Ear infections in children: Causes, symptoms and treatment

What causes ear infections in children?

An ear infection is when fluid and mucus build up behind the eardrum causing pressure and, eventually, pain. An ear infection most often affects the middle ear and is usually caused by bacteria.

An ear infection in children usually follows a respiratory infection such as a cold or a sore throat. If the ear infection is bacterial, the bacteria will spread to the middle ear causing an ear infection. In a viral infection, the bacteria are "driven" to the middle ear by the virus, resulting in a secondary infection.

What are types of ear infections in children?

There are three main types of ear infections, each with its own set of symptoms:

Acute otitis media (AOM)

This is the most common type of ear infection and is also known as an "earache." AOM affects the middle ear, causing pain. It is sometimes accompanied by a fever.

Otitis media with effusion (OME)

This condition occurs when fluid remains trapped after the infection has passed. Your child may not exhibit symptoms, although your doctor will be able to diagnose OME.

Chronic otitis media with effusion (COME)

This type of ear infection occurs if fluid remains trapped in the middle ear for more than three months. If this happens, your child usually had an ear infection that was treated and went away but left fluid behind the eardrum. Sometimes this can be seen with allergies. The fluid can then get infected and result in an ear infection. Fluid in the ear can also cause hearing loss. This is different from swimmer's ear (otitis externa) that follows water and infection in the outside part of the ear.

What are signs of ear infection in children?

Many ear infections happen before your child is able to speak. This can make it difficult to know how to tell if your child has an ear infection. When kids can't tell parents their ears hurt, they may show the following ear infection symptoms:

• Pulling or tugging at one or both ears

• Crying

• Difficulty sleeping

• Difficulty hearing soft sounds

• Fluid discharge from the ear

• Trouble with balance

• Fever (more common in infants and toddlers)

How to diagnose an ear infection

Your child's doctor will begin a diagnosis by asking you if your child has had a cold or sore throat. The doctor will also ask if your child has shown any of the above symptoms. The doctor will then use an instrument called an otoscope to examine the child's eardrum for signs of an ear infection.

How to treat a child's ear infection

An ear infection usually goes away on its own but, if it doesn't, your child may need treatment. Most doctors will prescribe an antibiotic such as amoxicillin. It's important that your child takes the exact dosage over the full amount of time, even if symptoms improve. Your doctor may also recommend over-the-counter medicine for ear infections with pain relievers such as ibuprofen or acetaminophen.

If your child has repeated ear infections within a short period of time, or has hearing loss due to fluid build-up, your child's physician may recommend ear tube surgery. Learn more about when a child may need ear tubes.

Remedies for ear infections in children

In addition to treating your child's ear infection, there are ways to help an ear infection in a child. Some of the best remedies for easing the pain of ear infections include:

• Applying a cold or warm compress to the ear

• Sleeping in a position that avoids putting pressure on the infected ear

• Getting plenty of rest

• Slowly rotating the neck

• Try getting a child's mind off their pain by doing a low-impact activity such as coloring, playing a board game, solving a puzzle or watching a movie

How to prevent ear infections

The Centers for Disease Control and Prevention (CDC) recommends the following to help prevent ear infections in children:

• Avoid exposing your child to secondhand smoke or air pollution

• Make sure children are up to date on their immunizations

• Breastfeed babies for 12 months or more (if possible)

• Bottle feed babies in an upright position

Learn more

Children's Health℠ offers the largest group of ENT pediatric doctors in North Texas, which gives parents and patients access to expertise, support and services not available anywhere else. Learn more about Pediatric Ear, Nose and Throat program.