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The human ear is composed of three parts: the outer ear (the fleshy part that sticks out from your head, as well as the ear canal); the middle ear (the eardrum, the three small bones that convey sound, and the eustachian tubes that run to the back of your throat); and the inner ear (which includes the cochlea and semicircular canals, important for hearing and balance). An ear infection, technically known as otitis media, is an inflammation of the middle ear. It’s usually caused by a backup of fluid in the eustachian tubes that then becomes infected with a bacteria.

Infants and toddlers are notorious for their susceptibility to acute ear infections. This is in part because their eustachian tubes are smaller and lie more horizontally, causing them to clog up easily after a cold. Symptoms of an active ear infection may include a child who:

  • Is extremely irritable and prone to crying, over and above her usual crankiness.
  • Has a low-grade fever, either during or shortly after a cold.
  • Has difficulty sleeping.
  • If able, verbally complains about ear pains.
  • Tugs, rubs, or holds ear if is not old enough to talk yet.  This is not diagnostic of an ear infection, though this certainly can be a sign of discomfort.

Many of these symptoms are non-specific, however, and can be seen in many children who are just under the weather.

Most acute ear infections clear up on their own within a couple of days. You can ease your child’s discomfort by administering an over the counter pain medication such as ibuprofen or acetaminophen. However, you should see a pediatrician if your child:

  • Is younger than six months and has a fever or other symptoms of an ear infection.
  • Has a fever higher than 102.
  • Does not improve after 48 hours.
  • Develops yellow or white drainage from the affected ear, as the ear drum may have ruptured.

A pediatrician’s diagnosis usually comes with a prescription for antibiotics to be administered for 7-10 days. If your child is over the age of 2, the pediatrician may advise a period of observation for 48-72 hours to see if the symptoms clear up on their own, but if they do not, your child will likely be prescribed an antibiotic at that time.  It’s extremely important NOT to stop the antibiotic treatment if your child seems better after 2-3 days, since the medicine will kill any bacteria that remain after the symptoms ease.

Takeaways

  • Infants and toddlers often develop ear infections in the wake of colds.
  • Most ear infections resolve on their own within a couple of days.
  • If your child is less than six months old, has a high fever, or has symptoms that persist beyond 48 hours, see a pediatrician.
  • Always finish the course of an antibiotic prescription, even if your child feels better after a couple of days.

References

  1. Medscape. Ear Anatomy.
  2. National Institutes of Health. Ear Infection – Acute.
  3. American Academy of Pediatrics. The Diagnosis and Management of Acute Otitis Media.

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Comments

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  1. I have to comment on this because my four-year-old has suffered alot with ear infections. He started getting them when he was only a couple months old. He was getting one almost every month but he was such a happy baby though that the way we’d know he had one was when he’d get cold-like symptoms. We would take him to the doctor and no surprise another double ear infection. Finally we were sent to an E.N.T doctor and he got tubes put in his ears. Everything was great until the tubes fell out a year later and he started getting them again. It’s been pretty hard. He blew a hole in his ear drum from getting so many infections but thankfully this has not affected his hearing. Just a couple months ago he had a surgery to close it because the doctor was hoping that it would close by itself but it did not. Also, we were not able to get another set of tubes put in because he started getting swimmers ear and the doctor said that the tubes would do nothing for those. I tried it all. If he’d get just a little bit of water in that meant he would get another infection soon. I think he could feel the fluid because he would tell me mom I have another ear infection and soon enough he’d have pus running out of his ear. The pus would run out like that cause of the hole (now closed). My poor baby had to wear a swimmer’s cap just to play water fights outside. Thank God since his last surgery he has not gotten sick again and I really hope it stays that way.

    1. What a difficult road your little guy has had! At least it has not affected his hearing. Hope things continue to go well!

  2. So sorry Carolina! I hope the infections are gone for good! I feel your pain to some degree. My son who is now 26 months had to get tubes as well. He had several ear infections starting at about 10 months, and then one that just would not go away. I was really against tubes at first, but didn’t want to keep giving him antibiotics. The tubes were great, but i got really nervous three months ago when the tubes came out. Everything was going good until two weeks ago when he got a cold, and unfortunately, another ear infection. Thankfully, we watched his ears and they have almost completely cleared on their own. I am really hoping that we are done with antibiotics for ear infections!

  3. My son has never had an ear infection (15 months old now–never been in daycare, breastfed until 14.5 months old, never been sick or been on antibiotics). Historically, have ear infections always been so common? Also, when did doctors start recommending and putting tubes in? I’m just curious about why so many children seem to have these issues. A lot of my mom friends’ babies have had issues with ongoing ear infections and several have had to resort to tubes or are receiving that recommendation now. I had ear problems as a baby, but I didn’t have tubes put in.

    1. My four year old has only had one ear infection and my two year old is on her second one now. The times they have gotten them they have started off with a cold and then it progresses into an infection. EVERY time they get a cold I suction their noses like crazy because I am so paranoid they will get another infection. I never know when they develop either because they haven’t ever been fussy or complained that their ears hurt. Both of my girls are in school part time so they get colds pretty often but if your son doesn’t have any issues than you don’t have to worry about getting tubes put in. I had them put in as a child but I had ear infections all of the time.

  4. My daughter has been through a lot with her ears. When she turned a year old she started having really bad ear infections. The doctors tried almost every kind of antibiotic and nothing cleared the infection up. She had them all the time from age of 1 till she was 2. It took several pediatricians before we could find one that would refer us to an ENT. On top of the infections, she had fluid that stayed in her ears. She couldn’t really hear, so she has speech delays that we are still battling with. She had tubes placed before her second birthday. She just had to have her second set of tubes placed not long ago. She is now 3.5 and still having problems with her ears.

    1. So glad you stuck with it and found a doctor who took your daughter’s problem seriously! Wishing your little one the best.

  5. I had ear infections as a child, alot!!! Had tunes around age 4! Even as an adult, I get ear infections every time I get a cold or sinus infection! So far my ear drum has ruptured twice on the same ear! Luckily, the hole healed by itself. I’ve always heard ear infections are hereditary, my twin sister has the same problems with her ears too as an adult! My son had ear infections at least twice a month once he was just a few months old. Tunes at 18 months, so far he’s had maybe 3 since having the tubes, he’s now 5! His tubes stayed in for some time! my daughter has not had 1 so hopefully it stays that way!

    1. Yes hoping her ear genes came from dad’s side of the family!

  6. I think ear infections are really bad because they take a long time to go away and sometimes effect balance.

    1. Yes even in young children we find that ear infections affect balance sometimes.