What is an ear infection?

Ear infections are common in babies and young children, especially between the ages of 6 and 18 months. Often the infection clears up by itself within a few days. You child’s ears might be painful for 2 or 3 days. Pain relief medication can help.

An ear infection that lasts a while can affect your child’s hearing. If your child has painful ears, you should see a doctor.

What are the symptoms of ear infections?

Ear infections can be very painful. While older children can tell you that their ears hurt, younger children can’t. You might see them pulling at or poking their ear. Children also might develop a fever, vomiting or problems with their balance.

An outer ear infection can make the ear and the area around it:

• red
• itchy
• swollen
• painful to touch

What causes ear infections?

There are 2 common types of ear infection:

1. middle ear infections, also called otitis media, which occur on the inner side of the ear drum
2. outer ear infections, which occur in the ear canal outside the eardrum

Read more about the ears here.

Middle ear infection

Middle ear infection is the most common type of ear infection. It is also called otitis media. This infection is caused by bacteria or viruses entering the ear from the throat via the Eustachian tube. This tube runs from the back of the throat to the middle ear. Children have short and narrow Eustachian tubes. This means they are prone to middle ear infections. As they grow, their Eustachian tubes grow longer, and they are less likely to develop ear infections.

A sinus allergy can also cause swelling and blockage of the Eustachian tube, leading to infection.

Infections lead to a build-up of fluid inside the ear, causing pressure and pain. This fluid usually drains in a few days without any treatment.

If it doesn’t drain quickly enough, the eardrum may burst. This may cause a yellow or bloody discharge to run from the ear. Once this happens, the pain goes away because the pressure has been relieved. A burst eardrum usually heals without treatment, but you should take care to prevent further infections.

Outer ear infection

Outer ear infection is often caused by excess moisture in the ear canal, sometimes after swimming. It is also called otitis externa or ‘swimmer’s ear’.

Damage to the ear canal, such as from cleaning ears with cotton buds, can also trigger infection.

When should I take my child to see a doctor?

You should see a doctor if:

• your child is unwell with an ear infection
• your child’s pain hasn’t improved after 1 – 2 days
• your child is getting a lot of ear infections
• there is redness and tenderness behind your child’s ear
• you are worried about your child’s hearing
• you are worried about your child’s language development

How are ear infections diagnosed?

If your doctor suspects your child has an ear infection, they will look into their ear to see:

• the ear canal
• eardrum

They can also check the pressure in the middle ear. This is done with a quick test that measures the movement of the eardrum.

How are ear infections treated?

Most ear infections clear up in a few days without treatment. Antibiotics generally don’t help, so the main treatment is pain relief. Give your child pain relief medicine in the doses recommended for their age and weight.

You should not:

• clean the ear with cotton buds or cotton wool
• let your child get water in their ears if their eardrum has burst, until it has mended
• give ear drops unless recommended by a doctor or pharmacist

If your child has recurring infections or glue ear for over 3 months, your doctor might refer them to a specialist. This is usually an ear, nose, and throat (ENT) specialist. They can help organise treatment options, such as:

• long courses of antibiotics
• grommets to allow drainage

Your doctor will be able to explain more about these options.

Can ear infections be prevented?

Middle ear infections generally occur after a cold, so keeping your child generally healthy will help.

Keep your child away from cigarette smoke, which reduces fluid drainage in the ear.

Wearing ear plugs when swimming can help protect your child from swimmer’s ear.

What complications are caused by ear infections?

Glue ear is a common condition that can follow middle ear infections. Fluid builds up in the middle ear and doesn’t drain away. It might not cause pain, but it can make it hard for your child to hear.

Persistent glue ear can affect your child’s language development, so it’s important to get treatment.

Resources and support

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call 7 days a week.