Information Source for Ear Infections

Children are much more likely than adults to get ear infections. Ear infections are by far the most common medical condition occurring in babies and young children. Most often, the infection affects the middle ear. Tubes inside the ears become clogged with fluid and mucus. This can affect hearing, because sound cannot get through all that fluid. 3 out of every 4 kids will get one or more ear infections by their 3rd birthday. In fact, ear infections are the most common reason parents bring their children to a doctor.

If your child does not yet talk, you need to look for signs of an infection:

Typically, baby ear infections go away on their own, but your doctor may recommend pain relievers. Chronic ear infections in young children and babies may require antibiotics. Children who get frequent or "chronic ear infections" may need minor surgery to place small tubes in their ears. The tubes relieve ear pressure so the child can hear well.

There are 3 Types of Ear Infections

There are three main kinds of ear infections, which are called acute otitis media, otitis media with effusion, and otitis externa (Swimmer's Ear). Sometimes ear infection can be painful and may even need antibiotics treatment. Your doctor will be able to determine what kind of ear infection your child has and if antibiotics may help the ear-infection. Ear infections are an all to common issue with children of all ages.

Type 1 - Acute Otitis Media

The type of ear infection that is usually painful and may improve with antibiotic treatment is called acute otitis media, or AOM. Symptoms of AOM include pain, redness of the eardrum, pus in the ear, and fever. Children may pull on the affected ear, and infants or toddlers may be irritable. Antibiotics are often prescribed to children for AOM, but are not always necessary.

Type 2 - Otitis Media with Effusion

Otitis media with effusion or OME, is a build up of fluid in the middle ear without signs and symptoms of acute infection (pain, redness of the eardrum, pus, and fever). OME is more common than AOM, and may be caused by viral upper respiratory infections, allergies, or exposure to irritants (i.e. cigarette smoke). The build up of middle ear flap does not usually cause pain and almost always goes away on its own. OME will not usually benefit from antibiotic treatment.

Type 3 - "Swimmer's Ear"

Swimmer's Ear is a commonly occurring ear-infection of the ear or its outer ear canal. It can cause the ear to itch or become red and swollen so touching the ear or pressure on the ear is very painful. There may also be pus that drains from the ear. Antibiotics are often needed to treat swimmers-ear: aka otitis externa. We have more information about symptoms, treatment, causes, and prevention of Swimmer's Ear.

Causes of an Ear Infection

An ear infection usually is caused by bacteria and often begins after a child has a sore throat, cold, or other upper respiratory infection. If the upper respiratory infection is bacterial, these same bacteria may spread to the middle ear; if the upper respiratory infection is caused by a virus, such as a cold, bacteria may be drawn to the microbe-friendly environment and move to middle ear as a secondary infection. During the ear-infection, fluid builds up behind the eardrum.

The ear has 3-major parts: the outer ear, middle ear and inner ear. The outer ear, also called the pinna, includes everything we see on the outside the curved flap of the ear leading down to the earlobe but it also includes the ear canal, which begins at the opening to the ear and extends to the eardrum. The eardrum is a membrane that separates the outer ear from the middle ear.

The middle ear which is where ear infections occur is located between the eardrum and the inner ear. Within the middle ear are three tiny bones called the malleus, incus, and stapes that transmit sound vibrations from the eardrum to the inner ear. The bones of the middle ear are surrounded by air.

The inner ear contains the labyrinth, which help us keep our balance. The cochlea, a part of the labyrinth, is a snail-shaped organ that converts sound vibrations from the middle ear into electrical signals. The auditory nerve carries these signals from the cochlea to the brain.

Other nearby parts of the ear also can be involved in ear infections. The eustachian tube is a small passageway that connects the upper part of the throat to the middle ear. Its job is to supply fresh air to the middle ear, drain fluid, and keep air pressure at a steady level between the nose and the ear.

Adenoids are small pads of tissue located behind the back of the nose, above the throat, and near the eustachian tubes. Adenoids are mostly made up of immune system cells. They fight off infection by trapping bacteria that enter through the mouth.

Treatment for Acute Middle Ear Infection

Many doctors will prescribe an antibiotic, such as amoxicillin, to be taken over seven to 10-days. Your doctor also may recommend over-the-counter pain relievers such as acetaminophen or ibuprofen, or ear drops, to help with fever and pain. (Because aspirin is considered a major preventable risk factor for Reye's syndrome, a child who has a fever or other flu-like symptoms should not be given aspirin unless instructed to by your doctor.)

If your doctor isn't able to make a definite diagnosis of OM and your child does not have severe ear pain or a fever, your doctor might ask you to wait a day to see if the earache goes away. Sometimes ear pain isn't caused by infection, and some ear infections may get better without antibiotics. Using antibiotics cautiously and with good reason helps prevent the development of bacteria that become resistant to antibiotics.

If your doctor prescribes an antibiotic, it is important to make sure your child takes it exactly as prescribed and for the full amount of time. Even though your child may seem better in a few days, the infection still has not completely cleared from the ear. Stopping the medicine too soon could allow the infection to come back. It is also important to return for your child's follow-up visit, so that the doctor can check if the infection is gone.

How long will it take my child to get better?

Your child should start feeling better within a few days after visiting the doctor. If its been several days and your child still seems sick, call your doctor. Your child might need a different antibiotic. Once the infection clears, fluid may still remain in the middle ear but usually disappears within three to six weeks.

What happens if my child keeps getting ear infections?

To keep a middle ear infection from coming back, it helps to limit some of the factors that might put your child at risk, such as not being around people who smoke and not going to bed with a bottle. In spite of these precautions, some children may continue to have middle ear infections, sometimes as many as five or six a year. Your doctor may want to wait for several months to see if things get better on their own but, if the infections keep coming back and antibiotics aren't helping, many doctors will recommend a surgical procedure that places a small ventilation tube in the eardrum to improve air flow and prevent fluid backup in the middle ear. The most commonly used tubes stay in place for six to nine months and require follow-up visits until they fall out.

If placement of the tubes still doesn't prevent infections, a doctor may consider removing the adenoids to prevent infection from spreading to the eustachian tubes.