Ear Infection FAQs

Ear infections are the most common reason for doctor visits in young children. Chances are your child has had or will have at least one ear infection. Since this is common year-round, today we are answering frequently asked questions about ear infections.

 

What is an ear infection? What causes an ear infection?

               An ear infection (also known as otitis media) is when the middle ear (the area behind the ear drum) has infectious fluid in it. It is diagnosed by a provider looking in the child’s ear with an otoscope to see if there is infection. 

               An ear infection is caused by fluid getting trapped in the middle ear (the area behind the ear drum). The Eustachian tube connects the middle ear into the sinuses, which allows fluid to drain. Sometimes (often after an upper respiratory illness), the sinuses are inflamed, not allowing the fluid to drain, and allowing infection to occur.  It is more common in children because their Eustachian tubes are horizontal. As we grow, they become more vertical, allowing fluid to drain more easily.

 

What are the symptoms of an ear infection?

               The most common symptom of an ear infection in older kids is ear pain, they may also have a fever. It often occurs after a cold or significant allergies, but not always.

In young children, it can be more difficult to discern these symptoms, as symptoms of an ear infection can be very non-specific. These include: fussiness/irritability, fever, not sleeping well, not eating well, pulling at the ears, headache, or overall not feeling well.

Drainage from the ear is also a sign of an ear infection, and possibly a ruptured ear drum. If your child has tubes in their ears, you also may see drainage from their ears.

 

Does my child need antibiotics?

               That depends on several factors: your child’s age, their history of ear infections, the severity of the infection, and if it is in one or both ears. The body is designed to fight infection, and can clear up an ear infection on its own.

Your provider will discuss options with you and together you will come up with the best plan for your child.  They may recommend a watch and wait approach, where you keep a close eye on your child for a few days to see if they improve or worsen which will help decide if they need antibiotics or not.
They also may recommend antibiotics at the time of diagnosis. If your provider does prescribe antibiotics it is important that your child completes the course, even if they are feeling better before they have finished.

 

How can I help their pain?

               Ear infections can be very painful, over the counter Tylenol or Ibuprofen can be very helpful.  Be sure you are giving your child the correct dose based on their weight. Ibuprofen should not be used in infants less than 6 months.

 

How long does it take to recover?

               Usually within 2-3 days after being diagnosed your child will feel better.  If they are not better within that time (whether they started antibiotics or not) it is important to let you provider know. They will likely want to evaluate your child to see what is going on.

 

Why does my child keep getting ear infections?

               Some children are more susceptible to ear infections than others. Research shows there is a genetic component to ear infections. The biggest risk factor for children is their age, the older they are the less likely they are going to have ear infections.

               If your child is having frequent ear infections, your provider may recommend they see an Ear, Nose and Throat Specialist (ENT). Talk to your provider if you are concerned about the frequency of your child’s ear infections.

 

What can I do to prevent future ear infections?

               Unfortunately, ear infections are often non- preventable, and some children are more prone to ear infections than others. There are some things that have shown to decrease the risk.  Breastfeeding, avoiding exposure to second hand smoke, and getting all recommended vaccines (including the flu vaccine) can all help prevent ear infections. Frequent handwashing is known to prevent the spread of illness, which in turn can help your child stay healthy! Encourage your children to wash their hands!

 

What is the difference between an ‘ear infection’ and ‘swimmers ear’?

               An ear infection is what most people refer to otitis media or a middle ear infection as. This infection is behind the tympanic membrane (ear drum).  This inside the body, and the ear drum acts as a barrier between the middle and outer ear.

Swimmers ear (otitis externa) is an outer ear infection, when the ear canal gets infected (often caused by water staying in the ear canal after swimming/bathing, or trauma to the ear canal). This is an external infection and is usually treated by drops.

 

Can my child go swimming with an ear infection?

               That depends on the ear infection. If the ear drum did not rupture then they can swim if it isn’t causing pain. Going underwater and changing pressure can be painful with an ear infection, but playing in the water (and not going under) shouldn’t be a problem. If they did have a rupture of the ear drum or have PE tubes talk to your provider, most of the time it is recommended to wait until they have recovered.

               If your child was diagnosed with swimmer’s ear (stay tuned for a blog all about that), it is also usually recommended that they do not swim until they have recovered.

 

This blog is not a substitute for medical care. Be sure to talk to your pediatrician with additional questions and if you have any concerns for your child.              

 

https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/ear-infection.html

https://www.uptodate.com/contents/ear-infections-otitis-media-in-children-beyond-the-basics?topicRef=6021&source=see_link#H16

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