If you’ve asked yourself these questions or others about ear infections, you aren’t alone.
Concern for ear infection (the medical term is otitis media) is among the most common reasons for a visit to the pediatrician. About half of all children between 6 months and 3 years of age will get at least one ear infection over the course of a year, and many children will experience several ear infections a year.
Most ear infections are treated with antibiotics. In fact, otitis media is the most common diagnosis for which children are prescribed antibiotics. Since most parents will deal with concern for an ear infection at some point, it’s important to separate the facts from the myths about their cause and treatment.
Take the quiz. Which common beliefs about ear infections are true? Which are false?
- Allowing water to drip into an infant’s ear during a bath can cause an ear infection.
- Spending time outside without a hat on a cold day can cause an ear infection.
- Almost all ear infections occur during or soon after a cold.
- Without antibiotics, an ear infection cannot resolve.
- Ear infections are always caused by bacteria.
- Most children outgrow the tendency to get ear infections.
So what exactly is an ear infection?
Ear infections occur when infected fluid fills the middle ear space. The middle ear is an air-filled cavity that sits behind the eardrum and connects to the back of the throat via the Eustachian tube. This middle ear cavity is lined with the same kind of respiratory tract tissue that lines the nose and sinuses. A child with a cold will develop mucous in the middle ear space, just like he’ll get mucous in the nose.
That mucous should continually drain down the Eustachian tube to the back of the throat, but in many young children, the Eustachian tube is angled poorly and is too narrow to effectively drain the mucous. Microorganisms take advantage of the warm, stagnant fluid and create an ear infection.
Here are the answers to our ear infection quiz. How did you do?
- FALSE. The ear drum seals off the middle ear space from the outside world — water dripping into the ear canal cannot cause infection.
- FALSE. Cold air does not cause ear infections.
- TRUE. Ear infections are almost always a complication of a cold.
- FALSE. Many ear infections will resolve on their own without use of antibiotics.
- FALSE. A significant proportion of ear infections are caused by viruses rather than bacteria. Antibiotics are not at all effective against viruses, but even bacterial infections can get better without the use of antibiotics.
- TRUE. And yes, thankfully, as children grow, their Eustachian tubes function better, and they outgrow the tendency to get ear infections.
How can a parent know if her child has an ear infection?
The only way to know for sure is to have your pediatric provider look in the ear using a special magnifying device called an otoscope.
Almost all ear infections occur in the setting of a cold or cough and are most common in the first two years of life. Parents should suspect an ear infection when their young child:
- Tugs at her ears or complains of ear pain
- Has drainage from the ear
- Has a cold which worsens rather than improves over time, sometimes with fever developing a few days into the cold
- Is uncomfortable lying flat or is having trouble sleeping
- Is irritable
Schedule a visit with your pediatric provider if you suspect your child has an ear infection.
Use the Boston Children’s Find a Doctor tool to locate a pediatrician.
About the blogger: Dr. Carolyn Sax is a primary care pediatrician at Hyde Park Pediatrics, a Boston Children’s Hospital Community of Care Preferred Pediatric Practice with locations in Hyde Park and Milton, and an assistant clinical professor of pediatrics at Harvard Medical School.