Fact Sheets : Ear Infections (Otitis Media) In Children

The symptoms of an ear infection include:

  • Earache
  • Irritability, or increased crying or fussiness
  • Discharge from the ear
  • Infants who cannot yet speak may tug at or rub their ears
  • And/or fever

Why ear infections occur so frequently in children

Otitis Media occurs when an infection develops behind the eardrum, in the area known as the "middle ear". Normally, the middle ear is filled with air, allowing the eardrum to vibrate and therefore transmit sounds to the brain. But sometimes when a person has a cold or other respiratory illness, the middle ear fills with fluid. In adults, this fluid usually drains naturally through the "Eustachian Tube", which extends downward from the middle ear to the back of the nose. But in young children the EustachianTube often drains poorly, because it isn't mature or strong enough, and because it extends horizontally rather than downward. As a result, fluid can build up in the middle ear. Bacteria from the nasal passages can easily invade this fluid and cause an ear infection. This is why Otitis Media occurs so often during or shortly after a cold, when the nose is congested or stuffy.

The "ear infection prone child"

There are a number of factors that may contribute to a tendency towards repeated ear infections. These include:

  • A history of ear infections in the family
  • Regular exposure to tobacco smoke
  • A history of allergies
  • Exposure to many other children such as in a day-care setting
  • A history of having been bottle-fed, rather than breastfed during infancy
  • Putting the baby to bed with a bottle or with a pacifier
  • Facial deformities associated with cleft palate or Down's syndrome
  • Onset of a first ear infection before 6 months of age

How middle ear infections are treated: The role antibiotics play

Otitis Media is usually treated with antibiotics that are taken by mouth, prescribed for a total of five to ten days, depending on the antibiotic selected. Symptoms should start to improve within 48 hours after starting the antibiotics. In the meantime, if needed, acetaminophen may be given for relief of pain or fever, in doses appropriate for the child's age and weight. If the child is still suffering from symptoms more than 48 hours after antibiotic treatment has started, the child should be re-examined by the doctor to determine if the antibiotic needs to be changed.

The use of antibiotics to treat ear infections has been questioned recently by those who argue that some ear infections, like colds, are caused by viruses rather than bacteria. Antibiotics are not effective in treating viruses. But in the case of Otitis Media, it's often impossible to determine whether the infection is caused by a virus or a bacteria, or whether the infection will heal without the use of antibiotics. However, it is known that roughly one third of all ear infections do not heal on their own without the use of antibiotic treatment. Untreated Otitis Media has the potential to develop serious infectious complications if bacteria spread including: meningitis, infection to other bones in the ear and spread through the blood to other areas of the body. It is because of these serious risks that antibiotic treatment is strongly recommended for most children with Otitis Media.