Ear infection

Otitis media is an infection behind the eardrum (middle ear). In most cases, ear infections develop in a child who has had a cold. 

Your child can't catch an ear infection from another child who has one. But he can catch the cold that caused the child's ear infection. About 1 in 2 babies gets at least one ear infection in the first year of life. 

What causes ear infection? 

Ear infection is caused by viruses and bacteria. Babies and preschool-aged children are especially likely to get ear infections for several reasons, including:

  • The tubes that connect the back of their throats and middle ear are small. (These tubes are called the eustachian tubes). The position of these tubes also increases the risk of infection.
  • Their immune systems are still developing.

What are signs and symptoms of ear infection?

Your child may have an ear infection if she:

  • Complains of ear pain
  • Pulls on her ear
  • Has a fever (above 100.4° F)
  • Cries more than usual
  • Has fluid coming out of her ear
  • Has trouble sleeping or hearing

What should you do if you think your baby has an ear infection?

Call your baby's health care provider if you suspect an ear infection. Providers can diagnose an ear infection by looking inside a child's ear canal. They do this with an instrument called an otoscope.

Some ear infections clear up without treatment within a few days. Severe infections and infections in young babies may require antibiotics. If the child is older and has mild symptoms, the provider may suggest waiting a few days before starting antibiotics to see if the infection clears up by itself.

If your child's provider recommends antibiotics, be sure your child takes them for the recommended length of time (even if she feels better sooner). If antibiotics are stopped too soon, the ear infection could come back, and then require stronger antibiotics.

The provider also will suggest treatment for ear pain, such as acetaminophen (Tyleno®l) or ibuprofen (Motrin® or Advil®), and sometimes ear drops.

After treatment, some children may have fluid in the ear that can affect hearing for three weeks or more. Hearing should return to normal when the fluid clears.

Some children are prone to repeated ear infections. In these cases, the provider may recommend low-dose antibiotic treatment to help prevent the infections. If this doesn't work, some providers recommend inserting tiny tubes in the eardrums to help drain the middle ear. The tubes may help prevent speech and language problems that may result from hearing loss from repeated or long-lasting ear infection. 

How can you help prevent ear infection in your baby?

You may be able to help prevent some ear infections in your baby by:

  • Breastfeeding your baby. Breast milk has antibodies that help protect a baby from many infections, including those that can cause ear infections.
  • Holding your baby in a partially upright position during bottle-feeding. This helps prevent formula from dripping into the eustachian tubes. Avoid keeping your baby's bottle in the crib after feeding.
  • Keeping your baby or young child away from cigarette smoke. Smoke appears to increase the risk of ear, as well as respiratory, infections. Minimizing dust in the home also may help.
  • Making sure your baby gets all the recommended immunizations. The pneumococcal vaccine may help prevent ear infections caused by certain bacteria.


Last reviewed: December, 2013

Otitis media is an infection behind the eardrum (middle ear). In most cases, ear infections develop in a child who has had a cold. 

Your child can't catch an ear infection from another child who has one. But he can catch the cold that caused the child's ear infection. About 1 in 2 babies gets at least one ear infection in the first year of life. 

What causes ear infection? 

Ear infection is caused by viruses and bacteria. Babies and preschool-aged children are especially likely to get ear infections for several reasons, including:

  • The tubes that connect the back of their throats and middle ear are small. (These tubes are called the eustachian tubes). The position of these tubes also increases the risk of infection.
  • Their immune systems are still developing.

What are signs and symptoms of ear infection?

Your child may have an ear infection if she:

  • Complains of ear pain
  • Pulls on her ear
  • Has a fever (above 100.4° F)
  • Cries more than usual
  • Has fluid coming out of her ear
  • Has trouble sleeping or hearing

What should you do if you think your baby has an ear infection?

Call your baby's health care provider if you suspect an ear infection. Providers can diagnose an ear infection by looking inside a child's ear canal. They do this with an instrument called an otoscope.

Some ear infections clear up without treatment within a few days. Severe infections and infections in young babies may require antibiotics. If the child is older and has mild symptoms, the provider may suggest waiting a few days before starting antibiotics to see if the infection clears up by itself.

If your child's provider recommends antibiotics, be sure your child takes them for the recommended length of time (even if she feels better sooner). If antibiotics are stopped too soon, the ear infection could come back, and then require stronger antibiotics.

The provider also will suggest treatment for ear pain, such as acetaminophen (Tyleno®l) or ibuprofen (Motrin® or Advil®), and sometimes ear drops.

After treatment, some children may have fluid in the ear that can affect hearing for three weeks or more. Hearing should return to normal when the fluid clears.

Some children are prone to repeated ear infections. In these cases, the provider may recommend low-dose antibiotic treatment to help prevent the infections. If this doesn't work, some providers recommend inserting tiny tubes in the eardrums to help drain the middle ear. The tubes may help prevent speech and language problems that may result from hearing loss from repeated or long-lasting ear infection. 

How can you help prevent ear infection in your baby?

You may be able to help prevent some ear infections in your baby by:

  • Breastfeeding your baby. Breast milk has antibodies that help protect a baby from many infections, including those that can cause ear infections.
  • Holding your baby in a partially upright position during bottle-feeding. This helps prevent formula from dripping into the eustachian tubes. Avoid keeping your baby's bottle in the crib after feeding.
  • Keeping your baby or young child away from cigarette smoke. Smoke appears to increase the risk of ear, as well as respiratory, infections. Minimizing dust in the home also may help.
  • Making sure your baby gets all the recommended immunizations. The pneumococcal vaccine may help prevent ear infections caused by certain bacteria.


Last reviewed: December, 2013