6.1 Information for parents, teachers and carers

Parents, teachers and carers should be aware that AOM and OME are particularly common in preschool children. In most cases they are transient episodes, however they can be recurrent and variable in presentation, and carers should be given clear information by primary care professionals of the circumstances requiring further attendances.

In cases where hearing loss is suspected or apparent, the following advice about basic communication is useful, making listening easier for the child and also reducing difficulties with adult interactions:

Basic communication tips: face the child when speaking get the child’s attention before starting to talk background noise should be reduced as much as possible speech should be clear with normal rhythm and volume.

Playgroup leaders, nursery or school teachers should be informed if a child has a hearing loss so that they can facilitate activities in class. This setting is often a difficult environment in terms of background noise and the child may be unwilling to highlight any difficulties in front of his or her peers.

The organisations listed in section 6.2 can provide patient information leaflets on otitis media and deaf awareness, either by post or on their websites.

6.1.1 ADVICE ON PARENTAL SMOKING

One large, rigorous cohort study,²² one small cohort study²⁷ and one meta-analysis²⁶ of 12 cohort and case control studies demonstrate an association between parental smoking and OME. The large cohort study showed a marked dose-dependent effect. The association persists after allowing for bias by social class.

Parents of children with otitis media with effusion should be advised to refrain from smoking.

6.1.2 ADVICE ON BREASTFEEDING

A large cohort study looked at the relationship between breastfeeding and OME.²² This one study on breastfeeding shows a protective effect. This is consistent with other proven anti-infective benefits of breastfeeding.

Parents should be advised that breastfeeding may reduce the risk of their child developing otitis media with effusion.

6.1.3 ADVICE ON SWIMMING AND BATHING FOLLOWING GROMMET INSERTION

The effect of swimming on otorrhea after grommet surgery is more difficult to research and the only RCT identified was flawed in that 33% of patients randomised to ‘non-swimming’ chose to swim anyway.⁷⁶

A later cohort study found no relationship between swimming and otorrhea.⁷⁷

Grommet insertion is not a contraindication to swimming.

Soap reduces surface tension and may increase water ingress through grommets. In the absence of trial data on this issue, it is advisable to avoid immersion of the head in soapy water.

6.2 List of useful contact details

Defeating Deafness The Hearing Research Trust
330-332 Gray’s Inn Road, London WC1X 8EE
Tel: 020 7833 1733 Text: 020 7915 1412 Fax: 020 7278 0404
Email:defeating.deafness@ucl.ac.uk
Defeating Deafness Information Service:
Freephone: 0808 808 2222
Website: www.defeatingdeafness.org

The National Deaf Children’s Society
15 Dufferin Street, London EC1Y 8UR
Switchboard: 020 7490 8656 Information & Helpline: 020 7250 0123 Fax: 020 7251 5020
Website:www.ndcs.org.uk

The National Deaf Children’s Society Scotland
293-295 Central Chambers, 93 Hope Street, Glasgow G2 6LD
Voice/Text: 0141 248 2429 Fax: 0141 248 2597

NHS 24
NHS 24 is a 24 hour nurse-led helpline providing confidential healthcare advice and information. This service will be available across Scotland in 2003.
Tel: 08454 24 24 24
Website: www.nhs24.com

The Royal National Institute for Deaf People
19-23 Featherstone Street, London EClY 8SL
Tel: 0808 808 0123 Text: 0808 808 9000 Fax: 020 7296 8199
Website: www.rnid.org.uk

Royal College of Speech and Language Therapists
2 White Hart Yard, London SE11NX
Tel: 020 7378 3004 Fax: 020 7403 7254
Website: www.rcslt.org

British Association of Teachers of the Deaf
Website: www.batod.org.uk