Ear Infections in Children
Posted in
Ear infections are a common health problem for young children. They happen when the middle ear gets swollen, often because of bacteria or viruses. The eustachian tubes, which connect the middle ear to the back of the nose, can get blocked. When that happens, fluid can build up and cause an infection.
We know how hard it can be for parents when their child has an ear infection. It is important to spot the symptoms of an ear infection early. Signs like ear pain, trouble hearing or fussiness could mean it is time to call your child's doctor. Things like going to daycare, breathing in secondhand smoke or bottle-feeding instead of breastfeeding can raise a child’s risk of getting ear infections.
In this blog, we speak to Jason B. Sigmon, M.D., an otolaryngologist (ENT) with INTEGRIS Health Grove, to learn more.
“Sleepless nights and painful ears present a frustrating dilemma for many parents. I’ve been there myself as a father of four children,” Sigmon says. “Our INTEGRIS Health ENT providers throughout our Oklahoma network are specially trained and equipped to take care of your loved ones suffering with chronic ear infections. Our ENT staff prioritize getting our young patients with recurrent and chronic ear infections in for appointments to undergo evaluation, testing and treatment.”
Understanding types of ear infections and their causes
Ear infections happen when germs get trapped in the ear and cause swelling and pain. In children, this often happens because their eustachian tubes are smaller and can get blocked more easily. There are a few different types of ear infections that parents should know about.
Middle ear infections (otitis media)
Otitis media is the most common type of ear infection in children. It happens when fluid builds up behind the eardrum in the middle ear, often after a respiratory infection like a cold. This fluid can cause pressure, pain and even mild hearing loss if it is not treated.
- Acute otitis media is a sudden infection that causes ear pain and swelling.
- Otitis media with effusion happens when there is fluid buildup without an active infection, but it can still affect hearing.
Outer ear infections (otitis externa)
Otitis externa, sometimes called "swimmer’s ear," affects the ear canal, which is the part of the ear that leads to the eardrum. It often happens when water stays in the ear after swimming, creating a place for bacteria to grow.
Inner ear problems
Although less common, problems with the inner ear can cause balance issues and trouble hearing. These issues are usually more serious and need care from a specialist in otolaryngology.
How doctors diagnose and treat ear infections
When you bring your child to a health care provider with signs of an ear infection, the doctor will start with a full checkup to find the cause and choose the right treatment.
Diagnosing an ear infection
- The doctor will use a tool called an otoscope to look inside the ear canal and check the eardrum.
- They will look for redness, swelling, fluid buildup or a bulging eardrum, which are signs of middle ear infection or acute otitis media.
- In some cases, doctors may check how well the eardrum moves, which can show if there is fluid buildup.
- The doctor may also ask about other symptoms, like a sore throat, runny nose or fever.
Treatment options
The right treatment depends on the child's age, how bad the infection is and whether it is a first infection or a repeat problem.
Watchful waiting
- For many older children with mild symptoms, doctors may recommend watchful waiting for a few days to see if the infection goes away on its own.
- This helps avoid unnecessary use of antibiotics, as many infections clear up without them.
Pain relief
- Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage ear pain and lower fever.
- Ear drops might also be prescribed for extra relief.
Antibiotics
- If the infection is severe, if the child is very young (under six months old), or if symptoms do not improve, antibiotics may be needed.
- It is important to finish all the medicine, even if the child feels better, to make sure the infection is fully gone.
Ear tubes
- If a child has repeated infections or lasting fluid buildup, the doctor might suggest ear tubes. These tiny tubes help drain fluid and prevent new infections.
Risk factors for ear infections in children
Some children are more likely to get ear infections than others. Knowing the risk factors can help parents take extra steps to protect their child's ear health.
Child's age
- Younger children, especially those between six months old and two years old, have a higher risk because their eustachian tubes are shorter and more easily blocked.
- As children grow older, their risk of middle ear infections goes down.
Daycare attendance
- Children who go to daycare are around more germs and respiratory infections, which can lead to more ear infections.
Bottle-feeding vs. breastfeeding
- Bottle feeding, especially when babies are lying down, can increase the risk of fluid reaching the middle ear.
- Breastfeeding helps boost a baby’s immune system and may lower the risk of ear infections.
Secondhand smoke exposure
- Exposure to secondhand smoke can irritate the lining of the nose and eustachian tubes, making infections more likely.
Family history
- Children whose parents or siblings had frequent ear infections may also be more likely to get them.
Other health issues
- Children with respiratory infections, frequent colds or conditions that affect the immune system are at a higher risk for developing infections.
- Problems with the back of the nose, like enlarged adenoids, can also block the eustachian tubes and cause more infections.
Preventing ear infections in children
While not all ear infections can be avoided, there are several steps you can take to lower your child's risk. Focusing on healthy habits and early action can protect your child’s ears and support better long-term health.
Stay up to date on vaccines
Keeping your child’s vaccines current is one of the best ways to prevent ear infections. Vaccines like the flu shot and the pneumococcal vaccine help protect against illnesses that often lead to middle ear infections.
Respiratory infections like the flu can cause swelling and fluid buildup behind the eardrum, increasing the risk of an infection. By staying on track with your child’s vaccine schedule, you reduce the chances of these illnesses developing into ear problems. Talk to your child’s doctor about the vaccines recommended by the American Academy of Pediatrics.
Breastfeed when possible
Breastfeeding can help build a stronger immune system in young children, which lowers the risk of ear infections. Breast milk contains natural antibodies that help babies fight off the bacteria and viruses that cause infections.
Studies have shown that babies who are breastfed for at least six months have fewer middle ear infections than those who are bottle-fed. If you do use a bottle, try to keep your baby sitting up while feeding. Feeding in a lying-down position can cause fluid to collect in the eustachian tubes, which can lead to fluid buildup and infection.
Avoid secondhand smoke
Exposure to secondhand smoke is a major risk factor for ear infections in children. Smoke can irritate the lining of the eustachian tubes, causing swelling and making it easier for infections to develop. Children who live with smokers or spend time in smoky environments are more likely to experience frequent middle ear infections.
Keeping your home and car smoke-free is an important step in protecting your child’s health. If someone in your household smokes, encourage them to quit or, at a minimum, avoid smoking indoors and near children.
Practice good hygiene
Teaching your child to practice good hygiene can lower their chances of catching the viruses and bacteria that often lead to ear infections. Encourage your child to wash their hands often, especially after playing with others, using the bathroom or before eating.
Good hygiene habits can help stop the spread of illnesses that can cause respiratory infections, which are a leading cause of middle ear infections. Simple habits like covering the mouth when coughing and avoiding close contact with sick individuals can also make a big difference in keeping your child healthy.
Limit pacifier use
Using a pacifier can comfort babies and toddlers, but using one too much, especially after six months of age, can increase the risk of ear infections. Research shows that frequent pacifier use can change the way the eustachian tubes work, making it easier for bacteria and viruses to cause infections.
If your child still uses a pacifier, try to gradually reduce its use after six months. Encourage other soothing methods like gentle rocking or offering a soft toy to help your child feel comforted without depending on a pacifier.
Manage allergies effectively
If your child has allergies, managing them well can also help prevent ear infections. Allergies can cause inflammation and swelling in the nasal passages, which may block the eustachian tubes and lead to fluid buildup in the middle ear.
Work with your child’s doctor to create a treatment plan that controls allergy symptoms. This might include medications, allergy testing or avoiding known triggers like dust mites, pollen or pet dander. Managing allergies helps protect your child's ears and can also improve their overall comfort and daily health.
Watch for early signs of trouble
Catching the early symptoms of an ear infection can make a big difference in treatment and recovery. If your child starts showing signs like ear pain, trouble hearing, fussiness or trouble sleeping, it is important to call your child’s doctor.
Early diagnosis and care can prevent the infection from getting worse or leading to more serious problems like hearing loss. Parents who stay alert to small changes in their child's behavior or health are better able to get the right help when it is needed most.
When to see a doctor about an ear infection
While some ear infections may clear up on their own, it is important to know when it is time to contact a health care provider. Recognizing when a child needs medical care can prevent the infection from causing bigger problems like lasting hearing loss or other complications.
Persistent symptoms
If your child has had ear pain, fever or other signs of an infection for more than 48 hours, it is a good idea to call your child’s doctor. Persistent symptoms may mean the infection is not improving and could require antibiotics or other treatments. Younger children, especially those under six months old, should be seen right away if they show any signs of an ear infection.
Fluid or discharge from the ear
Any fluid, pus or blood draining from the ear canal is a reason to seek care immediately. This could mean that the eardrum has ruptured due to pressure from a middle ear infection. A ruptured eardrum often heals on its own, but it still needs to be checked by a health care provider to make sure there are no lasting problems.
Hearing problems
If your child seems to have trouble hearing, is not responding to sounds or shows delays in language development, it is important to have their hearing checked. Repeated middle ear infections or fluid buildup can affect a child's hearing if left untreated. Early treatment can help protect your child's communication and learning skills.
Recurring infections
If your child has frequent ear infections, such as three infections in six months or four infections in a year, the doctor may suggest seeing a specialist in otolaryngology. Some children may need ear tubes to help drain fluid and reduce the number of infections they experience.
Getting the right care at the right time is key to protecting your child’s ear health. At INTEGRIS Health, our pediatrics team is ready to support families every step of the way, from diagnosis to recovery.
