Middle Ear Infection: How to Care for Your Child

A middle ear infection (often just called "ear infection") happens when the space behind the eardrum (called the middle ear) fills with pus (infected fluid). Sometimes an ear infection goes away on its own. Other times it needs to be treated with antibiotics. 

Your health care provider considered your child's age, how sick your child seems, how long the infection has lasted, and how often your child has ear infections to come up with the best treatment.

• If antibiotics were prescribed, be sure your child takes all the doses exactly as directed, even if they are feeling better. This is the best way to kill the harmful bacteria.

• Encourage your child to drink plenty of liquids.

• If your child is uncomfortable from fever, and your health care provider says it's OK, you can give acetaminophen (Tylenol^® or a store brand) or ibuprofen (Advil^®, Motrin^®, or a store brand). Follow the package directions for how much to give and how often. Don't give ibuprofen to babies under 6 months old. 

• Don't give aspirin to your child because it has been linked to a rare but serious illness called Reye syndrome.

• Follow up as recommended by your health care provider.

Your child:

• Has worsening ear pain

• Still has pain or fever after 2–3 days

• Has fluid or blood coming from the ear

• Isn't drinking or has signs of dehydration (not enough water in the body) such as a dry or sticky mouth, sunken eyes, peeing less often, darker than usual pee, or crying with little or no tears 

• Vomits more than a few times in 24 hours

• Has trouble hearing that doesn't go away within two weeks

You know your child best. If your child has symptoms that worry you or seems very sick, call your health care provider.

Your child:

• Has a swollen or red ear, or pain and redness over the bone behind the ear

• Has neck pain or a stiff neck

• Is very sleepy or can't be woken up

What causes middle ear infections? The middle ear is connected to the back of the throat by the eustachian tube. Colds and allergies can make the eustachian tube swell or get blocked. This can lead to a buildup of mucus in the middle ear. Germs (viruses or bacteria) that spread from the nose or throat grow in the blocked mucus, causing a middle ear infection. 

What are the symptoms of a middle ear infection? Kids with an ear infection usually have an earache. They may also have a fever, vomiting, or diarrhea; have trouble eating, drinking, or sleeping; be fussy; or have trouble hearing. If enough builds up, the eardrum can rupture (tear) and fluid will drain from the ear. 

How are middle ear infections treated? Some ear infections are treated with antibiotics, but many can go away without antibiotics. So the health care provider may recommend that you watch your child for a day or two to see if your child gets better without antibiotics. If your child's symptoms don't get better or they get worse, antibiotics will be started. If the eardrum tears from a middle ear infection, it usually heals on its own and doesn't cause lasting problems.

Are middle ear infections contagious (spread from person to person)? Middle ear infections are not contagious, but a cold or other virus that can cause an ear infection is contagious. To prevent the spread of viruses and other germs, teach family members to wash their hands well and often and stay away from people who are sick, if possible.