Ear infections are common in children. According to the , nearly 5 out of 6 children in the U.S. will have at least one ear infection before age 3.
That makes ear infections one of the most common health problems in children. For parents, these infections can raise questions about when to call a doctor.
Dr. Endaline Anunobi, a pediatrician at University Health, shares what parents should know about ear infections, symptoms and when to seek care.
Why Ear Infections Are More Common in Kids
“If it seems like children get more ear infections than adults, that’s because they do,” said Dr. Anunobi. Children are more likely to get ear infections for two key reasons, according to the AAP:
- Their immune systems are still developing and not at full strength.
- Their eustachian tubes connect the middle ear to the back of the throat. In children, these tubes are shorter, narrower and flatter than they are in adults. This can make it harder for fluid to drain from the ear.
Children also get more infections, such as colds and strep throat. These illnesses can cause fluid to build up in the ears.
Symptoms of Ear Infections in Children
It can be hard to know if your child has an ear infection, especially if they are too young to explain how they feel. Symptoms may include:
- Difficulty sleeping
- Ear drainage
- Ear pain
- Fever
- Fussiness or irritability
- Headache
- Problems hearing
- Problems with balance
- Rubbing or tugging on an ear
Dr. Anunobi notes that tugging on an ear is not always a sign of an ear infection. “Many children, and adults, may tug or pull on an ear to soothe themselves when they feel stress or anxiety,” said Dr. Anunobi.
Pay close attention to your child’s hearing. Older children may say they cannot hear well. With a younger child, you may notice they are not hearing you as well as usual. This can be a sign of an ear infection.
Types of Ear Infections
Not all ear infections are the same. Common types include:
Middle Ear Infection
When providers talk about an ear infection, this is often the type they mean. Middle ear infections, also called otitis media, happen when bacteria or a virus gets into the middle ear. This is the small space behind the eardrum.
This often happens when the eustachian tubes are blocked because of a cold or allergies. Fluid can then build up in the middle ear. This gives bacteria and viruses a place to grow.
Otitis Media With Effusion
This condition can happen after an ear infection. The infection may be gone, but fluid can stay trapped behind the eardrum. This is called otitis media with effusion.
Swimmer’s Ear
Swimmer’s ear is an infection of the outer ear. It affects the skin inside the ear canal or outer ear. It can happen when water stays in the ear canal and gives bacteria a place to grow.
As the name suggests, this type of infection is common after swimming or other activities in or around water.
When to Seek Medical Attention
Ear pain does not always need medical care, but there are some red flags to watch for. Call your child’s pediatrician or another provider if your child has:
- A fever of 102.2 F or higher
- Hearing loss
- Pus or another fluid coming from the ear
- Symptoms that linger for more than two days or that worsen
Dr. Anunobi strongly recommends urgent care if your child is younger than 3 months old and has a fever of 100.4 degrees Fahrenheit or higher.
How Ear Infections in Children Are Treated
If your child has an ear infection, a doctor may suggest watchful waiting. This means waiting to see if symptoms get better on their own. In some cases, a provider may prescribe an antibiotic but ask you to wait a few days before filling it to see if symptoms improve first.
These approaches can help prevent antibiotic resistance. This can happen when antibiotics are taken too often or when they are not needed.
Severe middle ear infections, or infections that do not improve after a few days, are usually treated with an antibiotic. A provider may also suggest over-the-counter pain medicine to help your child feel better.
Can a Mild Ear Infection Go Away on Its Own?
Ear infections do not always need antibiotics. Many ear infections clear up on their own without treatment.
If you are unsure what to do, make an appointment with your child’s primary care provider (PCP) or go to an urgent care clinic.
What You Can Do to Prevent Ear Infections in Children
There is no sure way to prevent ear infections, but these steps may lower your child’s risk:
- Dry your child’s ears well after bathing, showering or swimming
- Get your child an annual flu shot
- Keep your child up to date on recommended childhood vaccines
- Do not smoke or expose your child to secondhand smoke
- Practice good hygiene, such as regular handwashing
What Do Vaccines Have to Do With Ear Infections?
There is no vaccine for ear infections. But many vaccines protect against viruses or bacteria that can lead to ear infections, such as the flu. Staying up to date on vaccines can help lower your child’s risk.
When Your Child Should See an ENT Specialist
It is normal for children to get sick. But if your child has more than three ear infections in a year, ask your child’s PCP about seeing an ear, nose and throat specialist, also called an ENT specialist.
If antibiotics or other medicines do not work and your child has ongoing symptoms, such as ear pain, drainage or fever, an ENT specialist can talk with you about other treatments, such as ear tube placement.
Urgent Care for Children at University Health
University Health PediExpress is the only urgent care clinic in the San Antonio area with a board-certified pediatrician available seven days a week on a walk-in basis.
If your child has signs of a severe middle ear infection or another medical issue after your pediatrician’s office is closed, our experts can provide care when your child needs it most.
We also offer telemedicine and in-person care for many illnesses and injuries in children.
Find a University Health urgent care walk-in clinic near you and use the “Save My Spot” feature to get in line at the clinic before you arrive.
