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Middle Ear Infections in Children

Middle ear infections are the most common cause of earaches in children. According to the National Institute on Deafness and Other Communication Disorders, 75 percent of youngsters have had at least one infection by the time they are 3 years old.

The infections develop when bacteria or viruses infect fluid that builds up in the middle ear. The buildup is caused by congestion that blocks the natural channel (eustachian tube) that allows air and fluid to go in and out of the middle ear. 


A child with an ear infection may have many symptoms. Some of them are:

  • Pain. An older child can tell you about ear pain, but a younger one may just get irritable and cry. This may be more noticeable during feedings, because sucking and swallowing may cause painful pressure changes in the middle ear. Your child may also have less of an appetite and may have trouble sleeping because lying down can increase the pain.

  • Fever. The child may have no fever, or may have a temperature ranging from slightly elevated (100 degrees Fahrenheit) to quite high (greater than 102 degrees Fahrenheit).

  • Ear drainage. A yellow or white fluid, possibly blood-tinged, may drain from the child's ear. This generally indicates that the eardrum has ruptured.

  • Difficulty hearing. A child with an ear infection may have trouble hearing, and the problem could continue for several weeks after the infection clears. Watch for the following behavioral changes that may signal that the youngster isn't hearing well: talking softly, saying "huh?" or "what?" more than usual, not responding to sounds, having more trouble understanding language in noisy rooms, and turning up the television or radio louder than usual. Contact your pediatrician if your child is having trouble hearing. Being able to hear and listen to others talk helps a child learn speech and language. This is especially important during the first few years of life.


Most ear infections clear up on their own. Pain usually subsides within a day or two. Clearing fluid from the ear may take up to two weeks, experts say. If your pediatrician prescribes an antibiotic, however, make sure you give the youngster the entire prescription. If you stop the medication too soon, some bacteria could still be present and cause the problem to recur. 

To relieve the child's pain, the doctor may recommend an over-the-counter, nonaspirin medicine, such as acetaminophen or ibuprofen, and suggest putting warm (not hot) compresses against the youngster's ears. 

You should also keep your child sitting up as much as possible; this may help reduce pressure on the middle ear and ease pain. An extra pillow at night may also help an older child. Never use pillows in a crib. 

Preventive treatment

To prevent chronic ear infections, your pediatrician may recommend that your child take antibiotics for an extended period of time. These drugs are usually prescribed at a low dosage and are taken once or twice a day. Although the child may still suffer from infections, they'll probably occur less often. In children with allergies, daily antihistamines or decongestants may decrease the incidence of infection. 

Another type of preventive treatment is an outpatient operation in which small tubes are inserted through the eardrums. This maintains equal pressure on both sides of the eardrum and enables the ears to drain.