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Ear infections in children

Ear infections are anything but rare in babies and young children.

In fact, ear infections are among the main reasons for visiting the doctor. Fortunately, ear infections are neither contagious nor really serious – they usually clear up within a few days.

However, most children cannot properly express their discomfort in words. Therefore, in some cases, serious complications can occur. Here is some important information about ear infections, including causes, symptoms, diagnoses, risks, and treatment options you should be aware of.

How to recognize, treat and prevent ear infections in toddlers and babies

Ear infections are one of the main reasons for a visit to the doctor in young children. So there is nothing unusual about them. In some countries, up to four out of five children get them, and some children even suffer from ear infections several times a year. Quite often, an ear infection is preceded by a cold, a flu-like infection, or an infection of the sinuses.

The good news is that ear infections are not contagious and generally not dangerous. They usually clear up on their own in a few days. Their symptoms can be relieved with painkillers, which are available without a prescription.

The biggest difficulty in dealing with ear infections is that young children usually literally lack words to describe their discomfort. In certain situations, complications can also arise. Below is a brief overview of ear infections in babies and toddlers, as well as frequently asked questions, information on treatment options, home remedies, risks, preventive measures, and more.

Causes of ear infections

There are different types of ear infections*. Middle ear infections (technically called “otitis media”) are caused by viruses and bacteria. In many cases, an infection triggered by a cold, flu, or respiratory illness spreads from the throat to the ears. Such infections can cause the Eustachian tubes to swell and close. These tubes serve, among other things, to supply fresh air to the inner ear. When they become narrowed or closed, fluids can no longer drain from the ear. With such fluid inclusions, infections are almost inevitable. Fluids can also accumulate as pus behind the eardrum. This puts pressure on the eardrum. Irritation occurs and the eardrum bends and reddens.

Children under the age of three are more susceptible to ear infections because their immune systems are not yet fully developed. Their Eustachian tubes are also significantly shorter than those of adults and therefore close more easily. Some children suffer multiple ear infections per year.

In some cases, some fluid may remain behind the eardrum even after the infection heals. Outer ear infections (technically known as “otitis externa”) usually result from physical damage to the ear, often from drinking too much water or from foreign objects being inserted into the ear.

* Causes of ear infection

Symptoms of ear infections and earaches

Recognizing an ear infection in babies and young children can be problematic, primarily because the children cannot yet speak. Therefore, adults need to pay close attention to other signs.

They should look for the following symptoms, among others, that may indicate a middle ear infection:

  • Ear pain
  • Difficulty sleeping
  • Fatigue and listlessness
  • Restlessness, irritability, and hypersensitivity
  • Pain when sucking or chewing
  • Frequent grasping of the ear
  • Residue in the ear
  • Painful reactions when touching the ear
  • Fever
  • Difficulty with balance
  • Poor hearing or decreased response to sounds
  • Loss of appetite
  • Fluid leakage from the ear

These symptoms usually appear fairly quickly. Sometimes, however, fever and hypersensitivity may be the only signs. An ear infection may also be announced by a cough, runny nose, or sore throat.

Causes, Prevention & Treatment of Ear Infections in Babies and Toddlers

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Home remedies for ear infections

There are a few simple ways you can make life easier for children with an ear infection. Over-the-counter pain relievers are a good place to start, as they relieve ear and other pain and usually bring down a fever.  Warm folded cloths, washcloths, or compresses placed on the ear for 10 to 15 minutes can also help.

Children should drink quite a bit.  The movements involved in swallowing can help reopen the Eustachian tubes to allow fluid to drain down the throat. In addition, you can help fluids drain more easily by lifting the head.
If fluids do run out of the ear, remove them as quickly and carefully as possible. However, do not insert anything into the ear canal – including paper towels or cotton swabs. Also, keep soap, water, shampoo, and the like away from the ear.  Don’t take your child swimming or immerse him or her in water up to the ears when bathing.

Do not give your child antihistamines (allergy medicines) or decongestants – such medicines do not work for earaches and infections. It’s best to simply treat your child’s symptoms for 48 to 72 hours with over-the-counter pain relievers.

When do you need to see a doctor?

Most infections in babies and young children clear up on their own after a few days. If symptoms last longer or even get worse, you should see a doctor right away.
Certain ear infections last for more than a week. Some children are especially susceptible to ear infections and may get them more than once.

Other symptoms or circumstances for which you should see a doctor immediately include:

  • Children younger than six months
  • Changes in hearing or hearing loss
  • High fever
  • Fever lasting more than 48 hours
  • Repeated vomiting
  • Redness or swelling behind the ear
  • Rash
  • Fluid leakage from the ear


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Diagnosis and treatment

Your health care provider will start by asking you a few general questions about your child’s health.  You should be prepared to answer questions like these: How old is the child? What symptoms is your child experiencing? Have there been any problems sleeping recently? Does your child have a cold? Has your child had an ear infection before? How long did the infection last? How severe was it? Does your child have any other risk factors (see below)? Does your child have any other significant pre-existing conditions?

This is followed by an examination of the middle ear and eardrum with an otoscope (ear mirror). This instrument is equipped with a magnifying glass and a light. Often, some air is also blown into the ear. This allows the doctor to check if there are any blockages or fluids behind the eardrum.
A tympanometer may also be used during the examination. Basically, this is a small plug with a built-in speaker and microphone. When inserted into the ear, it can be used to check the internal pressure and flexibility of the eardrum.

You should expect that many doctors will probably not prescribe an antibiotic for your child. Most ear infections clear up on their own, but treatment with antibiotics can cause adverse side effects (such as allergic reactions and vomiting).

Their overuse can result in resistant strains of bacteria. Antibiotics may be prescribed if symptoms do not subside after three days, if your child is under two years old (to prevent the infection from spreading), if both ears are infected, or if the eardrum is damaged.

In this case, give your child all prescribed medications for the entire recommended period (usually 5 to 10 days), even if symptoms subside. If medications are stopped too soon, the infection may recur.

For children younger than three months, you may need to see a specialist.

Is there any way to prevent ear infections in children?

Ear infections are very common and can hardly be prevented, as they are associated with colds and flu-like infections. Below are some factors that increase your child’s risk of ear infections.

  • Secondhand smoke – the negative effects of tobacco smoke on the cardiovascular system have been widely documented. When children are passive smokers, they are at higher risk for lung, throat, sinus, and ear damage.
  • Allergies – Allergic reactions can trigger excessive mucus production. This mucus can easily enter the Eustachian tubes.
  • Colds and flu infections – anything that contributes to the overall risk of infection also increases the likelihood of ear infections in children and infants. These include the cold seasons (when people are less likely to leave the house) and intense contact with other children (kindergarten, playgroups, daycare).

Protective vaccinations, including against influenza, are important. Regular washing of your child’s hands and your own hands is also an excellent preventive measure. So children need to be taught why handwashing is really important.

  • Breastfeeding with a bottle – natural breast milk contains numerous antibodies that prevent and fight infections. Children who suffer from ear infections at a very early age may be much more susceptible later on.

If your child drinks from a bottle while lying on his or her back, milk can leak into the Eustachian tubes, causing irritation and inflammation. The sooner children learn to drink while sitting and the sooner they use a cup to do so, the better.

Never put your baby to bed with a bottle.

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Risks of ear infections

An infection of the middle ear increases the pressure in the head considerably. In some cases, this causes the eardrum to rupture or even burst. When this happens, your child may suffer from nausea and dizziness. In addition, pus or other fluids may leak from the ear. This sounds much worse than it actually is. It usually makes your child feel a little better because as the pressure goes down, so does the pain. Most ruptures in the eardrum heal within a few weeks.

However, there is a risk of long-term infection if healing is delayed or does not occur at all. In rare cases, such infections can spread from the ear to other nearby tissues. Mastoiditis may occur, whereby an infection develops on the bone behind the ear. This is accompanied by painful reddened swellings behind the ear. Treatment options include intravenous antibiotics and surgery to remove the infected cells.

Are ear infections contagious? Why do these conditions recur?

Ear infections are not contagious, but are often accompanied by a cold and flu – which in turn are, of course, contagious. Nevertheless, some children give the impression that they suffer from ear infections excessively often. It is not at all uncommon for some children to come down with a middle ear infection as many as five or six times a year.

A medical solution exists in the form of a small ventilation tube that is inserted through the eardrum into the middle ear. This tube improves air exchange, prevents fluid buildup, and equalizes pressure on both sides of the eardrum. Such tubes remain in the ear for about six to nine months before they fall out on their own.
The surgical procedure involved is called a myringotomy. Most children can leave the hospital the same day. The eardrum heals on its own in just a few days. In cases of repeated ear infections, doctors may advise removing the so-called polyps to prevent future infections.

Natural Remedies for Ear Infection – Video

Ear Infections in Babies and Toddlers - FAQ

❓ What causes ear infections in babies and toddlers?

Ear infections are caused by bacteria or viruses and lead to fluid buildup in the Eustachian tubes, which prevents them from draining normally from the middle ear. Ear infections often occur when a child has a cold, sinus infection, or allergies.

❓ What happens if a toddlers ear infection goes untreated?

If left untreated, they can lead to unnecessary pain and permanent hearing loss for your child. Ear infections usually go away in a few days. Your doctor will likely treat your child’s pain and fever with over-the-counter (OTC) pain relievers or eardrops.

❓ How long do ear infections last in toddlers?

Ear infections are very common in young children. Most ear infections are not cured after the first dose of antibiotics. Often, children don’t get better the first day. Most children get better slowly over 2 to 3 days.

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