear, such as excessive amounts of ear wax or foreign objects in the ear, may cause troubles. Swimmer’s ear also is seen in children with diabetes, chronic immunodeficiencies, or certain skin conditions (such as severe eczema, or psoriasis).

Prevention

As with many diseases an ounce of prevention is worth a pound of cure. Drying your child’s ears thoroughly by tilting the head and place a towel in the ear can significantly decrease the chance of infection. If your child is prone to swimmer’s ears the use of waterproof earplugs or a few drops of over-the-counter swimmers ears drops can help prevent. You can make your own swimmer’s ear prevention drops with equal parts of rubbing alcohol (isopropyl alcohol) and white vinegar (5 percent acetic acid). At the end of swimming dry your ears and place a few drops in both ears.

What about swimming with tubes?

In general, kids with tubes do not need ear plugs while swimming, unless it seems to bother the child or with lake swimming or deep diving. The exception to this: Swimming with draining ears in children with tubes should be discouraged until the drainage has stopped.

Both the American Academy of Pediatrics (AAP) and the Academy of Otolaryngology – Head and Neck Surgery Foundation published the following:

“Evidence from clinical trials shows no benefit or trivial clinical benefit from routine water precautions. Some children with tubes may benefit from water precautions in specific situations (lake swimming, deep diving, history of recurrent otorrhea, head dunking during bathing, or otalgia with water entry into the ear canal).”

We hope this answers a few of your questions and you have a safe and happy swimming season. #Lifeguardyourchild

Related Articles:

• Another ear ache. Is it time to see an ENT?
• Let's learn something: Ear infections and tubes
• 7 ear infection myths every parent should know

Swimmer’s ears are infections in the canals of the ears that make the ear very painful to touch and movement of the ear. It is typically caused from water sitting in the canal too long, resulting in swelling and drainage in the canal from the bacterial overgrowth.It is not typically accompanied by fevers and cold... symptoms.

Because it is outside of the ear drum we can use prescription drops to treat it. Motrin works well for the pain and heating pads if needed.

You can prevent them by using the over the counter ear drying drops after swimming. I have included a photo of what they look like. You can also make you own with equal part rubbing alcohol and white vinegar and place 5-10 drops in each ear.

Inner ear infections typically follow prolonged periods of nasal congestion from allergies or a cold. The nasal swelling causes fluid to back up behind the ear drum. It is not usually painful on the outside of the ear and can cause fevers. We have to use oral antibiotics to treat them, because the drops can’t penetrate behind the ear drums where the infection is.

You can keep swimming with an inner ear infection, we recommended waiting to swim until pain is resolved with a swimmer’s ear.

As always, call us with any questions and enjoy the warm weather and swimming season!!

-Sperry, NP