Ear Infections In Infants And Small Children

By Delialah Falcon. May 7th 2016

Ear infections are a common childhood ailment that affect children of all ages. The pain and discomfort caused by ear infections can leave children feeling miserable and parents feeling helpless.

What Is An Ear Infection?

An ear infection, clinically known as otitis media, occurs when the middle ear becomes inflamed. It generally occurs as a result of a bacterial infection that develops as a result of fluid accumulating behind the eardrum. Although both children and adults are susceptible to ear infections, children generally get them much more often than adults. In fact, three out of four children are likely to experience at least one ear infection.

Types Of Ear Infections

In general, there are three main types of ear infection that affect children. They are:

  • Acute otitis media (AOM)
  • Otitis media with effusion (OME)
  • Chronic otitis media with effusion (COME)

Acute otitis media is by far the most common ear infection seen in infants and small children. During acute otitis media, certain areas of the middle ear become infected. This results in fluid build-up behind the eardrum. When the fluid becomes trapped, the child experiences pain, or an earache.

Otitis media with effusion is a type of ear infection that occurs after an acute otitis media infection. It occurs when the fluid from the original infection does not drain entirely and remains trapped in the middle ear. Although the child may not have any symptoms, the condition is diagnosed when the child goes for another checkup visit. The doctor is able to see behind the eardrum with an instrument and detect the presence of trapped fluid.

Chronic otitis media occurs when fluid never drains form the middle ear completely and remains trapped behind the ear drum for a long period of time. It can also occur when a child continues to have bouts of fluid behind the ear drum even though an infection is not present. A child with chronic otitis media may have impaired hearing and have a more difficult time fighting off new infections that develop.

What Causes Ear Infections?

Many times, an ear infection is caused by a bacterial infection. It often occurs after a child or infant has been sick with a cold, sinus infection or upper respiratory illness.

When the sinus or upper respiratory infection is caused by bacteria, those same bacteria can spread and invade the middle ear. When this occurs, it is referred to as a secondary infection, or secondary bacterial infection. As a result of the infection spreading to the middle ear, fluid begins to accumulate behind the eardrum.

Many times, when a child has a cold, the sinus cavity becomes swollen and irritated. Mucus develops and becomes trapped in the sinus cavity, which can then trickle over to the Eustachian tubes in the ears.

The Eustachian tubes are tiny passages in the ear that connect the middle ear to the top of the throat. They have the important role of transporting oxygen to the middle ear and draining away any fluid that exists. If the Eustachian tubes become blocked with all of the excess mucus from the cold virus, they can no longer drain the fluid from the ear and an ear infection develops.

One of the reasons why infants and small children are more likely to get ear infections is because Eustachian tubes are shorter in children. Tubes that are shorter, combined with their horizontal alignment, are ineffective at draining fluid.

When children grow, their Eustachian tubes also grow. As the tubes become longer, they are more efficient at draining fluid and ear infections become less frequent.

Ear Infection Symptoms

Ear infections can be extremely painful. A child or infant with an ear infection may present with a variety of symptoms, including:

  • Fever
  • Tugging at the ear
  • Fluid draining from the ear
  • Unpleasant odor coming from the ear
  • Crying
  • Irritability
  • Decreased appetite
  • Difficulty sleeping
  • Loss of balance
  • Difficulty hearing
  • Runny nose

Children who have an ear infection will usually complain of pain in the ear. Infants, who are too young to speak, may just appear cranky and ill.

When To Call Your Doctor

If your child develops any of the symptoms listed above and does not recover in a couple of days, make an appointment with the child’s doctor. If your child has recently gotten over a cold virus or a respiratory infection and is still showing any of the symptoms above, an ear infection may be the culprit. Call your child’s doctor for fever over 102 F or 100.4 F in infants under 6 months of age.

How Is An Ear Infection Diagnosed

The doctor will ask questions about your child’s symptoms. He will use an otoscope to examine the eardrum. The doctor may also check for fluid behind the eardrum with either a pneumatic otoscope or a tympanometer.

What Is The Treatment For An Ear Infection?

Many times, an ear infection will clear up on its own without any treatment. If your child’s doctor believes treatment is necessary, a course of antibiotics will be prescribed. The most commonly prescribed antibiotic for ear infections in children is a 7-10 day course of Amoxicillin. An over-the-counter pain medication, such as acetaminophen or ibuprofen, may be recommended for pain.

Recurring Ear Infections In Children

Unfortunately, some infants and small children are plagued with recurring ear infections. If ear infections continue to occur, your child’s doctor may recommend having ventilation tubes placed in the eardrums to drain fluid and improve airflow. The tubes are placed in the ear surgically and can remain there for 9 months to up to 5 years or more.

How To Reduce Your Child’s Risk

To reduce your child’s risk of developing an ear infection, you need to limit the risk factors that are associated with them. Preventative measures include:

  • Keep your child away from second hand smoke
  • Don’t put baby to bed with a bottle
  • Wash your hands frequently to prevent the spread of germs
  • Keep your child away from sick children

Unfortunately, ear infections are common in children of all ages. Take steps to reduce your child’s risk of ear infections. If you suspect your child may be suffering from an ear infection, schedule an appointment with his or her doctor.


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