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Childhood ear infections

Ear infections are the second most common illness in children. Nearly every child will have at least one.

What’s an ear infection?

Your child’s ears can become infected when fluid collects and/or germs grow in the middle ear (the space behind the eardrum). This can also cause problems with hearing.

Signs and symptoms of an ear infection may include:

  • pain
  • fever
  • fussiness
  • tugging on the ears
  • fluid or blood coming from the ears

Some children may not show any signs at all.

Why does my child get ear infections?

If the tube that connects the middle ear to the back of the throat (the Eustachian tube) doesn’t open properly, fluid can build up behind the eardrum. Germs can get into this fluid and cause an infection.

As your child grows older, the size and position of the Eustachian tube changes, and they will usually get fewer ear infections. It may be hard to tell why your child has an ear infection.

The following makes it more likely your child will get an ear infection:

  • family history of ear infections
  • contact with sick children
  • head and neck problems (e.g., cleft palate)
  • smoking in the home
  • allergies
  • asthma
  • cold and flu season
  • bottle feeding while your baby is on their back

Why should I be concerned about ear infections?

Ear infections can cause your child to have problems hearing for a little while. Your child may hear sounds as muffled or unclear.

Ear infections may also cause your child to have trouble with:

  • building listening skills
  • talking
  • understanding what you’re saying
  • paying attention and behaving
  • learning

Take your child to see your doctor. An ear infection can cause serious medical and/or hearing problems if it’s not treated.

Who may be involved in my child’s care?

A doctor may examine your child with a special light (called an otoscope) to look for fluid or infection behind the eardrum. The doctor may prescribe medicine to help with the infection. If the infection and hearing trouble continues, the doctor may refer your child to other specialists. The doctor may also recommend other treatments (e.g., taking antibiotics for a long period of time). Even if your child gets treated for their ear infection, they may still get another one.

Some doctors specialize in treating ear, nose, and throat (ENT) problems (ENT doctors or otolayngologists). An ENT doctor may recommend putting tubes in your child’s eardrums.

An audiologist is a health care provider that checks for and manages hearing problems. They may check to see if there’s fluid and/or infection in your child’s middle ears and if there are related hearing problems. The audiologist can also offer advice to help your child with listening and learning. It’s important to have your child’s hearing retested in 3 to 4 months, or after tubes have been put in, to check for problems with the middle ear.

What can I do to help my child?

Watch for signs of ear infection, including when your child:

  • has a fever or discomfort (e.g., they pull on their ears)
  • doesn’t startle or try to look for noises
  • asks “what” or says “huh” often
  • moves closer to the television or turns up the volume
  • watches facial expressions and gestures

Understand your child’s treatment.

  • Ask your doctor to explain anything you don’t understand about your child’s treatment.
  • If your doctor prescribes medicine, make sure you know how to give it to your child, and be sure your child finishes all the medicine.
  • Ask your doctor what you can do to help with your child’s ear pain at home.
  • Ask your doctor when you should bring your child back for an ear check.

Encourage your child’s speech and language.

  • Children often imitate what they hear. Talk about everything your child does during the day and add to the words they say (e.g., if your child says “dog”, you could say “brown dog” or “that’s a nice brown dog”).
  • Repeat your child’s words, pronouncing them properly (e.g., if your child says “dus”, you could say “ that good juice?”).
  • Read to your child.
  • Move close to your child and speak clearly.
  • Help your child learn new words and use them whenever you can (e.g., while shopping, bathing, eating, taking a walk). ​​

Where to go get help

For more information about how speech-language pathologists and audiologists can help, contact:

  • Your doctor, public health nurse, or other health provider
  • Your local health centre

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