If your child has frequent ear infections, you are not alone. The American Speech-Language-Hearing Association says it is the most common childhood illness (other than colds) for infants and young children. Ear infections occur most frequently between the ages of 3 months and 3 years, but are common until the age of 8. Five out of six children will have at least one ear infection before their third birthday and nearly 40% of children will have three or more ear infections before that age.
Why are ear infections so common?
Basically, ear infections are common because the tubes and spaces in children’s ears are so small. When a child gets a cold, sore throat or upper respiratory infection, bacteria from those illnesses can spread to the middle ear. The bacteria causes fluid to build up in the middle ear (the space behind the ear drum), it becomes infected, the eardrum becomes inflamed, and bingo, you have an ear infection.
The pathway that the bacteria takes to get to the ear is called the Eustachian tube. It runs from the top of the back of the throat to the ear and is designed to clear fluid from the ear. However, in infants and children, this tube is nearly horizontal so it fills up with fluid easily. As we age, the tube becomes more vertical, works more effectively and that is why the older we are, the fewer ear infections we get.
3 types of ear infections
Medically speaking, an ear infection is called Otitis Media and there are three types:
- Acute Otitis Media is the most common type of ear infection. Parts of the middle ear are infected and swollen and fluid gets trapped behind the eardrum.
- Otitis Media with Effusion can occur after the ear infection has run its course, but fluid stays trapped behind the eardrum. There may be no symptoms, but a physician can see the fluid.
- Chronic Otitis Media with Effusion occurs when fluid in the middle ear remains for a long time, or recurs multiple times. Even though there is no infection, the fluid in the ear can make it harder for children to fight new infections and may impact their hearing.
In addition to contracting a cold or upper respiratory infection, there are two other reasons why your child may get frequent ear infections:
A young immune system: A child’s immune system is young and not as strong as that of an adult. That can make it difficult fight off infection.
Tonsils and adenoids: The adenoids are a flap of tissue at the top and back of the throat, considered the uppermost tonsil. Bacteria can get trapped in the adenoids and when it does it can cause an infection that moves through the Eustachian tubes to the middle ear.
Symptoms of an ear infection
If your child gets frequent ear infections you probably know the symptoms well:
- Fussiness and fever
- Fluid draining from the ear
- Tugging or pulling at the ear
- Problems with balance
- Trouble hearing
- Inability to respond to low volume sounds
What are the best treatments for ear infections?
Some ear infections get better on their own. Others need to be treated with an antibiotic. Always discuss antibiotic use with your ENT doctor to make sure that your child is taking them only when needed. There is always the risk that bacteria will develop a resistance to frequently used antibiotics.
- Acute Otitis Media (AOM-described above) may get better without treatment. If the infection doesn’t improve in 2-3 days, antibiotics may help. However, some types of AOM are caused by viruses which don’t respond to antibiotic treatment.
- Otitis Media with Effusion (OME) almost always goes away on its own without the use of antibiotics. Fluid may remain in the ear for a while but the infection will recede well before that.
Treatments for ear infections can include:
- Observation: Once your doctor determines that your child has a middle ear infection, he or she will recommend the best treatment based on the type and severity of the infection.
- Antibiotics: Your physician may need to prescribe antibiotics to fight your child’s ear infection. If so, issue the medication as prescribed. Do not stop administering the medication when your child begins to feel better. The entire dose must be taken to kill the bacteria causing the infection and to prevent it from flaring up again. Consult with your ENT to confirm.
- Pain relief: Children’s pain relievers like acetaminophen or ibuprofen may be suggested until the antibiotics can take effect to reduce pain and fever. Aspirin should not be taken when a child has a fever in order to avoid the risk of Reye’s Syndrome. Consult with your ENT to confirm.
- Tubes in the ear: If fluid remains in your child’s ear for more than 3 months, your ENT doctor may recommend inserting small tubes into the eardrum to allow fluid to drain from the ear. The procedure, called the Grommet Procedure, is done under general anesthetic and lasts 15-20 minutes. The tubes usually remain in the ear for 6 to 18 months and then fall out on their own as the Eustachian tubes grow and become larger.
Can frequent ear infections be prevented?
Sometimes. The key to preventing frequent ear infections is to make sure that the home environment is as clean as possible and that your child is not exposed to a lot of colds during the first year of life. Other preventions that you can take include:
- Do not let your child near smoke. Second-hand smoke can cause your child to have more infections. Make sure no one smokes in your house, car or your child’s day care center.
- Check your child’s allergies: When allergies cause inflammation, an ear infection can result.
- Try not to expose your child to a lot of colds during his or her first year of life. Your child’s immune system is in its infancy, as well, and it may not be strong enough to fight off infection.
- Don’t put your child to bed with a bottle. Always feed your child and hold the bottle at a 45-degree angle to avoid formula flowing through the upper part of the mouth into the Eustachian tube and then into the ear.
- If your child breathes through the mouth or snores it may be caused by large adenoids. Larger than normal adenoids can attract the bacteria that causes ear infections. Inform your doctor so that the size of the adenoids can be checked.
- Wash your hands frequently. Wash your hands and teach your children to wash their hands frequently. It is the #1 way to stop the spread of illness and infection.
Researchers sponsored by the National Institute on Deafness and Other Communication Disorders (NIDCD) are working to further understand ear infections, their prevention, diagnosis and treatment. They are trying to find better ways to predict which children are at higher risk for ear infections in order to prevent them.
In the meantime, the pediatric ENT doctors can help treat your child’s ear infections. We are trained in diagnosing and treating pediatric ear infections, chronic runny nose, recurrent sore throats and snoring. We will discuss with you the best treatments to reduce frequent ear infections, whether it is medication, imaging or surgery. We can place ear tubes to reduce fluid buildup and we can remove tonsils and adenoids.
References
Causes of Hearing Loss in Children
Ear Infection Overview
Ear Infections in Children
FAQs
Why Do Children Have So Many Ear Infections? ›
"Children are more susceptible to ear infections than adults because their
There are multiple causes for recurring (chronic) ear infections, or recurring otitis media, ranging from allergies, sinusitis, ear injuries, and bacterial infections from colds or flu.
Why do kids get more middle ear infections and what is often the solution? ›Kids (especially in the first 2 to 4 years of life) get ear infections more than adults do for several reasons: Their shorter, more horizontal eustachian tubes let bacteria and viruses find their way into the middle ear more easily. The tubes are also narrower, so more likely to get blocked.
Why do kids get ear infections in day care? ›Kids are exposed to a lot of germs
Colds, allergies, and infections all cause mucus and pus to develop, building up in the inner ear. Kids are in school and daycare where they're exposed to a lot of these contagions and haven't yet built up immunity.
The provider may prescribe antibiotics if the infection is caused by bacteria. These medicines may need to be taken for a long time. They can be given by mouth or into a vein (intravenously). If there is a hole in the eardrum, antibiotic ear drops are used.
What age do kids stop getting ear infections? ›Despite your natural concern for the health and comfort of your child, there is good news: Most children will outgrow ear infections by 3 to 5 years of age.
What happens if my child keeps getting ear infections? ›Ear infections are one of the most common complaints in children. When an ear infection lasts a long time or comes and goes, it is considered chronic. Chronic ear infections can cause permanent damage to the ear including hearing loss, which affects speech development.
How do you prevent chronic ear infections in children? ›- Vaccinate your child against the flu. ...
- It is recommended that you vaccinate your child with the 13-valent pneumococcal conjugate vaccine (PCV13). ...
- Wash hands frequently. ...
- Avoid exposing your baby to cigarette smoke. ...
- Never put your baby down for a nap, or for the night, with a bottle.
How often do kids get ear infections? 90% of children have at least 1 ear infection. Frequent ear infections occur in 20% of children. Ear infections are the most common bacterial infection of young children.
Can kids go back to daycare with ear infection? ›Ear infections are not contagious. Your child can safely return to child care or school after the pain and fever subside. However, he should continue taking the antibiotics as prescribed until the pills or liquid are used up.
Do kids get ear infections from baths? ›
While some children can swim all summer long and not get swimmer's ear, others can develop an outer ear infection after a bath or shower if too much moisture remains in the ear. If your child has a naturally curvy and narrow ear canal, it's more likely water can get trapped after any type of water exposure.
What is the most common cause of ear infection in children? ›Causes. Bacteria or viruses can cause a middle ear infection: Bacteria, like Streptococcus pneumoniae and Haemophilus influenzae (nontypeable) are the two most common bacteria causing middle ear infection. Viruses, like those that cause colds can cause middle ear infection.
Why does my 3 year keep getting ear infections? ›Children are more likely to suffer from ear infections than adults for two reasons: Their immune systems are underdeveloped and less equipped to fight off infections. Their eustachian tubes are smaller and more horizontal, which makes it more difficult for fluid to drain out of the ear.
Why does my 5 year old keep getting ear infections? ›The most likely cause of persistent ear infection in children is chronic otitis media. Persistent ear problems in children often happen because there is a build-up of fluid in the inner ear. The Eustachian tube isn't draining this fluid properly.
How many ear infections are too many? ›How many ear infections are too many? One or two ear infections a year is fairly normal — never fun to handle, but normal nonetheless. However, if your child has three episodes in six months or four in a year (with at least one in the past six months), then you've got a case of recurrent ear infections.
Does cold air cause ear infections? ›Contrary to popular belief, cold weather does not cause ear infections. An ear infection is caused by bacteria in the upper respiratory system that travels up the Eustachian tube into the middle ear. Even though cold weather doesn't cause the issue, it can make symptoms more pronounced.
What is the best antibiotic for an ear infection? ›Amoxicillin is a first-choice antibiotic for adults with otitis media. It's typically taken by mouth 2 to 3 times daily for 5 to 10 days. Your symptoms should start to improve within 3 days after starting it. Augmentin is a common alternative if amoxicillin isn't effective.
How many ear infections before tubes? ›Ear tubes may be used to prevent new infections. Your doctor may recommend them if your child has three or more distinct episodes of infection in six months or four or more episodes in a year.
What allergies cause ear infections? ›Nasal allergies, or allergic rhinitis, can cause ear pain. Allergens trigger the release of histamine and other chemicals in the body. These chemicals cause irritation in the nose and sinuses, which can affect the ear and cause ear pain. In some cases, swelling and a buildup of fluid can also cause ear infections.
Can you do anything to 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.
How do you prevent future ear infections? ›
- Prevent common colds and other illnesses. ...
- Avoid secondhand smoke. ...
- Breast-feed your baby. ...
- If you bottle-feed, hold your baby in an upright position. ...
- Talk to your doctor about vaccinations.
Ear infections are the most common illness in children. They occur when fluid builds up in the middle ear and then becomes infected. Ear infections are most common in children ages 6-24 months, but may occur at any age. The medical term for ear infections is “otitis media,” which means inflammation of the middle ear.
Why does my 6 year old keep getting ear infections? ›If your child gets repeated infections—more than three in six months, or four in a year—or has one or two severe infections that are tough to treat, talk to your doctor. Your child may be a candidate for ear tubes.
Should kids stay out of pool with ear infection? ›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.
Can a child fight an ear infection? ›Antibiotics work most of the time to treat ear infections caused by bacteria. But they won't treat ear infections caused by viruses. No matter what causes the infection, most children 6 months and older won't need antibiotics. Up to 80 out of 100 ear infections get better on their own, while 20 out of 100 don't.
Can bad hygiene cause ear infections? ›We conclude from these clinical results that there is no statistically meaningful relationship between the oral hygiene and the middle ear.
Does putting cotton in your ears help ear infection? ›When the ear starts to hurt or feels blocked, typically you may try to clean the ear with cotton swabs (Q-tips) or irrigate it with solutions like hydrogen peroxide. Unfortunately, this tends to make the issue worse. As the swelling in the ear canal worsens, the pain may become severe.
Can you smell a child's ear infection? ›An ear infection can cause drainage and you might notice a bad smell. Children with ear infections may have these signs and symptoms as well: ear pain. tugging on the ear.
What is most likely a direct cause of an ear infection? ›Middle ear infections, which are the most common ear infections, are caused by a bacterium or virus that infects fluid that builds up in the middle ear. Ear infections are often a direct result of a common cold, allergy or other upper respiratory illness.
Why did I have so many ear infections when I was younger? ›A young immune system: A child's immune system is young and not as strong as that of an adult. That can make it difficult fight off infection.
Is Covid 19 caused by ear infections? ›
In general, COVID-19 has not been associated with ear infections, and generally these types of infections do not share a great deal of common symptoms.
How many ear infections is too many in a year? ›How many ear infections are too many? One or two ear infections a year is fairly normal — never fun to handle, but normal nonetheless. However, if your child has three episodes in six months or four in a year (with at least one in the past six months), then you've got a case of recurrent ear infections.
Are ear infections common this time of year? ›While it's common that the flu goes around during the winter months, ear infections also seem to occur more often during this time of year.
How do you prevent ear infections in children? ›- Vaccinate your child against the flu. ...
- It is recommended that you vaccinate your child with the 13-valent pneumococcal conjugate vaccine (PCV13). ...
- Wash hands frequently. ...
- Avoid exposing your baby to cigarette smoke. ...
- Never put your baby down for a nap, or for the night, with a bottle.
You can help prevent ear infections by doing your best to stay healthy and keep others healthy. Make sure your child is up to date on vaccinations and gets a flu vaccine every year. The pneumococcal vaccine protects against Streptococcus pneumoniae, a common cause of middle ear infections. Clean your hands.
What does crackling in your ear mean? ›The eustachian tube, which is a tiny tube in your ear, is the cause of these noises. The crackling occurs when these mucus-lined passageways open, allowing air and fluid to circulate and equalize the pressure in your ears.
Do ear infections go away on their own? ›The body's immune system can often fight off middle ear infection on its own. Antibiotics are sometimes not needed for middle ear infections. However, severe middle ear infections or infections that last longer than 2–3 days need antibiotics right away.
How long do ear infections last? ›Most ear infections clear up within 3 days, although sometimes symptoms can last up to a week. If you, or your child, have a high temperature or you do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better.
When should kid get ear tubes? ›The average age for ear tube insertion is 1 to 3 years, but babies can get ear tubes as young as 6 months. Ear tubes are generally extruded (forced out naturally as the child's ear grows) from the ear drum anywhere from six to 18 months after insertion.
When does a child need tubes in ears? ›Dunham and other doctors at CHOP will recommend ear tubes if your child: Has had three or more ear infections within six months, especially if they retain fluid in between the episodes. Is suffering from hearing loss caused by the persistent build-up of fluid in the middle ear (otitis media with effusion).
What age is ear infection most common? ›
Ear infections are the most common illness in children. They occur when fluid builds up in the middle ear and then becomes infected. Ear infections are most common in children ages 6-24 months, but may occur at any age. The medical term for ear infections is “otitis media,” which means inflammation of the middle ear.
Does hydrogen peroxide help ear infections? ›Hydrogen peroxide is a solution (liquid) that can be used to treat ear infections or the build-up of wax. It is generally safe to use in all ears. Do not use if it irritates you or causes pain.
What percentage of ear infections go away? ›But they won't treat ear infections caused by viruses. No matter what causes the infection, most children 6 months and older won't need antibiotics. Up to 80 out of 100 ear infections get better on their own, while 20 out of 100 don't.