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Health Information For Parents
Ear infections happen when viruses or bacteria get into the middle ear, the space behind the eardrum. When a child has an ear infection (also called otitis media), the middle ear fills with pus (infected fluid). The pus pushes on the eardrum, which can be very painful.
Ear pain is the main sign of a middle ear infection. Kids also might have:
Older kids can complain about ear pain, but a younger child might just tug at the ear or be fussy and cry more than usual.
If the pressure from the fluid buildup gets high enough, it can rupture the eardrum, with fluid draining from the ear. This is a common cause of ruptured eardrums in children. A child with a ruptured eardrum might feel dizzy or nauseated, and have ringing or buzzing in the ear.
A middle ear infection usually happens because of swelling in one or both of the eustachian tubes (which connect the middle ear to the back of the throat). The tubes let mucus drain from the middle ear into the throat.
A cold, throat infection, acid reflux, or allergies can make the eustachian tubes swell. This blocks the mucus from draining. Then,
grow in the mucus and make pus, which builds up in the middle ear.
When doctors refer to an ear infection, they usually mean otitis media rather than swimmer’s ear (or otitis externa). Otitis media with effusion is when noninfected fluid builds up in the ear. It might not cause symptoms, but in some kids, the fluid creates a sensation of ear fullness or “popping.”
Kids (especially in the first 2 to 4 years of life) get ear infections more than adults do for several reasons:
Other things that can put kids at risk include secondhand smoke, bottle-feeding, and being around other kids in childcare. Ear infections are more common in boys than girls.
Ear infections are not contagious, but the colds that sometimes cause them can be. Infections are common during winter weather, when many people get upper respiratory tract infections or colds (a child with an ear infection also might have cold symptoms, like a runny or stuffy nose or a cough).
Middle ear infections often go away on their own within 2 or 3 days, even without any specific treatment.
In some cases, an infection can last longer (with fluid in the middle ear for 6 weeks or longer), even after antibiotic treatment.
Doctors will do a physical exam and examine the ear. They use an otoscope, a small instrument similar to a flashlight, to see the eardrum.
To treat an ear infection, health care providers consider many things, including:
The type of otitis affects treatment options. Not all kinds need to be treated with antibiotics. Because most ear infections can clear on their own, many doctors take a “wait-and-see” approach. Kids will get medicine for pain relief without antibiotics for a few days to see if the infection gets better.
Antibiotics aren’t routinely prescribed because they:
Also, overuse of antibiotics can lead to antibiotic-resistant bacteria, which are much harder to treat.
If a doctor does prescribe antibiotics, a 10-day course is usually recommended. Kids age 6 and older who don’t have a severe infection might take a shortened course for 5 to 7 days.
Some children, such as those with recurrent infections and those with lasting hearing loss or speech delay, may need ear tube surgery. An ear, nose, and throat doctor will surgically insert tubes (called tympanostomy tubes) that let fluid drain from the middle ear. This helps equalize the pressure in the ear.
Antibiotics can be the right treatment for kids who get a lot of ear infections. Their doctors might prescribe daily antibiotics to help prevent future infections. And younger children or those with more severe illness may need antibiotics right from the start.
The “wait-and-see” approach also might not apply to children with other concerns, such as cleft palate, genetic conditions such as Down syndrome, or other illnesses such as immune system disorders.
With or without antibiotic treatment, you can help to ease discomfort by giving your child acetaminophen or ibuprofen for pain and fever as needed. Your doctor also may recommend using pain-relieving ear drops as long as the eardrum isn’t ruptured.
Fluid buildup in the middle ear also blocks sound, which can lead to temporary hearing problems. Kids having a problem might:
In kids who have otitis media with effusion, the fluid behind the eardrum can block sound, so mild temporary hearing loss can happen, but might not be obvious.
A child whose eardrum has ruptured might have ringing or buzzing in the ear and not hear as well as usual.
Some lifestyle choices can help protect kids from ear infections:
Very rarely, ear infections that don’t go away or severe repeated middle ear infections can lead to complications. So kids with an earache or a sense of fullness in the ear, especially when combined with fever, should be seen by their doctors if they aren’t getting better after a couple of days.
Other things can cause earaches, such as teething, a foreign object in the ear, or hard earwax. Your doctor can find the cause of your child’s discomfort and treat it.
Many kids get middle ear infections (otitis media). Doctors may suggest ear tube surgery for those with multiple infections or a hearing loss or speech delay.
Swimmer’s ear is an infection of the ear canal caused by many types of bacteria or fungi. Find out how to prevent it.
An earache requires a visit to the doctor’s office. Here’s what to do if your child complains of ear pain.
Hearing problems can be overcome if they’re caught early, so it’s important to get your child’s hearing screened early and checked regularly.
A “popped” eardrum is more than just painful – it can sometimes lead to hearing loss. Learn about ruptured eardrums and how to prevent them.
Ear injuries not only can affect a child’s hearing, but sense of balance too. That’s because our ears also help keep us steady on our feet.
Earwax helps protect the eardrum and fight infection. Parents shouldn’t attempt to remove earwax at home, as doing so risks damage to the ear canal and, possibly, a child’s hearing.
Ototoxicity is when a person develops hearing or balance problems. Learn about this side effect of taking certain medicines.
That weird ear-popping sensation is a normal part of air travel. Here’s how to help equalize the air pressure in your child’s ears to prevent or decrease ear pain.
Swimmer’s ear is an infection of the ear canal that can be caused by different types of bacteria or fungi. Find out how to prevent or treat it.
How do you take care of your ears? Find out in this article for kids.
A middle ear infection happens when germs like bacteria and viruses get in your middle ear and cause trouble. Read this article to find out more.
You swam! You splashed! And now you have it: swimmer’s ear.
Hearing is their main job, but it’s not all your earsÂ do. Find out all about them in this body basics article for teens.
Hearing impairment occurs when there’s a problem with or damage to one or more parts of the ear. Find out its causes and what can be done to help correct it.
Antibiotics are powerful medicines that can help kids feel better — but only when they have certain illnesses. Find out if an antibiotic is right for your child.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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