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Between ages 2 and 4 years, kids are especially vulnerable to middle ear infections (otitis media). When the space behind the eardrum is infected by a virus or bacteria, inflammation flares and fluid builds up, adding pressure and causing pain.
Older kids can tell you when their ear hurts. Babies, infants and younger children will cry more than usual, be extra fussy and often tug at their ear.
Middle ear infections often go away in a few days without any specific treatment.
A child is more likely to get a middle ear infection because the eustachian tubes that run from behind the eardrums to the throat are shorter, narrower and more horizontal until they grow more.
The adenoids — tissue behind the nose that can become enlarged in young children — can interfere with the eustachian tube openings. All that makes the eustachian tubes vulnerable to getting blocked, limiting their ability to equalize air pressure and drain fluids. Germs can flourish in such an environment.
Secondhand smoke, bottle-feeding and being around other kids in day care raise the risk of ear infections.
An ear infection is not contagious, but the upper respiratory infection that causes it can be. Ear infections are common during winter weather, when many are getting colds and other respiratory infections.
In addition to ear pain, some may have:
The fluid buildup and pressure can be enough to rupture the eardrum. If the eardrum is perforated, the built-up fluid will drain and may be noticeable. A child with a ruptured eardrum might feel dizzy or nauseated and have ringing or buzzing in the ear. Any hearing loss will start to return once the eardrum heals.
Call your pediatrician or other health care provider if your child has an earache or a sense of fullness in the ear, especially when combined with a fever. Home care is typically fine for helping your child through an ear infection, but keep your medical provider informed as frequent ear infections can cause permanent damage.
Permanent hearing loss can result from a chronic infection in the middle ear. Recurring infections over time can cause permanent damage to the eardrum, the bones of the middle ear or the hearing nerve.
An ear infection isn’t the only cause of earaches. Teething, something stuck in the ear or hardened earwax can all cause an earache. A medical professional can determine the cause and provide a treatment.
A middle ear infection is different from swimmer’s ear (otitis externa), an infection of the ear canal on the outside of the eardrum. Symptoms of swimmer’s ear include itching in the ear canal, slight redness in the ear or some drainage.
The type of ear infection, its severity, the child’s age and how often the child gets ear infections all influence the course of treatment.
Ear infections don’t always need antibiotics. Often the ear infection will clear up on its own with medicine for pain relief for a few days. Antibiotics won’t treat a virus, won’t help drain fluid in the middle ear and typically don’t do much for pain.
To ease discomfort, child-strength acetaminophen or ibuprofen can help with pain and fever. Discuss with your child’s health care provider, who may also recommend pain-relieving ear drops if the eardrum hasn’t ruptured.
A child who has multiple ear infections that do not get better easily or who seems to have hearing loss or speech delay may be a candidate for ear tube surgery. With two million ear tubes placed in children in the U.S. each year, ear tube surgery is relatively common.