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An ear infection (or acute otitis media) describes an infection in the middle ear. The middle ear is the space behind the eardrum. It can become inflamed and infected by viruses or bacteria.
The Eustachian tube connects the middle ear to the back of the throat. This tube helps to ventilate (air) and drain the middle ear. Colds cause more mucus and tissue swelling which can block the Eustachian tube. This blockage has 2 main results:
Ear infections are most common in kids between 6 months and 2 years old, although they can happen throughout childhood. Most children will have at least one ear infection, but some children may have many of them.
In younger children the Eustachian tube is shorter and smaller. It is more likely to be blocked from swelling and mucous during colds, or nearby tissues such as enlarged adenoids.
As a child gets older, the ear structures change and they grow out of the tendency to have ear infections.
Most ear infections develop during or after a child has an upper respiratory infection (eg: cold). The type of symptoms and how long they last is different for every child. Most children have ear pain from the pressure and fluid against the eardrum. Other common symptoms include:
Some children can get a small perforation (tear/hole) in their eardrum from the high pressure in the middle ear. You may notice cloudy or yellow fluid draining from the ear. These holes usually heal in about a week. If your child has repeated infections with perforations, there is a risk of scarring on their eardrum. This may affect their hearing and should be followed by your child’s regular doctor.
Your doctor will have to examine your child properly. They will use an otoscope (lighted magnifying glass) to look in your child’s ears. They are looking for redness, fluid and bulging of the eardrum.
The only way to know for certain if the ear infection is a virus or bacteria is by using a needle to take a sample of the fluid behind the eardrum. This is only done sometimes by Ear, Nose & Throat specialists (ENTs) for children with difficult to treat or multiple ear infections.
Antibiotics are not always needed to treat an ear infection. In healthy children, it is safe to wait 1 to 2 days to see if the symptoms get better on their own. The most important thing is to keep your child comfortable.
Pain and Fever control:
Daycare and School:
Call 911 anytime you think your child may need emergency care.
Seek immediate medical attention if:
Know your options
It can be scary when your child is sick. But in most cases, you don’t need to go to the emergency department. If you’re unsure, visit ahs.ca/options to learn about the options so you can get the care you need.
The Alberta Health Services HEAL (Health Education and Learning) program was created by a team of doctors, nurses and other clinical staff who work at the Alberta Children’s Hospital and the Stollery Children’s Hospital, to support families and patients with up-to-date and useful information about common childhood health concerns. Learn more at ahs.ca/heal.
To see this information online and learn more, visit: ahs.ca/heal/page12431.aspx
Ear pain in children: HEAL
For 24/7 nurse advice and general health information call Health Link at 811.
Current as of: March 1, 2023
Author: Pediatric Emergency Medicine, Alberta Health Services
This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.