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Middle Ear Infections (Otitis Media)

What Are Middle Ear Infections?

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.

What Are the Signs & Symptoms of an Ear Infection?

Ear pain is the main sign of a middle ear infection. Kids also might have:

  • a fever 
  • trouble eating, drinking, or sleeping. Chewing, sucking, and lying down can cause painful pressure changes in the middle ear.

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.

How Do Ear Infections Happen?

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,

How Can I Help My Child Feel Better?

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.

Can Ear Infections Affect Hearing?

Fluid buildup in the middle ear also blocks sound, which can lead to temporary hearing problems. Kids having a problem might:

  • not respond to soft sounds
  • need to turn up the TV or radio
  • talk louder
  • seem inattentive at school

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.

Can Ear Infections Be Prevented?

Some lifestyle choices can help protect kids from ear infections:

  • Breastfeed infants for at least 6 months to help to prevent the development of early episodes of ear infections. If a baby is bottle-fed, hold the baby at an angle instead of lying the child down with the bottle.
  • Prevent exposure to secondhand smoke, which can increase the number and severity of ear infections.
  • Parents and kids should wash their hands well and often. This is one of the most important ways to stop the spread of germs that can cause colds and, therefore, ear infections.
  • Keep children's immunizations up to date because certain vaccines can help prevent ear infections.

When Should I Call the Doctor?

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.

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