Pediatrician answers common questions about ear infections in infants and toddlers

Published: June 1, 2018 | Updated: July 30, 2020

My son had his first ear infection when he was 8 months old. We were on vacation in Florida, his first beach vacation, when he spiked a fever of 104. Prior to this, he hadn’t had any ear infections or colds. We knew he had teeth coming in, so we chalked his fever up to teething. But as that first day of vacation wore on, we knew something more was going on. We ended up at the emergency room, where he was diagnosed with an ear infection. The antibiotics worked, and we had a great week in Florida.

Fast forward a few weeks: We are at the pediatrician’s office for another ear infection. And then four more times after that, with an ear infection being diagnosed either at the Norton After Hours Pediatric Care or our pediatrician’s office. That’s six ear infections in seven months! At that point, our pediatrician recommended we see an ear, nose and throat (ENT) specialist — and ear tubes were placed a few weeks later.

If you’re a new parent or you’ve noticed your child has been experiencing recurrent ear infections, here are four questions to ask your pediatrician:

1. How many ear infections are too many?
2. What is causing my infant or toddler’s ear infection?
3. How can I treat my child’s ear infection?
4. Are there preventive measures I can take to reduce my child’s risk of getting an ear infection?

How many ear infections are too many?

According to Becky S. Carothers, M.D., pediatrician at Norton Children’s Medical Group – Broadway, children who experience three or more ear infections during a six-month period, or four within a year, may be a candidate for ear tubes due to chronic or recurrent ear infections.

What is causing my infant or toddler’s ear infection?

Ear infections can be caused by bacteria or a virus, due to fluid behind the eardrum not draining properly. Allergies and colds can be the culprit, blocking the Eustachian tube, which causes fluid to become trapped in the middle ear. When this happens, the fluid becomes infected, resulting in an ear infection diagnosis.

How can I treat my child’s ear infection?

“A classic ear infection, also called an acute ear infection, can typically be treated in a healthy child with acetaminophen or ibuprofen for pain relief, as most ear infections can get better without an antibiotic,” said Dr. Carothers.

She noted that an antibiotic would be appropriate treatment if:

• Symptoms do not improve after 48 to 72 hours
• Your child is 6 months or younger
• Your child is 6 months to 2 years old and is experiencing severe symptoms with a diagnosis of suspected or certain acute infection
• Your child is between ages 2 and 12 and is experiencing severe symptoms with a diagnosis of certain acute infection

If you believe your child is experiencing an ear infection, talk to your pediatrician. He or she can recommend the best course of action.

Are there preventive measures I can take?

Luckily, there are ways parents can help reduce the onset of an ear infection.

“Preventive measures include breastfeeding, practicing good hand hygiene, creating a healthy environment and staying up to date on immunizations,” said Dr. Carothers.

• Breastfeeding: Breastfeed your baby for six to 12 months if possible. Antibodies in breast milk can help protect against ear infections. If feeding your child with a bottle, ensure you are feeding him or her upright, and keep baby upright for 30 minutes after feeding. Never put an infant or toddler down for a nap or at night with a bottle.
• Hand hygiene: Wash hands frequently. Hand-washing helps prevent the spread of cold and flu germs, which can cause the bacteria or viruses that lead to an ear infection.
• Healthy environment: Avoid secondhand smoke. Protect infants and toddlers from secondhand smoke. Exposure to cigarette smoke can make ear infections happen more often. Avoid or limit exposing your child to people with a cold or flu. If your child attends day care or is around someone who is sick, wash your and your baby’s hands often to avoid the spread of germs.
• Immunizations: Keep your infant and toddler up to date on all immunizations, including the pneumococcal vaccine and a flu shot every year (for babies 6 months and older).