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Infant Toddler Development Training
Module 6, Lesson 2


baby sneezingColds are the most common upper respiratory infection (URI). Viruses are the usual cause for colds. A runny nose called rhinorrhea and a cough are common especially at night. There is often an initial low-grade fever. Other viral symptoms may also be evidenced dependent on the virus. The rhinorrhea usually lasts from 1 – 2 weeks. The nasal drainage turns from clear to cloudy and is thicker and greener during the course of time. If there is a new onset of fever at the end of the course, it could be a signal that there is a bacterial infection or a new illness and this should immediately by checked by the child's primary medical provider. Complications of colds are otitis media and sinusitis.

Ear Infections

Ear Infections can occur in the outer, middle or inner ears, but are more common in the middle ear. An infection of the middle ear is called otitis media. Otitis media usually occurs secondary to a cold. It may also begin as a response to an allergen. Approximately 33 % of children are prone to otitis media infections and many have three or more infections a year. The first infection usually occurs before 3 months of age. There are also a third of children who almost never have an otitis media infection.

Viruses are the most common cause of ear infections. Bacteria may also cause otitis media including pneumoccus, group A streptococcus, staphlococcus aureus, and Haemophilus influenza. A mycoplasma infection may also cause an otitis media. The symptoms include redness of the eardrum (tympanic membrane), fluid behind the eardrum and/or pus in the external auditory canal. Fluid may continue to be present following the infection. Seventy percent (70%) of children have fluid present 2 weeks after the infection; 40% after 4 weeks; 20% after 2 months; and 10% after 3 months. Fluid causes sounds to be muffled and can affect the acquisition of good speech. Therefore all otitis media infections need to be followed closely by the primary medical provider or health care practitioner.

Ear Infection Treatment

The primary treatment of ear infections includes the use of antibiotics over a period of time. Sometimes tubes are inserted into the ears if fluid continues for longer than 3 months. This requires the child to be anesthetized while they are inserted. Tubes may occasionally cause scarring and can affect the tympanic membrane. Therefore, a specialist needs to explain the pros and cons of this treatment carefully to the parents.

What should the team consider concerning ear infections related to hearing and speech?


Diarrhea is stools without form and with a lot of water. The cause of diarrhea in infants and toddlers is often linked to food. Diarrhea can be caused by infections with viruses being the most common cause; however bacteria and protozoa may also be the cause.

Soft, frequent stools may be common in infants who are fed breast milk. These infants may have up to 10 stools per day whereas a formula fed infant may have 1 – 6 stools a day or as few as one stool in three days. A soft, loose stool may be normal if the stool has some form and the frequency is normal.

If blood is noted in the stool, if the infant appears to be in continuing pain, and if there is weight loss, colitis (inflammation of the bowels) is suspected and should be treated by the primary medical provider immediately. Damage can occur if the diarrhea is severe or prolonged, keeping the intestine from absorbing necessary water and nutrients. Diet can worsen the condition and an infant under the age of 12 months should not be given cow's milk. Infants take up to two weeks to repair damage and toddlers take a shorter period of time whereas adults only take 2 – 3 days. The intestine is considered repaired if the intestine is able again to reabsorb water and the diarrhea abates. If gas, cramping, and loose stools persist after the repair period the infant or toddler would still be at nutritional risk of malabsorption. Treatment of colitis is usually supportive. If accompanied by a fever the child may be put on antibiotics. Often a lactose-reduced diet is recommended.


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