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Childhood ear infections: Causes and cures

By Noelle Leong, M.D. [August 19 2010]

Few parents are strangers to ear infections. Roughly, half of all children suffer one by their first birthday. By age 3, one-third of those youngsters will have two or more ear infections

This common ailment, called otitis media (OM), often occurs when the eustachian tube (the narrow canal that connects the middle ear to the back of the nose) is blocked. An upper respiratory infection or allergy can cause one or both eustachian tubes to swell shut, preventing drainage. Enlarged adenoids (lymph nodes located in the top of the throat) can also block the eustachian tube opening. A child's eustachian tubes are shorter and more horizontal than an adult's, making it more difficult for fluid to drain.

A common condition

A child showing signs of otitis media should see his or her physician. Possible symptoms include a feeling of fullness in the ear, severe earache, fever and chills, nausea and diarrhea, hearing loss, and periodic seeping of fluid from the ear. Young children who cannot describe an earache may pull at or rub one or both ears. Your child may also be fussy or seem to have difficulty hearing you.

An antibiotic may be prescribed if an infection is present. It must be taken for the full duration of the prescription — usually 10 to 14 days — even if the child's symptoms disappear before then. Other treatment may include antihistamines (if allergies are the suspect OM cause) and medication to relieve pain and reduce fever.

If hearing loss or fluid in the middle ear persists, surgery may be advised. For children who suffer from a persistent ear infection or have recurrent ear infections, physicians may recommend a small plastic tube (called myringotomy tubes) be inserted through the eardrum to allow the middle ear to drain. Also, an adenoidectomy can remove enlarged adenoids if they are suspected of contributing to the problem.

Prevention tips
There's no sure way to prevent otitis media, but these defensive measures may help:

  1. Avoid spreading germs. Since the process leading to otitis media often starts with a cold, try to keep your child out of contact with children who have colds and other respiratory infections.

  2. Don't smoke. Children who live with smokers are more susceptible to otitis media than those who live in smoke-free homes. Cigarette smoke irritates the linings of the nasal passages and middle ear cavities, which interferes with the eustachian tubes' normal functioning.

  3. Raise an infant's head during feedings. This may help prevent fluid from collecting in the middle ear and is especially important if the baby has a respiratory infection. Never feed a baby lying flat and avoid bottle propping; you should hold the bottle while the baby drinks.

  4. Breastfeed. A mother's immunities to disease pass through breast milk, helping protect babies from colds and respiratory infections, which can lead to otitis media.


Noelle Leong, M.D., is a pediatrician at The Hospital of Central Connecticut's Outpatient Pediatric Clinic. For more information about pediatric services, visit our Pediatrics section.