Ear Infections in Children

Ear infections are one of the most common reasons children visit the pediatrician. While they can be painful and frustrating, the good news is that many ear infections improve on their own and there are effective treatments available when needed. In this blog, we talk about the signs of an ear infection, how they're treated, and when to call the doctor.

An ear infection, also called acute otitis media, occurs when fluid builds up behind the eardrum and becomes infected by bacteria or viruses. Ear infections often develop after a cold or other upper respiratory infection because swelling in the nose and throat can block the Eustachian tubes, the small passages that connect the middle ear to the back of the throat. When these tubes become blocked, fluid can become trapped in the middle ear, making it easy for germs to grow. Young children are especially prone to ear infections since their Eustachian tubes are shorter, narrower, and more horizontal than those of older children and adults. This makes it easier for fluid to become trapped. As children grow, these tubes mature and drain more effectively, which is one reason ear infections become less common with age.

The symptoms of an ear infection can vary depending on your child's age. Older kids may complain of ear pain, a feeling of fullness in the ear, or trouble hearing. Babies and toddlers may not be able to tell you what hurts, so parents should watch for other signs. These can include fussiness, crying more than usual, pulling or tugging at the ears, difficulty sleeping, poor feeding, or a fever. Some children may also have fluid draining from the ear if the eardrum has ruptured. While this can look alarming, it often relieves pressure and pain, and the eardrum usually heals with appropriate care. Keep in mind, however, that pulling on the ears alone does not always mean a child has an ear infection. Babies often touch or pull their ears for many reasons, including teething or simply exploring their bodies. A proper diagnosis requires an examination by a pediatrician, who can look at the eardrum using an otoscope.

While antibiotics are sometimes prescribed to treat an ear infection, they are not always necessary. Many ear infections, particularly those caused by viruses, improve on their own within a few days. For certain children, especially those with mild symptoms and children over 2 years of age, it is recommended to closely monitor their symptoms for 48 to 72 hours while treating pain and discomfort. If symptoms improve during that time, antibiotics may not be needed. When antibiotics are recommended it's important to give the medication exactly as prescribed and complete the entire course, even if your child begins feeling better after a few days. This helps ensure the infection is fully treated and reduces the chance of bacteria becoming resistant to antibiotics.

Whether or not antibiotics are prescribed, relieving your child's discomfort is an important part of treatment. Pain-relieving medications such as acetaminophen or ibuprofen can help, depending on your child's age. These medications can reduce pain and fever while your child's body fights the infection.

If your child has frequent infections or persistent fluid behind the eardrum that affects hearing, your pediatrician may recommend further evaluation by an ear, nose, and throat (ENT) specialist. In some cases, ear tubes may be recommended to help drain fluid and reduce future infections. Although it's not always possible to prevent ear infections, there are steps that may lower your child's risk. Staying up to date on recommended immunizations, including the flu vaccine and pneumococcal vaccine, can help protect against illnesses that sometimes lead to ear infections. Breastfeeding during infancy and avoiding exposure to tobacco smoke have also been shown to reduce the risk. 

If your child has severe ear pain, a fever that persists, drainage from the ear, symptoms that worsen, or symptoms that do not improve after a few days, call our office. Early evaluation can help determine the best course of treatment and ensure your child recovers comfortably.