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RENEE MONTAGNE, host:

It's MORNING EDITION from NPR News. I'm Renee Montagne, good morning.

In Your Health today, a curse of winter - stuffy noses and ears that feel like they're filled with cotton. We'll look at how saltwater rinses can help keep your nose and sinuses clear.

First, NPR's Patty Neighmond takes a look at ear tubes, when kids need them and when they don't.

PATRICIA NEIGHMOND: Adrian Dutei(ph) is two years old. He lives in Los Angeles. Adrian's bilingual and thrilled to name the characters pasted on the wall near his diaper-changing table.

(Soundbite of baby and father)

NEIGHMOND: Adrian's usually in a good mood, says his dad, Arno, which is why it was so upsetting to see him crying and not feeling well so much over the past year and a half. Dutei.

Mr. ARNO DUTEI (Father): Then we were seeing that his mood was changing, and then he was getting frustrated very quickly, and annoyed in doing things that he would not normally do.

NEIGHMOND: Adrian had fever and a runny nose. Doctors saw pus when they looked in his ears. Dr. Nina Shapiro is a pediatric ear, nose and throat specialist at UCLA, who sees lots of kids like Adrian.

Dr. NINA SHAPIRO (UCLA): These kids are up at night, screaming, and they get Tylenol, they get Motrin, they're in the emergency room. It's very, very painful. For any adult that's ever had an ear infection, they know how painful it is. It's really like a sharp, stabbing pain.

NEIGHMOND: The passageways inside kids' ears aren't fully developed until about age 12. For some kids, that means air doesn't circulate properly and fluid can build up behind the eardrum. If that fluid becomes infected, the eardrum gets inflamed and swells, which is why it's so painful. Arno Dutei.

Mr. ARNO DUTEI: At some point we were going to our pediatrician every other week. And every other week he was getting antibiotics. It was taking more and more time to clear, down to the point where we were wondering if the medication had any effect; seems like he was constantly sick.

NEIGHMOND: When antibiotics are used a lot, bacteria can become resistant. Dr. Shapiro says today there's a 50-50 chance normal doses of antibiotics won't work, which is why tiny tubes implanted in the eardrum are an option.

Dr. SHAPIRO: They act as mature ventilation systems, so if the tube is in the eardrum, it prevents fluid from building up. And if there's no fluid that builds up behind the eardrum, then that fluid can't become infected.

NEIGHMOND: Tubes decrease the number of infections by at least one, and maybe several a year. If kids do get an infection, tubes reduce the swelling and the pain. But Shapiro cautions tubes are only for kids with chronic ear infections, at least six or more a year.

Dr. SHAPIRO: Some children have, say, what a parent would consider a lot of infections; say they've had three infections this year, and oh my gosh, these were horrible. Children get 10-12 colds per year, which is really about a cold per month. So if they're getting a few ear infections per year, that's considered quote-unquote "normal," not necessarily needing tubes.

NEIGHMOND: In addition, there's another group of kids who get ear tubes who don't need them. They don't have chronic painful infections; instead they've been prescribed tubes because fluid frequently builds up behind their eardrum, often after a cold. This fluid can muffle sound. Doctors worried that this temporary hearing loss might lead to speech and learning problems.

But in a recent study that followed such children for 10 years, those who got ear tubes did no better on speech and language tests than those who didn't. Pediatrician Steve Berman with Children's Hospital in Denver.

Dr. STEVE BERMAN (Denver Children's Hospital): I think we can be totally reassured now that those children are not going to have bad effects from having that degree of mild or moderate hearing loss.

NEIGHMOND: Berman says about a third of all ear tubes maybe unnecessary.

Dr. BERMAN: Each of those surgeries probably costs between $3,500 and $5,000, so we're potentially talking about a lot of money could be saved by avoiding these unnecessary surgeries.

NEIGHMOND: Berman says to help speech development, many parents would do better spending time, reading and talking to their children.

Patty Neighmond, NPR News.

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