If your child’s ear is hurting, it could be an ear infection, which is an inflammation of the middle ear. Five out of six children will have at least one ear infection by their third birthday. Ear infections are the most common reason parents take their children to see their doctor.
“Although usually not dangerous, ear infections can be very painful and disruptive to a young child’s life,” says Dania Lindenberg, MD, a pediatrician at Scripps Coastal Medical Center Hillcrest. “Fortunately, there are treatments and measures that can be taken at home to prevent ear infections in children.”
Children are more likely than adults to get ear infections because their immune systems are still developing, which makes it harder for them to fight off infections.
“Young children are the most vulnerable also because they have shorter, softer and more level Eustachian tubes than adults, which makes it more difficult for fluid to drain out of the ear,” Dr. Lindenberg says.
The Eustachian tube connects the upper part of the throat to the middle ear. If the Eustachian tube is swollen or blocked with mucus due to a respiratory illness like a cold, fluid may not be able to drain. The most common ear infection is called acute otitis media, where parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum.
Common ear infection symptoms in children include:
- Ear pain
- Fussiness or irritability
- Rubbing or tugging at an ear
- Difficulty sleeping
“The best way to prevent ear infections is to reduce the risk factors associated with them,” Dr. Lindenberg say.
Here are things you can do to reduce your child’s risk for ear infections.
Make sure your child is up to date on vaccinations. Studies show vaccinated children have fewer ear infections. The pneumococcal vaccine protects against streptococcus pneumoniae, a common cause of middle ear infections. The flu vaccine can also help prevent ear infections.
Children and adults who wash their hands with soap and clean, running water can help prevent the spread of germs that can cause colds and ear infections. Hand-washing is important especially after using the bathroom, when preparing food, before eating, and after coughing, sneezing or blowing your nose.
Breastfeed your baby. Breast milk contains antibodies that can help protect your baby against various illnesses, including ear infections. The American Academy of Pediatrics recommends breastfeeding your baby exclusively for the first six months and can be continued for as long as both mother and baby desire it.
Avoid bottle feeding your baby when he or she is lying down. Milk may pool in their throat and enter the Eustachian tubes, creating a medium for bacterial growth.
Don’t smoke and avoid exposure to secondhand smoke. Smoking has been associated with an increased incidence of ear infections. Possible explanations include inflammation of the Eustachian tubes caused by the smoke and reduced effectiveness of our ear’s built-in mucous clearing mechanism in the presence of smoke.
Remember not to allow smoking in or near your home or in your car. Make sure that your children’s daycare and school are tobacco-free zones.
Pacifiers have been associated with an increased incidence of ear infections. The sucking may inhibit proper eustachian tube function.
The American Academy of Pediatrics and the American Academy of Family Physicians recommend weaning children from pacifiers in the second six months of life to prevent middle ear infection.
Kids in large centers tend to be exposed to more upper respiratory viruses, predisposing them to ear infections.
Be sure to visit your child’s pediatrician if you’re concerned your child has an ear infection.
See your doctor if your child has:
- A fever of 102.2°F (39°C) or higher
- Pus, discharge, or fluid coming from the ear
- Worsening symptoms
- Symptoms of a middle ear infection that last for more than 2–3 days
- Hearing loss
Your doctor can check for an ear infection by looking inside your child’s ear and checking if there is pus in the middle ear.
Sometimes antibiotics, such as amoxicillin, are needed to treat severe cases right away or cases that last longer than 2–3 days.
For mild cases of middle ear infection, your doctor might recommend watchful waiting to see if antibiotics are needed, or delayed antibiotic prescribing, where the prescription is given with the suggestion to wait 2-3 days to fill it.
Even when antibiotics are prescribed, they won’t take effect for 24 to 48 hours. Fortunately, there are simple, effective ways to reduce your child’s discomfort and pain during an ear infection, including using over-the-counter fever and pain medicine.
Despite your best efforts to prevent them, your kids may still develop recurrent ear infections. If that’s the case, he or she may need to be evaluated by an ear, nose and throat specialist.