There are a number of things that you can do at home to help your child deal with ear problems. These choices apply to common middle ear infections, but not to ear injuries, or to serious cases where there are symptoms of meningitis or mastoiditis (see Complications). In any case, since there is disagreement even within medical circles about ways of treating middle ear infection (otitis media), you need to be well informed.

Probably the best that you can do for your child is to be patient, wait out the problem, and treat the pain. You can also help your medical provider by becoming skilled at examining your child ears at home with an Earscope.

RELIEVE PAIN

The way you ask children about ear pain is very important. Children will frequently answer ''yes'' to any question that tends to be leading. Parents can actually suggest ''ear pain'' to a child who appears to be ill. (Your ear hurts again, doesn't it?) Ask a child how he or she feels, or ask them to point to where it hurts, rather than suggest an area. EARS, An Owner's Manual, Rod Moser.

If your child has an acute (sharp or intense) ear pain, treat the pain with pain relievers (not aspirin) as you would, say, a toothache. Alan Greene, MD, in his book The Parent Complete Guide to Ear Infections, suggests alternating acetaminophen (Panadol, Tylenol) with ibuprofen (Advil, Motrin) as a way to both treat pain and reduce fever. He recommends first giving ibuprofen, followed three hours later by acetaminophen, then ibuprofen again three hours later, and so on for a minimum of 12 hours, but no longer than 72 hours. Check the bottle for children's dosage. Usually ear pain is not a medical emergency although it may be very painful. Once you have the pain under control you can think about other things to do or not to do. As it turns out, not doing anything has some decided advantages.

WATCH & WAIT: Recent research suggests that watching and waiting is the best course of action for many ear infections. With a healthy immune system most ear infections (up to 80%) are self resolving.

WATCH - With an Earscope you can watch symptoms of an infection (if there is one) increase or decrease, and as you gain experience you will learn what looks normal and what doesn't. Even better, the next time your child seems sick, you can easily check the ears to see if they are involved, or if your child has tubes, you can check to see if they are still in place. Kids often put beads, food, sand, etc. in ears and a quick check will tell you if the ear canal is clear.

There is nothing mysterious about the ear drum and ear canal except that they are hidden. With experience you can learn to notice small changes to the canal and drum, and since you have constant access to your kid ears you will know better than anyone what appears normal. But be careful - ears can fool you. Crying can cause ear drums to be red without an infection, and many times middle ear fluid behind the ear drum is difficult to see. Have your provider show you what to look for, or see the very good color pictures in Rod Moser book, Ears, an Owner's Manual. Such regular monitoring of ears at home will give you a continuing progress report, something even your doctor won't have.

WAIT -How long you wait depends on what you see in the ear canal along with other important symptoms. Current literature suggests about four days of watchful waiting to give the body own defenses a chance to fight the infection. If there has been no improvement by then (normal appearing ear drum, lowered fever) antibiotics might be your best choice. Because what seems like a simple ear infection may, in rare cases, be something more serious, you will want to be in touch with your doctor while monitoring your child ears.

We strongly suggest that you find a physician who is willing to work cooperatively with you. If you get an Earscope ask your physician to show you how to use it.

COMMON COLDS: Most ear infections accompany colds so you should treat accordingly with the usual bed rest, fluids, moist air - anything that will help dilute the mucus. Since middle ear infections are related to the blockage of the Eustachian tube (which connects to air passages) anything you can do to clear it will help. Saline nose drops sometimes help, as do gargles with hot salt water if your child is old enough. Caution - do not use antihistamines, decongestants or vaso-constrictors, which have a drying effect). Elevate the head to help drainage by having the child sit up during the day, and prop up the head at night by elevating the end of the mattress. Pillows can be dangerous for infants. For older children try sugarless gum chewing, yawning, and/or have the child gently suck/blow while holding his/her nose a number of times to exercise the Eustachian tube.

DIET: There are many theories about the connection of food with wellness. Check with a medical provider before changing an infant diet, but for older children, milk products are often mentioned as possible allergens or mucus builders. Try some of the many milk substitutes. In any case, do supply lots of liquids. A diet for a healthy immune system is in Dr.Andrew Weil's best selling book Spontaneous Healing, or check his web site at www.drweil.com. See Prevention and Related sites.