If your little one is cranky, unusually fussy and tugging at his or her ear or is feverish and having difficulty sleeping, chances are it may be due to an ear infection.
Ear infections in children often go away on their own or in some cases with antibiotic treatment. The challenge for many parents is knowing what to do, what to watch for and when to call their pediatrician.
Five out of six children experience an ear infection by the time they are 3 years old, according to the National Institutes of Health. The odds are that your child will have an ear infection before kindergarten.
Ear infections can be caused by either bacteria or a virus, often following a cold. The common cold can cause the middle ear to become inflamed and fluid to build up behind the eardrum. The Eustachian tube, which connects the ears, nose and throat, can also become swollen.
“Children are more susceptible to ear infections than adults because they have shorter and narrower Eustachian tubes, and it is easier for germs to reach the middle ear and for fluid to get trapped there,” says Kara Hutton, MD, a pediatrician at Scripps Clinic Rancho Bernardo. “Babies and children also have weaker immune systems, so it is more difficult for their bodies to fight an infection.”
The onset of ear infections is often on day three of a cold. Ear infections peak at age 6 months to 2 years, and are a common problem until age 8, according to the American Academy of Pediatrics.
Some ear infections require antibiotic treatment, but many can get better without this medicine.
If you suspect your child has an ear infection, your pediatrician can diagnose it and determine the appropriate treatment.
“Common ear infections often do not require antibiotics, except in severe cases or in infants younger than six months,” says Dr. Hutton. “Many ear infections will resolve on their own within a week.”
For mild cases, your doctor might recommend watchful waiting to give your child’s immune system time to fight off the infection or delayed antibiotic prescribing, which gives you time to see if your child is still sick before filling it.
Even when antibiotics are prescribed, they won’t take effect for 24 to 48 hours. Your child need not suffer needlessly. There are simple, effective ways to reduce your child’s discomfort and pain during an ear infection.
Over-the-counter medications can help reduce pain and fever in your child. Based it on age and weight and consult with your pediatrician if necessary.
Read labels and instructions carefully when giving fever-reducing medications. “It’s very important to follow instructions and give the appropriate dosage according to your child’s weight and age,” says Dr. Hutton.
- For children younger than 6 months, give only acetaminophen, such as Tylenol.
- For children older than 6 months, you may give also give an ibuprofen product, such as Advil, for fever and pain.
- Infants younger than 3 months old who have a fever need immediate medical attention even if they appear well and show no other signs of being ill.
- Do not give aspirin to children because it can cause Reye’s syndrome, a rare but very serious illness that harms the liver and brain, according to the Centers for Disease Control and Prevention (CDC).
Put a cold wet washcloth on the outer ear for 20 minutes to help with pain until the pain medicine starts to work.
Some children prefer a warm compress to help alleviate pain. Use a warm washcloth and apply until it becomes cool. “Make sure that the compress is only warm, not hot,” says Dr. Hutton.
Make sure to keep your child well hydrated. Give lots of cold fluids.
“Keeping your child’s head elevated can ease some of the pressure,” says Dr. Hutton.
If your child is older than 2 and no longer sleeps in a crib, use a pillow, but never use a pillow with an infant. You can keep an infant upright in a car seat to alleviate pressure.
Pus discharge can be normal with an ear infection. Most often, this heals after the ear infection is treated. Wipe the discharge away. Careful not to plug the ear with cotton as retained pus can cause an infection of the lining of the ear canal.
Pediatricians recommend calling your doctor if:
- Fever lasts more than two days on antibiotics
- Ear pain becomes severe or crying becomes nonstop
- Ear pain lasts more than three days on antibiotics
- Ear discharge is not better after three days on antibiotics
- Your child becomes worse
Talk with your pediatrician if your child suffers recurrent ear infections, especially if you have a family history of allergies and asthma
While you can’t fend off every germ, there are steps you can take to reduce the risk of an ear infection, including by:
- Breastfeeding your infant to pass along immunities
- Avoiding secondhand smoke
- Washing your hands
- Keeping immunizations up to date