Recommendations for clinical care guidelines on the management of Otitis Media in Aboriginal and Torres Strait Islander Populations

Section A: Prevention of Otitis Media and Hearing Loss

Prevent the occurrence of otitis media and hearing loss in Aboriginal and Torres Strait Islander children

Page last updated: 14 October 2011

Prevent the occurrence of otitis media and hearing loss in Aboriginal and Torres Strait Islander children

StrategyRecommendation and GradingEvidence StudiesEvidence -Based Guidelines
Anticipatory GuidanceGPP*: Tell all expectant mothers about the importance of prevention, early detection and treatment of OM for prevention of OM associated hearing loss. The potential effects on language and education should be emphasised.
Encourage Early InterventionsGPP: Ensure that information about OM and effective communication strategies for people with hearing loss is available throughout the community.IV25;29;59,60I~A15
GPP: Tell the families/caregivers that:
  • Onset of OM in Aboriginal infants may occur within the first months of life. The early onset of OM is associated with high risk of:
  • Persistent OME
  • CSOM
  • Hearing loss.
Children are at increased risk of AOM during other upper respiratory infections.IV5;6;64I~A15,16,18,19I~B23
  • To attend the health centre as soon as possible whenever a child develops ear pain or discharge, particularly if the child is young.
Encourage Early Interventions continued
  • Some features of OM (such as ear pain) may be absent, and that regular health centre attendance for ear examinations is recommended.
  • All forms of OM are associated with some degree of hearing loss.
  • Hearing loss can affect the development of speech and language skills. Additional language stimulation is very important for normal language development.
IV67,69I~A18 I~B23
  • (If applicable) certain babies are at high risk for development of OM and its consequences (e.g. those with cleft palate and other craniofacial abnormalities, foetal alcohol syndrome, fragile X syndrome, Down syndrome).
Breast FeedingGPP: Encourage mothers to continue breast feeding for at least 6 months to reduce the risk of OM.IV5;25,26;55;70I~A15,16,18
Personal HygieneGPP: The health practitioner should tell families or caregivers that nasal discharge carries germs (viruses and bacteria) which are responsible for OM. Children should wash and dry their hands after blowing their noses or coughing. Children’s faces and hands should be kept clean of nasal discharge. Frequent hand washing is also recommended.IV5;39;71-73I~A16
VaccinationGrade A: Give pneumococcal conjugate vaccination during infancy according to local immunisation schedule to reduce AOM, rAOM and the need for surgery. I37;74-78;5;29I~A16
Grade B: Give influenza vaccination according to local immunisation schedule. This may be beneficial if given just before the flu season. I38;79;58;5;29I~A16
PacifierGrade B: Tell the families/caregivers that the use of a pacifier (dummy) after 6 months of age can increase the risk of OM. II26,25,28;55;87I~A15,16,19
SwimmingGrade D: Swimming should not be discouraged routinely.

If swimming is known to be associated with new or persistent ear infections in an individual, it is reasonable to recommend keeping the ear dry.
SmokingGPP: Strongly discourage people from smoking around children.IV55;83-86I~A15,16,18
Bottle Feeding GPP: Tell the families/caregivers that if the child is bottle-fed, the upright position is recommended. IV6;25;88I~A15,16,18
*GPP = Good Practice Point
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