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Ear infections are one of the most common illnesses experienced by young children.

At some point in your child's life, you may be faced with dealing with an ear infection.

What is an Ear Infection?

Ear infections, also called otitis media, happen when bacteria gets in the space behind the eardrum called the middle ear. The space fills with the infected fluid and pushes painfully on the eardrum.

Why do Kids Get Ear Infections?

An ear infection begins with a viral infection like the common cold or with unhealthy bacterial growth. Either of these can cause the eustachian tubes (the passageway connecting the middle ear to the back of the nose) to become swollen or cause inflammation of the middle ear and trapping fluid buildup behind the eardrum.

This is a problem for children because their immune systems aren't as resistant to infections as an adult's. A child's eustachian tubes are shorter, narrower and more horizontal than adults which can make it easier for germs to reach the inner ear and trap the infected fluid.

Ear Infection Prevention

Limiting exposure to germs is the first step in preventing ear infections and other illnesses.

Good Hygiene

Teaching your child good hygiene like covering their mouth when they sneeze or cough and how to wash their hands afterwards and after going to the bathroom, will go a long way to preventing sickness.

Transition from the Bottle

When your kids are ready, try to transition them to a sippy cup. Sippy cups have less surface area for germs to breed than a bottle. However, Do not let your kids have sippy cups nor bottles in their beds, as this can lead to ear infections if milk or juice spill into their ears.


If you can, breastfeed your baby. Breastfed babies don't develop as many illnesses including ear infections. Breast milk contains many good substances to protect your child from infections and diseases.

Avoid Second Hand Smoke

Smoking is as hard on the smoker's health as it is on those around the smoker. Second hand smoke in the home is a major contributor to childhood illnesses including ear infections.

Keep Vaccinations Up to Date

Vaccinations and flu shots can also protect against ear infections.

Ear Infection Diagnosis

Indications of a ear infection could include:

  • More crying than usual, especially when lying down
  • Fever
  • Trouble sleeping
  • Trouble hearing
  • Fluid coming from the ears
  • Tugging on the ears - but this could also be a child exploring or self-soothing technique

If your child is showing some of these signs especially fever, call your child's doctor and ask if they should be seen. The doctor may ask you to take the approach of "wait-and-see" for 48-72 hours.

Ear infections tend to resolve themselves on their own, so not many doctors are prescribing antibiotics as often. Antibiotics don't help with infections caused by a virus or remove fluid from the middle ear. They can also have side effects and usually won't help with the pain in the first 24 hours. Using antibiotics unnecessarily or too often can cause the bacteria to develop a resistance to the antibiotics causing other problems down the line.

This doesn't mean you shouldn't see your child's doctor. They'll use an instrument called an otoscope - it resembles a flashlight - to identify if it is an ear infection or not and to make sure the eardrum hasn't ruptured. They can recommend over-the-counter pain relievers to help alleviate the pain as your child recovers.

For children with a cleft palate, a genetic condition like Down Syndrome or other immune system disorder, doctors may forgo in the "wait-and-see" approach in favor of seeing the child right away.

If your child has many recurrent ear infections, your doctor may prescribe antibiotics and may discuss inserting tubes in the ears. The tubes, called tympanostomy tubes, drain the fluid in the middle ear helping to equalize pressure. The tubes are best for children with recurring hearing and speech problems caused by multiple infections.

Ear Infection Treatment

The treatment for ear infections is a three-step process.

  1. After the wait-and-see time period, a doctor will use the otoscope to determine if it is an ear infection.
  2. Your doctor will discuss the risk factors for the ear infection and how to prevent them in the future.
  3. If it is an ear infection, they'll observe and treat the symptoms to ensure your child recovers with very minimal pain.

An earache may be a sign of something other than an ear infection such as, foreign objects in the ear, hard earwax, or teething. Whether an ear infection or other issue, your doctor will be able to find the cause, treat it and get your child back to their everyday, happy, healthy self.

Amanda Votruba, MD

Methodist Physicians Clinic 192 Dodge Pediatrics

Dr. Votruba answers your questions about child health and parenting. As a pediatrician, Dr. Votruba feels that seeing the kids every day is the best part of her job. With four children, including one set of twins, she enjoys sharing her experience and assisting parents through all phases of their child's life. She feels that by knowing the child's health history she can help parents and patients feel more comfortable and trust that she will take this into account. She has college students ...

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