What to know about ear infections in kids, children, toddlers and babies

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Kids and ear infections: Causes and treatment tips

An ear infection, also known as otitis media, occurs when the middle ear becomes inflamed due to bacteria or viruses trapped behind the eardrum. It often happens after a cold or upper respiratory infection, when fluid builds up in the eustachian tubes (which connects the ear to the throat), creating the perfect environment for germs to thrive. They’re more common during cold and flu season.

In this blog:

• What is an ear infection?
• What causes ear infections in kids?
• Ear infections in babies, toddlers and young children
• What are ear infection symptoms in kids?
• What does an ear infection look like in babies and toddlers?
• How are ear infections treated?
• Home remedies for kids’ ear infections
• Are frequent or recurring ear infections bad for kids?
• Can ear infections be prevented in kids?

What is an ear infection?

A kids’ ear infection, also called pediatric otitis media, is an infection in the middle ear that occurs when fluid builds up behind the eardrum, often due to bacteria or viruses. It’s especially common in children because their eustachian tubes, which help drain fluid from the ears, are shaped differently and more easily blocked.

Ear infections are one of the most common childhood infections and can occur in one ear at a time or both ears at the same time. Ear infections can be painful, although it can be hard for babies or toddlers to express their discomfort or communicate ear infection symptoms. Kids and adults can develop an ear infection at any time of the year. Learn more about ear infections or otitis media and treatment and care.

What causes ear infections in kids?

Ear infections are typically caused by bacteria and viruses. They tend to be more common in kids than adults because of differences in a child’s ear anatomy and immune system. In kids, the tube that connects the middle ear to the throat (called the eustachian tube) is shorter, narrower and more horizontal, which makes it easier for bacteria and viruses to get trapped in the middle ear.

Kids’ developing immune systems are also less able to fight off infections than adults’.

Other factors that can cause or contribute to kids’ ear infections include allergies, poor air quality (like exposure to cigarette smoke), swimming (trapped water in the ear can lead to infections) and changes in air pressure, which can affect fluid drainage in the ears.

Ear infections in babies, toddlers and young children

How babies, toddlers and young children get ear infection may vary and depend on a variety of factors. Common ways ear infections develop in babies and toddlers:

• Pacifier use may cause more ear infections - Babies and toddlers who use a pacifier regularly are a little more likely to develop ear infections. While we’re not sure exactly why, it’s possible because sucking on a pacifier changes the pressure in the throat and ears. In addition, pacifiers often touch the floor and other surfaces that might spread germs.
• Bottle-fed babies may be prone to ear infections - Similarly, babies who are bottle-fed tend to have more ear infections than those who are breastfed, especially if they take a bottle while lying down. Breast milk may also contain antibodies that help reduce the risk of ear infections.

What are ear infection symptoms in kids?

While pain in and around the ear is a telltale sign of an ear infection, other symptoms can include:

• Cough
• Ear drainage
• Fever
• Irritability
• Nasal discharge
• Poor appetite
• Sleeplessness 

Having an ear infection may cause a cough, fever, irritability, nasal discharge and more. Similarly, showing some of these ear infection symptoms may also be an early sign that an ear infection is developing, Signs and symptoms can show up at different times and before or after ear pain or ear infections. Seek medical attention or get into your doctor if your baby, toddler or kid has ear infection symptoms. Don’t wait for more pain or symptoms to show up!

What does an ear infection look like in babies and toddlers?

Children who aren’t old enough to speak might be fussier or seem to have trouble hearing or responding to quiet sounds.

Other ear infection signs may include:

• Crying and irritability
• Difficulty sleeping
• Fever
• Fluid draining from the ear
• Loss of balance
• Tugging or pulling the ear (although it’s not always a reliable symptom by itself)

How are ear infections treated?

Some ear infections might clear on their own with close follow-up. If a kids’ ear infection symptoms last more than 2-3 days without improvement or if the child develops a fever of 102°F (38.9°C) or higher, call your child’s pediatrician.

Antibiotics are typically used to treat kid ear infections. Seeking timely medical attention can prevent complications and ensure your child receives proper treatment for their ear infection, especially if antibiotics or further intervention are needed.

For children with frequent or severe ear infections, doctors might recommend ear tubes (tympanostomy tubes) to help drain fluid and prevent future infections. Always consult a pediatrician to determine the appropriate treatment for kids’ ear infections.

Home remedies for kids’ ear infections

You can take steps at home to help relieve ear pain in kids:

• Treat cold symptoms. Ear infections often follow a cold or respiratory infection, so managing cold and cold symptoms can help. See tips for managing cold symptoms.
• Alternate hot and cold compresses. Heat helps the muscles in the ear canal relax and cold can reduce pain and inflammation.
• Try over-the-counter (OTC) pain relievers. OTC medications like ibuprofen and acetaminophen can help relieve your child’s pain. See our guide for OTC medications.
• Change sleeping position. Once a child is old enough move their head freely and has transitioned out of a crib, they can try sleeping on the opposite ear or propping up their head to help fluid drain.

If your child has been prescribed antibiotics like amoxicillin to treat ear infections, be sure to complete the full course as directed to fully clear the infection. Consult your pediatrician if ear infection symptoms don’t improve after a few days of treatment.

Are frequent or recurring ear infections bad for kids?

Frequent ear infections could lead to decreased sensitivity of bacteria to antibiotics if frequent rounds of antibiotics are used, making infections in the future more difficult to treat. Hearing loss is a rare, but potentially permanent, residual of frequent ear infections. Repeated ear infections may also lead to speech, language and learning delays.

Your doctor may suggest ear tubes if your child has frequent ear infections or persistent fluid in their ears. Ear tubes improve airflow and prevent fluid buildup in the middle ear.

Can ear infections be prevented in kids?

While not all ear infections can be prevented, here’s how to reduce your child’s risk:

• Get recommended vaccines. Ear infections typically follow upper respiratory infections. Vaccinated children get fewer ear infections than children who aren’t vaccinated.
• Wash hands often. Washing hands helps prevent germs from spreading and keep your child from getting sick in the first place.
• Avoid cigarette smoke. Young children who are around smoking tend to have more ear infections.
• Avoid bottles at bed or nap time. Drinking from a bottle while lying down may contribute to ear infections.
• Limit exposure to sick kids. Do your best to avoid spending time with other kids when they’re sick.

Our Pediatricians can help with ear infections

Our team of pediatricians can help children with ear infections. Find a primary care pediatrician.