Ear infection in children

Ear infections are fairly common in children and can also occur in adults. The middle ear or the outer ear may be infected.

The middle ear is the pea-sized area behind the eardrum. Middle ear infections are more common in winter months when colds and flu are more likely. The tubes that connect the ear to the nasal passages are shorter and more narrow in children. With a cold, these tubes become swollen. The swelling can block these small tubes causing fluid build-up in the middle ear. If infections last too long or occur too often, they can lead to rupture of the eardrum, scarring, and permanent hearing loss.

Symptoms of a middle ear infection include:

• pain (mild ache to severe throbbing)
• sleeplessness
• rubbing or pulling on the ear
• fever
• decreased sensitivity to sounds or
• a sense of fullness in the ear

Because an ear infection often occurs with a cold, other common symptoms are runny or stuffy nose, coughing and loss of appetite. When fluid builds up in the middle ear, it can cause a feeling of dizziness or loss of balance. This build-up of fluid puts pressure on the eardrum and can cause it to tear or rupture. The ear may drain a thick yellowish-white fluid.

Most middle ear infections respond well to antibiotics. However, recent studies have shown that not all middle ear infections need antibiotics. Ask your healthcare provider to recommend an over-the- counter medication to relieve the ear pain. Your provider may also prescribe ear drops containing an anesthetic to decrease the pain locally. A warm moist washcloth over the ear may also help reduce the discomfort. Extra cuddling and activities like reading a book can help comfort a child.

When the eardrum bulges too much, treatment may also include a small incision to relieve pressure. If someone has repeated episodes, other treatments may be considered. One fairly common procedure is to place tiny tubes in the eardrum. The tubes assist in preventing fluid build-up. The tubes usually fall out by themselves in 6 to 12 months. With ear tubes, swimming should be limited to surface swimming in chlorinated pools. It is best to avoid swimming in lakes and ponds. Avoid underwater swimming or diving. Normal bathing and showering is okay. Try to keep soapy water and shampoo out of the ears, but this is not a cause for concern.

While there are no specific immunizations against viral respiratory infections or bacteria that cause middle ear infections, there are a few things that can help avoid repeated ear infections. Children who have been breast-fed have fewer ear infections. Infants that nurse from a bottle should not be lying down when they are fed. Smoking in the home or in vehicles should be avoided because exposure to secondhand smoke increases the risk of middle ear infections. Try to limit contact with anyone that has a cold, sore throat, or the flu. Be sure to get the recommended vaccinations for your child to help prevent infections they may be exposed to.

Outer ear infections are even more common than middle ear infections. They occur in the canal outside the eardrum or in the external ear itself. One cause is water that stays too long in the canal. That is why it is sometimes called "swimmer's ear." Carefully dry the ear canals after swimming to help prevent swimmer's ear.

Another cause of outer ear infections is putting a foreign object into the ear. Irritation from the object can lead to an infection. The entire canal could become blocked by pus. The outer ear may be tender to touch and there may be a hearing loss. The best way to prevent outer ear infections is to keep all objects out of the ear, including fingers and cotton swabs, and to keep your ears as dry as possible.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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