A Guide to Pediatric Ear Infections

By Alex Manteghi, DO

Kids’ ear infections are a source of frustration for children, babies, and parents alike. They can be painful and persistent, making them a common reason families visit a care provider. According to the American Academy of Otolaryngology, by the age of 5, the majority of young children will have an ear infection.

Ear infections develop when bacteria or viruses get in the middle ear, the air-filled space behind the eardrum, responsible for transmitting sound. This infection causes congestion and swelling of the nasal passages, throat, and eustachian tubes, which connect the middle ear to the back of the nose and throat. In children, the eustachian tubes are narrower and more horizontal, making them more prone to inflammation.

Identifying and treating ear infections in children and babies is important because hearing is a key element in speech development and other growth milestones. A child with an ear infection may have trouble hearing, and the problem could continue for several weeks after the infection clears.

Behavioral changes that may signal your child isn’t hearing well include: saying “huh?” or “what?” more than usual, not responding to sounds, having more trouble understanding language in noisy rooms, and turning up the television or radio louder than usual. Signs of ear infections in babies include fever, irritability, poor sleep, and pulling or tugging at ears.

Most ear infections will resolve without medical intervention or with a dose of antibiotics. But in some children, ear infections may become chronic.

To relieve the child’s pain, try applying heat to the outer ear, using a warm (not hot) compress. Pediatric versions of antiinflammatory acetaminophen or ibuprofen can also provide relief, but check with your pediatrician about the right dosing information.

If symptoms persist, or if your child continues to get regular ear infections, talk to your pediatrician about additional steps to treat and prevent them.

Antibiotics may be prescribed if the ear infection does not resolve with more conservative methods. If your pediatrician prescribes an antibiotic, make sure you administer the entire prescription. If you stop the medication too soon, some bacteria could still be present and cause the problem to recur.

If your child gets three ear infections in six months or four in one year, it may be time to consider ear tubes. Ear tubes are tiny cylinders that allow air to move into the middle ear. The tubes, which are implanted during a surgical procedure, provide ventilation and drainage that helps prevent fluid buildup in the ears. Although anesthesia is required, the whole procedure takes about 15 minutes. The tubes usually stay in place for six months to a year, and generally fall out on their own.

Risk of ear infections may be reduced by: breast-feeding, if a viable option; avoid exposing children to smoke, including wood smoke; do not let a child under age 2 lie flat while drinking from a bottle; and make sure your child gets all necessary vaccinations and washes their hands regularly.

Dr. Alex Manteghi is a board-certified ear, nose, and throat (ENT) specialist with pediatric ENT sub-specialization at Barton ENT. He offers surgical and non-surgical services for pediatric and adult patients by referral. Dr. Manteghi’s pre-recorded Wellness Webinar: “Pediatric Ear Infections” is available at BartonHealth.org/Lecture. To learn more about ear, nose, and throat care, visit www.BartonHealth.org/ENT.