What is an ear infection?

Also called otitis media, an ear infection refers to inflammation or infection of the eye ear (the little air-filled pocket backside the eardrum).

At that place are a few unlike types of center ear infections, but the 1 virtually commonly experienced past babies and children is called astute otitis media (AOM). In this type of ear infection, fluid is trapped backside the eardrum, and parts of the eye ear become infected and bloated. This causes pain in the affected ear and your child may also develop a fever.

What causes ear infections?

A eye ear infection can be caused by bacteria or a virus. After an affliction such equally a cold or flu, fluid can build upward in the centre ear, allowing leaner or viruses that have traveled to the area to multiply and cause an infection.

Usually any fluid that enters this expanse drains quickly through the eustachian tubes, which connect the middle ear to the back of the nose and throat. But if a eustachian tube is blocked – as ofttimes happens during colds, sinus infections, and even allergies – the fluid gets trapped in the centre ear.

Germs like to abound in night, warm, wet places, and so a fluid-filled middle ear is the perfect breeding ground. Every bit the infection gets worse, the inflammation in and backside the eardrum also tends to worsen, making the status more painful. Your kid may also develop a fever as his body fights the infection.

Using a pacifier may increase the take a chance of heart ear infections. In one study, the incidence of ear infections was 33 percent lower in babies who didn't use pacifiers.

Babies are more than prone to ear infections because they have short (virtually one/2 inch) horizontal eustachian tubes. Every bit children grow to adulthood, their tubes triple in length and become more vertical, allowing fluid to drain more easily.

sticky wax covering part of ear

© Dr. P. Marazzi / Science Source

Signs of an ear infection in babies and children

The easiest fashion to tell if your baby might accept an ear infection (or whatever other affliction, for that thing) is by observing a change in her mood.

If your infant gets fussy or starts crying more than than usual, be on the lookout for a problem. If she develops a fever (whether slight or high), y'all have some other big clue. Ear infections tend to follow a common cold or sinus infection, so keep that in mind as well.

You may also notice the following symptoms:

  • Pulling, grabbing, or tugging at the ear. This could be a sign that she's in pain. (Babies practice pull on their ears for many other reasons, so if your infant seems otherwise fine, she probably doesn't have an ear infection.)
  • Diarrhea  or vomiting . The bug that causes the ear infection can also bear on the gastrointestinal tract.
  • Reduced appetite. Ear infections tin can cause gastrointestinal upset. They tin also make information technology painful for your infant to consume and chew. If your baby has an ear infection, she may pull abroad from the breast or bottle after the first few sips.
  • Xanthous or whitish fluid draining from the ear. This doesn't happen to near babies, but it's a sure sign of infection. It also signals that a small hole has adult in the eardrum. (Don't worry – this volition heal once the infection is treated.)
  • Unpleasant smell. Y'all may smell a foul odour coming from your child's ear.
  • Difficulty sleeping. Lying down can make an ear infection more painful.
  • Fever. Your child may have a rectal temperature of 100.iv degrees F or higher.

If you have a toddler or an older child, an earache is often the first noticeable symptom. Your toddler may seem cranky or might tug at her ear. Or your child may tell you that her ear hurts.

In addition to the symptoms above, you may observe these symptoms in your toddler or older child:

  • Headache. Pain from the ear tin radiate to the head.
  • Trouble hearing sounds. Fluid buildup in the middle ear can block sound.
  • Difficulty with balance. The ear helps with equilibrium, so yous may notice that your child seems a bit unsteady.

How common are ear infections in children?

Ear infections are ane of the most normally diagnosed illnesses in children in the United States. A large report plant that 23 percent of babies had at least 1 ear infection by their first birthday, and more than than half had at least one ear infection past age three.

Ear infection treatment in babies and children

Handling depends on the severity of the infection and the age of your child. Babies who are 6 months and younger, and children with severe cases, may need to exist treated with antibiotics. For most other children, doctors recommend a wait-and-see approach for two to three days, because ear infections normally clear up on their own. (About fourscore percent of kids with AOM get improve without antibiotics.)

For years, antibiotics were the start line of defense against ear infections, but now doctors are prescribing them more judiciously. Taking antibiotics too often is a concern because it can ready children upward to be vulnerable to antibiotic-resistant infections (run into below for more information).

Ask your child'southward medico whether she suggests watchful waiting or prescription medicine. The doctor may advise an approach like this:

  • If your child is between 6 and 24 months former and has mild symptoms in only ane ear, or if he's at least ii and has mild symptoms affecting one or both ears, keep an eye on his condition outset. Your child's doctor may also propose an over-the-counter pain reliever to help him experience better.
  • If your child doesn't improve in 48 to 72 hours, follow up with your kid's doctor, who may consider starting an antibiotic.

The American Academy of Pediatrics (AAP) recommends treating AOM with antibiotics for:

  • Babies 6 months or younger; infants don't withal have a stiff allowed system and are especially vulnerable to complications from AOM
  • Children half dozen months or older with severe symptoms, such as a fever college than 102 degrees F or moderate to severe ear pain that lasts at least 48 hours
  • Children between 6 and 24 months old who have AOM affecting both ears (even without severe symptoms)

If your child does need an antibiotic, give him the entire grade, even afterward he seems to feel meliorate. So have his ear rechecked a few weeks subsequently so the doctor tin can make sure the medication worked.

If your child doesn't improve after 48 to 72 hours on the antibiotics, let the doctor know. She may want to switch medications.

Why are doctors concerned about prescribing antibiotics for ear infections?

Doctors are mostly cautious about prescribing antibiotics because more and more bacteria are becoming resistant to them. And besides contributing to antibiotic resistance, giving a child antibiotic medication kills good bacteria, which are essential for keeping the digestive tract healthy.

Besides, an ear infection can be caused by either leaner or a virus. Since antibiotics don't work against viral infections, doctors are more cautious about prescribing them.

Drug companies used to stay one stride ahead by continually introducing new medications, but leaner have been mutating rapidly in response, making the drugs less effective. (Doctors say that parents can help combat this problem past not requesting antibiotics for every ear infection or tour with the common cold.)

When to call the doctor

Call at the first sign of an ear infection. If the doctor asks you to come in, she'll probably wait in your child'due south ear with an otoscope. An eardrum that's ruby, bulging, and possibly draining is probably infected.

The doctor may besides bank check whether the eardrum moves in response to a device chosen a pneumatic otoscope, which releases a brief puff of air into the ear. If it's not moving, that'due south another indication that fluid is collecting in the heart ear and may be infected.

Whether the treatment is watchful waiting or antibiotics, your kid'southward condition should amend each twenty-four hours. If your child isn't doing better after 48 to 72 hours, let the doctor know. She may want to accept yous come back for a follow-up exam and get-go antibiotics, or to change antibiotics if your child was already taking them.

Domicile remedies and other ways to care for pain and discomfort

Here are a few ways to help your child feel better:

  • Hurting reliever. The correct dose of infant acetaminophen or ibuprofen (only requite ibuprofen if your child is 6 months or older) can salve pain. If your child is younger than 3 months, inquire her doctor before giving her whatsoever medication.
  • Warm shrink. Concord it gently to your kid's ear to help relieve pain.
  • Lots of fluids. Encourage your child to drink more fluids, because swallowing helps to drain the center ear and relieve painful pressure. If you take an infant, offer the breast or bottle more oftentimes. Encourage your toddler or older kid to sip on water throughout the solar day.

Here's what Non to practise:

  • If your child is 3 years or younger, practice Not give your child over-the-counter (OTC) cough and cold medications such as decongestants or antihistamines. These non simply won't help her get better, they tin can as well cause dangerous side effects in young children. (The AAP does not recommend OTC cough and cold medications for children under the age of 6, though some doctors may suggest it for 4- and five-yr-olds. Be sure to follow your doctor's advice.)
  • Never give your child aspirin because it makes her more susceptible to Reye'south syndrome, a rare but potentially fatal disease.

How to forbid ear infections in babies and children

The following are steps you can have to lower your child'due south take a chance of recurring ear infections. (The beginning few are specifically intended for babies.)

  • Breastfeed your baby for at to the lowest degree 6 months.Breast milk provides antibodies against ear infections. A major study published in the journalPediatrics showed that children who are breastfed for the first half-dozen months of life are less likely to develop ear infections.
  • Hold your baby upright when feeding him.Hold him so his head is higher than the balance of his body. Babies fed while they're lying downward are more than likely to develop AOM.
  • Wean your baby off the pacifier if your baby is prone to ear infections.Babies who are half dozen months of age or older are slightly more likely to develop ear infections if they employ pacifiers. But since using pacifiers in the first twelvemonth may help protect against SIDS, enquire your babe's doc nearly the best fourth dimension to wean.
  • Launder your hands frequently.Although ear infections aren't contagious, the respiratory infections that lead to them are. Go along your kid's hands clean, and stay abroad from people with respiratory infections whenever possible.

  • Make sure your child'due south vaccinations are up to date.Immunizations help prevent certain illnesses that can lead to an ear infection. For example, the pneumococcal conjugate vaccine has dramatically reduced the number of ear infections in children. Research shows that since the pneumococcal conjugate vaccine has been on the immunization schedule, the number of 3-yr-olds who accept had at least one ear infection dropped past 20 percent.

    If your child has repeated ear infections, especially after bouts of the influenza, talk to your doctor most giving your child an annual flu vaccine. (Just children who are at to the lowest degree 6 months old can get a flu shot.)

  • Avoid secondhand smoke. Researchers have concluded that kids whose parents smoke are more likely to go ear infections and have hearing problems.

    Children living with a smoker have a 37 percentage higher risk of center ear infections and hearing issues, and a 62 per centum higher hazard if the mother is the household smoker. Kids are too 86 percent more likely to receive surgery for their middle ear problems when their mothers smoke, compared with children who have no smokers in their household.

    Even a weekend spent in a business firm with a smoker can significantly harm a child and raise his chances of getting an ear infection. Tobacco smoke seems to suppress the allowed system, making it more difficult for your child to fight off infection. Don't permit people smoke in your business firm, and keep your child out of smoky environments.

Can ear tubes help with repeated ear infections?

Possibly. Doctors vary on whether ear tubes should be used for recurrent ear infections considering there isn't much inquiry on their effectiveness, and the available data is inconclusive. According to the AAP, "More and better controlled studies of [ear] tube placement would help decide its do good versus harm."

If your kid's doctor suggests ear tube surgery, you'll have a conversation about the process's pros and cons. The doc may suggest this treatment if your child:

  • Is at least 6 months onetime
  • Has recurring hearing problems or speech delays due to multiple ear infections
  • Has persistent fluid behind the eardrum
  • No longer responds to antibiotic treatment

The AAP says ear tubes can be offered to babies (who are at least half dozen months former) and children who have had three episodes of recurrent AOM in half-dozen months, or 4 episodes in ane year with the virtually recent episode occurring within the concluding six months.

Hither'south how ear tube surgery works:

  • Your child is taken to the operating room and given full general anesthesia.
  • An otolaryngologist (ear, nose, and throat md) makes a tiny incision in the eardrum and removes fluid using suction.
  • The doctor inserts a small tube into the slit.
  • The tube releases force per unit area and acts as a vent, letting air in and fluid out, and so bacteria tin't flourish.
  • Your child will wake upward in the recovery room.

As with whatever surgery, in that location are risks, which can include the post-obit:

  • Complications from the anesthesia
  • Bleeding
  • Infection
  • The tubes can sometimes come out past themselves
  • Increased gamble of damage to the eardrum

Are ear infections in babies and children always serious?

They tin can be. A astringent or untreated infection can rupture your child's eardrum. Ruptures don't happen very oft and mostly heal quickly, simply it'due south of import to follow upward with your child'southward doc to make sure the infection has cleared up and the eardrum is healing well.

Repeated ear infections can sometimes cause hearing loss and scarring. And in very rare cases, untreated ear infections pb to mastoiditis (a skull infection behind the ear) or meningitis.

Learn more:

Is it true that colds cause babies to go ear infections?

How to requite medicine to your child safely and effectively