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Listen Up—It May Be An Ear Infection

Published on Feb 28, 2018
Medically reviewed by Alison Mitzner, MD

What do you think is one of the most common reasons why parents bring their kids to the doctor? If you answered a cough or sore throat, you’d be wrong. The answer is an ear infection, often located in the middle part of the ear. About 75% of kids will have at least one ear infection before their third birthday. Surprising, right?

While ear infections are quite common, especially for children, there may be things you can do to lower your child’s risk. Scroll down to read more about what causes ear infections, how to spot them, and what you can do to reduce the risk.

What are the causes?

An ear infection is commonly caused by bacteria often following another illness, such as a cold, sore throat, or respiratory infection. Mucous membranes become inflamed and cause fluid to build up behind the eardrum. There is also inflammation and swelling of the middle part of the ear.

Ear diagram

Ear pain, fever, and short-term muffled or trouble hearing are often the end result because of all the fluid behind the eardrum that is infected.

Children are more likely to get an ear infection than adults because:

  • The size and shape of the tubes connecting the upper throat to the middle ear, called Eustachian tubes, are shorter and at less of an angle so fluid doesn’t drain as well.
  • They have less mature immune systems.

What are the different types of ear infections?

The most common type of ear infection is called acute otitis media (AOM). As mentioned above, this typically causes pain and fever. Other types include:

  • Otitis media with effusion (OME). This happens when the fluid remains behind the eardrum even after the acute infection clears up. A child may not have symptoms but the doctor can see the fluid when looking inside the ear with an otoscope (instrument used to check inside ears).
  • Chronic otitis media with effusion (COME). This happens when the fluid is trapped for a long time or keeps returning. COME can possibly affect hearing or make it hard to fight off new infections.

How can you tell if your child has an ear infection?

If your child is too young to tell you they are in pain, it helps to look for these signs that may point to an ear infection:

  • Tugging or pulling their ear(s)
  • Fussiness or crying
  • Trouble with sleeping, hearing, or balance
  • Fever, mainly in infants and younger children
  • Fluid draining from the ear

What are the treatments?

Not all earaches are caused by an infection. It may be congestion from a sore throat or tooth pain, for example. It is important to see your doctor to determine the cause of the ear pain. If an ear infection is diagnosed, not all infections need antibiotic treatment. Many resolve on their own and antibiotics won’t help if it is due to a virus.

Depending on your child’s age and how bad the infection is, your doctor may wait a couple of days before starting on antibiotics to see if the infection clears up on its own. Many children feel better after a couple of days of fever and pain medication only.

If your doctor does prescribe an antibiotic, make sure to give it to your child for the full length of time prescribed—even if you see an improvement before then. Doing so will help make sure the infection is completely cleared up. When not taken as directed, the bacteria may have more of a chance to start growing again and become harder to treat. This could lead to antibiotic resistance, where the bacteria no longer respond to treatment.

What can you do to lower your child’s risk of an ear infection?

Here are some tips to help reduce the risk of ear infections in your child:

  • Get all recommended vaccines, including the flu and pneumococcal vaccines. Research shows that children who are vaccinated have fewer ear infections compared to children who are not vaccinated.
  • Breastfeed your newborn for at least 6 months, if possible. Antibodies in the mother’s breast milk help protect against ear infections.
  • Don’t bottle feed when your baby is lying down.
  • Limit pacifier use.
  • Avoid secondhand smoke.
  • Wash his or her (and your) hands often to help reduce the risk of catching a cold.

[1] [2] [3] [4] [5] [6]


  • 1. National Institutes of Health. National Institute on Deafness and Other Communication Disorders. Ear Infections in Children. Accessed January 29, 2018.
  • 2. National Library of Medicine. PubMed Health. Middle ear infection: Overview. Accessed January 31, 2018.
  • 3. National Institutes of Health / U.S. National Library of Medicine. MedlinePlus. Earache. Accessed February 23, 2018.
  • 4. National Institutes of Health / U.S. National Library of Medicine. MedlinePlus. Ear Infections. Accessed February 21, 2018.
  • 5. Mayo Clinic. Ear infection (middle ear). Accessed January 31, 2018.
  • 6. U.S. Food and Drug Administration. Combating Antibiotic Resistance. Accessed February 28, 2018.
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