Learning About Ear Infections (Otitis Media) in Children

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What is an ear infection?

An ear infection is an infection behind the eardrum. The most common kind of ear infection in children is called otitis media. It can be caused by a virus or bacteria.

An ear infection usually starts with a cold. A cold can cause swelling in the small tube that connects each ear to the throat. These two tubes are called eustachian (say "yoo-STAY-shun") tubes. Swelling can block the tube and trap fluid inside the ear. This makes it a perfect place for bacteria or viruses to grow and cause an infection.

Ear infections happen mostly to young children. This is because their eustachian tubes are smaller and get blocked more easily.

An ear infection can be painful. Children with ear infections often fuss and cry, pull at their ears, and sleep poorly. Older children will often tell you that their ear hurts.

How are ear infections treated?

Your doctor will discuss treatment with you based on your child's age and symptoms. Many children just need rest and home care.

Regular doses of pain medicine are the best way to reduce fever and help your child feel better. You can give your child acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for fever or pain. Your doctor may also give you eardrops to help your child's pain. Be safe with medicines. Read and follow all instructions on the label. Do not give aspirin to anyone younger than 18. It has been linked to Reye syndrome, a serious illness.

Doctors often take a wait-and-see approach to treating ear infections, especially in children 6 months and older who aren't very sick. A doctor may wait for 2 or 3 days to see if the ear infection improves on its own. If the child doesn't get better with home care, including pain medicine, the doctor may prescribe antibiotics then.

Why don't doctors always prescribe antibiotics for ear infections?

Antibiotics often are not needed to treat an ear infection.

  • Most ear infections will clear up on their own. This is true whether they are caused by bacteria or a virus.
  • Antibiotics only kill bacteria. They won't help with an infection caused by a virus.
  • Antibiotics won't help much with pain.

There are good reasons not to give antibiotics if they are not needed.

  • Overuse of antibiotics can be harmful. If your child takes an antibiotic when it isn't needed, the medicine may not work when your child really does need it. This is because bacteria can become resistant to antibiotics.
  • Antibiotics can cause side effects, such as stomach cramps, nausea, rash, and diarrhea. They can also lead to vaginal yeast infections.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child is confused, does not know where he or she is, or is extremely sleepy or hard to wake up.

Call your doctor or nurse call line now or seek immediate medical care if:

  • Your child seems to be getting much sicker.
  • Your child has a new or higher fever.
  • Your child's ear pain is getting worse.
  • Your child has redness or swelling around or behind the ear.

Watch closely for changes in your child's health, and be sure to contact your doctor or nurse call line if:

  • Your child has new or worse discharge from the ear.
  • Your child is not getting better in 2 to 3 days (48 to 72 hours).
  • Your child has any new symptoms after the ear infection has cleared, such as a hearing problem.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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