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Everything You Need to Know About Ear Infections in Children

7 min read

While we commonly hear of the dreaded cold and infamous viral fevers, ear infections in children are another reason for those ridiculously high temperatures that your child might be running.

Remember mums, if your child has a high fever that goes on for over 5 days, there’s definitely more to it.  A fever is often a sign that something out of the ordinary is going on and your body is trying to fight it off. 

Table of Contents

  • What Is an Ear Infection
  • Causes of Ear Infections in Children
  • Risk Factors for Ear Infections in Children
  • Symptoms of Ear Infection in Children
  • How Is an Ear Infection Diagnosed in Children
  • Treating Ear Infections in Children
  • How to Prevent Ear Infections in Children
  • Are Ear Infections in Children a Serious Problem

What Is an Ear Infection

Firstly, what are ear infections all about? Ear infections in children usually occur in the middle ear, and are caused by bacteria occurring from the fluid that builds up behind the eardrum. In medical terms, ear infections are referred to as Otitis Media (OM).

There are three types of ear infections in children.

1. Acute otitis media

This is the most common ear infection in children. It is when parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum. Children get earaches and fever as a result.

2. Otitis media with effusion

This is sometimes an aftereffect of a regular ear infection. It happens when fluid continues to be trapped behind the eardrum after an ear infection. This is tricky because it doesn’t typically cause symptoms and can only be diagnosed by a doctor inspecting your child’s ear using a specific instrument.

3. Chronic otitis media with effusion

This happens when fluid remains in the middle ear for an extended period or returns again and again even without an infection. This condition makes it difficult for children to fight new infections and can damage their hearing. 

Causes of Ear Infections in Children

ear infections in children

Image Source: kids-ent.com Children are more likely than adults to get ear infections because their Eustachian tubes are smaller.

As always, bacteria and viruses are the culprits. Often after your child has a sore throat, cold, or any other upper respiratory infection, the bacteria may spread to the middle ear. 

Also, fluid that enters the area usually drains quickly through the eustachian tubes which connect the middle ear to the back of the nose and throat. But when colds, sinus infections and allergies occur, these tubes get blocked and fluid ends up trapped in the middle ear. 

Wet, warm places are breeding grounds for germs so a fluid-filled middle ear naturally paves the way for an infection to occur. 

Ear infection in children is also more common than in adults because their eustachian tubes are smaller and more level than in adults. This makes it harder for fluid to drain out of the ear (even in normal conditions).

On another note, a child’s immune system is not as developed and effective as an adult’s and this makes it harder for him to fight infection. 

Risk Factors for Ear Infections in Children

There are primary and secondary risk factors for ear infections in children.

Primary risk factors 

  • Age (children below three years old are most susceptible)
  • Children with weak immune systems
  • Family history of ear infections
  • Sleeping or lying down with a milk bottle in the mouth 

Secondary risk factors 

  • Recurrent colds and upper respiratory infections
  • Exposure to cigarette smoke 
  • Being in a childcare centre with other children 

Symptoms of Ear Infection in Children

Parents, watch out for the following signs that your child may have an ear infection:

  • Pain in the ear
  • Fever 
  • Yellow or whitish fluid draining from the ear
  • Trouble sleeping (lying down makes an ear infection more painful)
  • Reduced appetite (painful to chew and swallow)
  • Unpleasant smell or foul odour from the ear
  • Trouble hearing sounds
  • Difficulty with balance 
  • Fussiness and crying
  • Tugging or pulling of the ear
boy touching his ears

Image Source: iStock

How Is an Ear Infection Diagnosed in Children

An otoscope will be used by your healthcare practitioner to examine your child’s ear. The hue of a healthy eardrum is pinkish grey and transparent (clear). The eardrum may be inflamed, enlarged or red if an infection is present.

A pneumatic otoscope which blows a small amount of air at the eardrum can also be used to look for fluid in the middle ear. The eardrum should shift back and forth as a result of this. If there is fluid inside the ear, the eardrum will not move as freely. 

Tympanometry is another test that uses air pressure to look for fluid in the middle ear. This is not a hearing test. If your child had a long-term or recurrent ear infection, or fluid in the middle ear that is not draining, your child’s doctor may arrange a hearing test by an audiologist to detect probable hearing loss.

Your healthcare practitioner will also use a stethoscope to listen to your child’s breathing and inspect her throat and nasal tract for symptoms of upper respiratory infection.

Treating Ear Infections in Children

If it’s just a case of an outer ear infection, or there is no infection, doctors may treat it with ear drops. However, for middle ear infections, it’s likely he will prescribe your child a dose of antibiotics that will last for seven to ten days.

This is usually given with other medication such as Ibuprofen to treat your child’s fever. While other medications do not have to be completed, it’s extremely important that you complete the course of antibiotics. 

In the case of frequently recurring ear infections in children, doctors might recommend a surgical procedure that places a small ventilation tube in the eardrum to improve airflow and prevent the building up of fluid.

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Don’t be alarmed if the doctor performs a hearing test on your child. The fluid in the ear can cause temporary mild loss of hearing that should get better once the infection resolves.

How to Prevent Ear Infections in Children

Take note of these reminders in caring for your child’s ear.

  • As far as possible, keep your child away from other children who are sick
  • Get the appropriate vaccines such as pneumococcal and Haemophilus vaccines to prevent pneumonia and meningitis 
  • Frequent washing of hands
  • Keep your child away from tobacco and second-hand smoke 
  • Don’t put your baby down for a nap or to bed, with a bottle
  • Refrain from inserting items in your child’s ear canal (yes, that includes cotton swabs)

Are Ear Infections in Children a Serious Problem

Yes, they can become a serious problem. If left untreated or if the infection is severe, it can rupture your child’s eardrum. 

Repeated ear infections in children can lead to hearing loss and scarring. In very rare cases, untreated ear infections can lead to mastoiditis (a skull infection) or meningitis.

So mums, remember, if your child has a persistent fever, try to get to the root of the problem. If you find yourself pumping him with dose after dose of paracetamol only to have the fever returning with a vengeance, it’s best that you get medical attention.

Everything You Need to Know About Ear Infections in Children

Image source: iStock

Singhealth, National Institute of Deafness and Other Communication Disorders 

Here at theAsianparent Singapore, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.

Got a parenting concern? Read articles or ask away and get instant answers on our app. Download theAsianparent Community on iOS or Android now!

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