Find out what causes common ear infections in babies and toddlers — and what you can do to ease your little one’s pain in the ear.
What an Ear Infection Is
Also known as acute otitis media, a childhood ear infection is when the middle ear (between the outer part of the ear and the innermost part of the ear) becomes plugged with fluid, infected, and inflamed, resulting in redness in the eardrum, pain, and often fever. Ear infections are one of the most common childhood illnesses — striking kids younger than four most often.
What Causes Childhood Ear Infections
Childhood ear infections are usually brought on by a cold or other upper-respiratory infection, which causes the lining of the eustachian tube (the tube that connects the middle ear to the nose and the back of the throat) to swell, become congested, and accumulate fluid. The fluid becomes a breeding ground for infection-causing germs (they could be viral, bacterial, or even fungal). The pain and temporary hearing loss your child may experience are due to the fluid putting pressure on the eardrum; the fever he may develop is due to the infection in the middle ear that his little body is fighting. While an ear infection isn’t contagious, the cold or illness that led to one can be.
Ear infections are more common in babies and toddlers because their eustachian tubes are very short and small compared with the tubes in adults’ (or older kids’) ears, making it easy for fluid to get trapped and build up there. That’s why most kids have at least one ear infection by the time they turn two.
Some babies and toddlers may be especially prone to chronic ear infections. While experts aren’t entirely sure why some kids get more ear infections than others, there are a few factors that seem to raise the risk for them, including a family history of ear infections and living with a smoker. Bottle-feeding when lying down is another risk. Experts believe that this can cause formula to flow into the middle ear, resulting in infection (the sucking motion a baby makes while breastfeeding doesn’t have the same effect).
What the Symptoms of Childhood Ear Infections Are
- Tugging or pulling at the ear or intentionally hitting his head (if your child is talking, he’ll complain of pain in his ear or a headache)
- Crying more than usual
- Night waking
- Failing to respond to sounds, including your voice
- Crankiness and irritability
- Dizziness (your toddler may stumble more than usual or bump into things)
- Unhappy when lying down, chewing, or sucking (all of which can cause painful pressure changes in the middle ear)
- Decreased appetite
- Clear or bloody discharge or pus that drips out from the ear
What to Do About Childhood Ear Infections
- If you suspect an ear infection, call the doctor so that you can get your child’s ears checked. If the infection is severe, or if your baby is younger than six months old, the doctor will probably prescribe a course of antibiotics. But don’t be surprised if your pediatrician suggests a wait-and-see approach. Not every childhood ear infection warrants antibiotics — some are caused by viruses or fungi that won’t respond to antibiotics. Also, it turns out that most ear infections clear up without antibiotics after two or three days, and giving your child too many antibiotics can put him at risk for becoming resistant to these potent drugs when they’re really needed.
- Whether or not your child gets meds, your doctor will likely recommend acetaminophen or ibuprofen (ibuprofen is recommended only for babies older than six months) for pain and fever relief. Your doctor may also prescribe a decongestant to help relieve inflammation and pressure in the ear and/or pain-relieving eardrops.
- Once your child has cleared the ear infection (usually within a week to ten days), it’s not uncommon for there to still be a bit of fluid leftover in the ear. Your pediatrician should check the ears at each visit to make sure there is no infection.
If your child keeps on getting ear infections, talk with your pediatrician about getting a hearing test. That’s because repeated ear infections or chronic fluid buildup in the ear can cause hearing problems, which can in turn cause speech delays.
When to Call the Doctor
Besides calling the doctor when you suspect an ear infection, also call if you see any of the following troubling symptoms.
- Fever: While some pediatricians have different standards for what constitutes a fever, if you suspect an ear infection and your child is running any kind of fever, don’t worry about “bothering” your pediatrician with a call to the office. And definitely call the doctor immediately if your baby is less than three months old and has a temperature of 100.4° or higher (this could be a sign of a serious infection) or if your child is between three months and three years old and the fever reaches 101.5°F or higher.
- A discharge of blood, fluid, or pus from the ear: This could mean that the pressure from the buildup of fluid in the ear has caused your child’s eardrum to rupture. This is not as scary as you might think. The release of pressure usually relieves some pain, and the eardrum usually heals itself within a few weeks. Still, you’ll want to see the pediatrician within a day or so since your child will likely need antibiotics to kill the bacteria that caused the ear infection.
- No improvement in your child’s symptoms after three days with or without antibiotics — or if the infection seems to get better and then returns. This could mean that your child is dealing with chronic ear infections.
How to Prevent Childhood Ear Infections
While you can’t do much to change a family history of childhood ear infections (if only!), there are some preventive measures youcan take.
- Prevent exposure to secondhand smoke, which makes children more vulnerable to ear infections.
- Reduce exposure — as much as possible — to upper-respiratory infections, which can lead to ear infections. That means steering clear of sick kids and washing your and your child’s hands frequently.
- Stay up-to-date on your child’s immunizations. The pneumococcal vaccine (Prevnar), which is given to prevent serious infections such as pneumonia and meningitis, may also reduce the risk of ear infections.
- Breastfeed your baby for at least six months, if you can, since breast milk contains antibodies that may offer protection from ear infections.
- Hold your baby upright if you feed him from a bottle to avoid letting milk get into the middle ear.