Ear Infections & Motor Delay
“Can frequent ear infections be a possible cause of motor delay or difficulty/apprehension with motor exploration?”
ANSWER - This is SUCH a common question, especially as many of us are in the thick of cold/flu season, so let's talk about it!
Ear infections or fluid in the ears from congestion (or even allergies) can be such common issues for our little ones, primarily because of the anatomy of the inner ear in children as compared to adults. Within the inner ear, there is something called the Eustachian tube, which connects the middle ear to the nose and works to maintain balanced pressure on both sides of the eardrum. In children, the Eustachian tube is MUCH shorter, much narrower and much more horizontally aligned than adults, which can lead to increased frequency of ear infections because bacteria can more easily become trapped in the tube & infected, especially when the already narrow tube is even more narrow from swelling during an illness.
THEN, within the inner ear, there are 3 connected canals (called the semicircular canals) that are filled with fluid and lined with small hairs. The inner ear & these canals play a big part in balance because when we move our head, the fluid & hairs move within the canals, which then communicate your head position with your brain via a nerve….want to guess which one?!
THE VESTIBULAR NERVE! Once the brain receives those signals from the semi-circular canals/hairs, the brain then communicates with your body & muscles to modify anything needed so that balance is maintained. As an aside, a really cool example that has always stuck with me of how these canals/fluid/hairs work is to think of a time when you spun around in a circle multiple times in a row or wound up a swing to spin quickly around and around. Even once you stop, it takes a minute or two for your balance to return - and that’s because until the fluid within the semicircular canals stops sloshing against the hairs, your brain actually thinks you’re still spinning! Once that fluid stops moving, so does that dizziness. Aren’t humans freakin amazing?!
How Does This All Fit Together?
So…back to the question at hand - why can it be so common to see changes in motor exploration & even brief regressions in previously attained motor skills when there is something going on in our little one’s ears?
Ultimately, because the ear is SO intimately connected with the vestibular & balance systems built into our bodies- any added swelling, pressure, fluid, etc ALSO directly impacts our ability to correctly perceive where our head/body are in space and adjust accordingly.
Adding to that - when only ONE ear is infected, those signals from the semi-circular canals to the brain are even more impacted and out of sync with each other, which can result in our brain going a little haywire and causing symptoms like dizziness, loss of balance, increase in falls, and more. For our younger babes, that may look more like a noticeable change in a child’s willingness to explore motorically, especially when it requires frequent head position changes, like during crawling, rolling, rising into stand, etc. Again, because the inner ear is so closely interconnected with our vestibular and balance systems, when the usual input they receive in regards to where their body and head is in space is altered (through fluid in the ears, infection, pain), those activities can really trigger those feelings of dizziness and imbalance- so in turn, our little’s may REALLY try to avoid those activities!
Ultimately, whenever I notice or hear of a change in a child’s willingness to explore, move freely through their environment, or that they’ve ‘paused’ a previously mastered skill (especially when it is a skill that requires major head position changes) - I recommend checking in with your pediatrician and just making sure nothing is going on inner ear wise, AND, know that it’s okay to take a pause on those activities. 99.9% of the time, once the fluid has resolved, they bounce right back to their old self and are right back into their old activities. And I don’t know about you, but when I’m not feeling well the last thing I want to do is exercise or go to the gym - and that’s exactly what our babes are doing for the majority of their day when freely exploring & playing, so I get it!
I hope this helps set your mind at ease, and if you are looking for more information - I have another blog (linked here) on helping a little one get back to the floor & tummy time after an illness with more information & tips!
Hope this helps!
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For developmental questions, tips and guidance related to milestones about tummy time, rolling & sitting, crawling and walking, check out KC’s developmental Masterclasses linked here.
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KC is a pediatric doctor of physical therapy, wife and mom of three! She has spent her career working with children and young adults of all ability levels, and currently specializes in birth to three years.
