Middle ear infection
A middle ear infection (otitis media) is an infection behind the eardrum. It is very common in young children, often after a cold. It causes ear pain and fever and usually gets better within 3 days, often without antibiotics. Repeated or untreated infections can lead to a discharging ear, hearing loss and, rarely, a serious infection spreading to the bone behind the ear.
Symptoms
- Ear pain — young children may pull or rub the ear
- Fever
- Crying, irritability and poor sleep
- Not feeding well
- Difficulty hearing
- Fluid or pus coming out of the ear (if the eardrum bursts — the pain often eases after this)
Causes
- Germs from a cold or throat infection travel up the tube between the throat and the ear
- Young children have shorter, flatter ear tubes, so infections are more common
- Smoke in the home (cigarettes, wood or other cooking fires)
- Bottle-feeding while the baby lies flat
- Enlarged adenoids
Prevention
- Breastfeed for at least the first 6 months
- Keep the child away from cigarette smoke and indoor smoke
- Do not bottle-feed a baby who is lying flat
- Vaccinate on time, including the pneumococcal (PCV) vaccine
- Wash hands to reduce colds
Treatment
- Paracetamol or ibuprofen in the right dose for age and weight, for pain and fever
- Many infections get better within 2 to 3 days without antibiotics
- Antibiotics (often amoxicillin) if the child is under 2 with both ears infected, has pus from the ear, or is not improving — prescribed by a doctor
- For a discharging ear: gently dry the ear with clean cotton wicks; do not put oil, herbs or anything else in the ear
- A hearing check if infections keep coming back
- Do not give antibiotics without a doctor
Common questions
Does my child always need antibiotics for an ear infection?
No. Many ear infections are caused by viruses or clear up on their own in 2 to 3 days. Pain relief is the main treatment; a doctor will decide if antibiotics are needed.
Can I put oil or drops in the ear?
Do not put oil, garlic, herbs or any drops in the ear unless a doctor prescribes them. If the eardrum is torn, these can cause more infection and damage hearing.