About half of kids get at least one ear infection, also known as acute otitis media, before their second birthday. Here’s why this condition is so common, and what you can do to help keep your child healthy.
What Causes an Ear Infection?
The middle ear is a small space behind your eardrum. It has tiny bones that vibrate and help you hear. This part of your ear is supposed to be vented by air. The air passes into your nose and throat, and through a passage called the eustachian tube. If anything blocks air from getting through, the middle ear can become warmer and more damp — a perfect breeding ground for germs.
In babies and kids, the eustachian tube is often very soft and has a hard time staying open. Allergies, postnasal drainage, sinus infections, common cold viruses, and problems with the tonsils can all prevent enough air from passing into the middle ear.
The most common trigger of an ear infection in kids is an upper respiratory infection, such as a cold or the flu. These viruses can swell the eustachian tube so that air can’t flow into the middle ear. Allergies to pollen, dust, animal dander, or food can have the same effect. So can smoke, fumes, and other environmental toxins. Bacteria can cause an ear infection, but usually these germs come after a virus or an allergic reaction. Bacteria can infect an already inflamed ear and cause other symptoms, such as a fever.
A shot called the conjugate pneumococcal vaccine can help protect your child against some of the most common bacteria that cause ear infections. It’s routinely given to babies and toddlers to prevent serious illnesses such as meningitis, pneumonia, and blood infections. Keeping your child up to date on this vaccine may help prevent at least some ear infections.
Some kids only get an ear infection once, or once in a while. If so, it’s called acute ear infection (or acute otitis media). If the infection clears up but comes back as many as three times in a six-month period (or four times in a year), your child may be diagnosed with recurrent acute otitis media. That’s often a sign that your child’s eustachian tube isn’t working well. At times, fluid can also build up in your child’s middle ear without signs of infection. If so, it’s called otitis media with effusion.
What Are the Symptoms of an Ear Infection?
If your child or baby has an ear infection, they may have symptoms such as:
- Fever
- Liquid (discharge) coming out of their ear
- Pain or itching in the ear (babies will rub or pull on their ears)
- A feeling of fullness in their ear
- Trouble hearing
- Crying or pain when sucking
- Loss of sleep or appetite
How Is an Ear Infection Diagnosed?
If a doctor looks at your child’s eardrum and sees that it’s red and bulging, they’ll diagnose them with an ear infection.
What Are the Treatments and Complications of an Ear Infection?
Many times, an ear infection goes away on its own within a few days. No medication is needed. But some kids, especially younger kids, will need an antibiotic. The drug starts to work within a day or so but always take the full course of antibiotic. Your doctor may also give your child different types of eardrops, including antifungal, steroid, or painkilling eardrops.
Sometimes the fluid in the middle ear doesn’t drain, blocking the eardrum and causing temporary hearing loss. This is common. In many cases, another round of antibiotics or another type of antibiotic will clear it up.
Repeat ear infections can be a concern since they’re linked to short-term hearing loss. In early childhood, hearing is key to speech development. If your child has serious hearing loss for a long time, learning to speak and understand language may be harder.
If your child has hearing loss from an ear infection, talk in a louder voice than you usually do and turn off any background noise, like TV, so they can better understand you. Hearing loss that doesn’t go away is rare.
To Tube or Not to Tube?
For many years, kids who had repeat ear infections and hearing loss were given “ear tubes.” During a short surgery called a myringotomy, tiny tubes are put into the ear to keep the middle ear vented. Now, many doctors opt to skip this surgery. Preventing ear infections is always the first step rather than surgery.
Studies show that ear tubes aren’t always needed. If your doctor suggests ear tubes for your child, you can always get a second opinion.
When to See a Doctor
Call a doctor if your child has been taking the antibiotic for more than two days and the fever comes back or never goes away. You should also call a doctor if:
- They’ve taken an antibiotic for more than three days and still aren’t better
- They’ve taken an antibiotic for more than three days and the ear discharge comes back or never goes away
If your child has any of the following symptoms, call their doctor right away:
- Serious ear pain that doesn’t get better after taking ibuprofen
- Nonstop crying
- Facial weakness (you may notice their smile looks crooked)
- Not being able to walk properly
- A fever higher than 104 degrees F
- Stiff neck
How Can I Prevent an Ear Infection?
For starters, remove as many pollutants from your home as you can, including:
- Dust
- Cleaning supplies and household products that contain harsh chemicals
- Tobacco smoke
If your child has allergies, ask their doctor for tips to control them.
Taking steps to prevent colds, the flu, and other illnesses can prevent some ear infections. To do that:
- Be sure everyone in your home, including your child, stays up to date on the shots your doctor suggests (That includes flu and pneumococcal vaccines)
- Make hand-washing a habit that becomes part of your family’s routine.
- If your child goes to daycare, look for a center that monitors kids for illness and requests that sick kids stay home, especially during cold and flu season.
- Breastfeed your baby for a year or longer, if you can.
- If you bottle-feed, hold your baby’s head higher than their stomach (This will help keep their eustachian tubes from getting blocked).
- Avoid group daycare during your child’s first year, if that’s an option (Caring for them in a home setting could cut back on the number of germs they’re exposed to).
Takeaways
Ear infections are common in kids. The most common trigger of an ear infection is an upper respiratory infection, such as a cold or the flu. These viruses can cause the eustachian tube in your ear to swell, blocking air from reaching the middle ear. If your child has an ear infection, they may have other symptoms, including fever, pain, and itching in and around their ear. Many ear infections go away on their own, but your child may need antibiotics from the doctor.
To prevent future ear infections, make sure your kids are up-to-date on their shots and wash their hands to keep from getting sick.
Ear Infection FAQs
Here are some of the most commonly asked questions about ear infections.
How many ear infections are too many for a toddler?
If your toddler gets four ear infections in a year (or more than three ear infections in six months), take them to get checked out. Their doctor can tell you more about what to expect.
What can be mistaken for an ear infection?
Other conditions that cause ear pain can be mistaken for an ear infection. That can include conditions such as:
- Swimmer’s ear or water trapped in your ear
- Allergic reactions
- Toothache or tooth pain
- Pain from your jaw or from a sore throat
Does hydrogen peroxide help with ear infections?
Yes, hydrogen peroxide can sometimes help with ear infections. To try it, put 1-3 milliliters of hydrogen peroxide into a dropper or syringe. Have your child lie down and turn their head to the side. Gently fill their ear with the hydrogen peroxide. Let it fizz and bubble for a minute before letting your child turn their head. You can put a tissue up to their ear so the liquid gets absorbed.
How can you relieve ear pain while pregnant?
If you’re pregnant and have ear pain, you can try some home remedies. That may include using hydrogen peroxide or a hot, warm compress, for example. But when in doubt, call your doctor to see what your options are.
How many types of ear infections are there?
There are a few different types of ear infections. It depends on where the infection is and what causes it. If the infection is in your middle ear, it’s called a middle ear infection (acute otitis media). If you get an infection in your outer ear canal, that’s called swimmer’s ear.
