Ear Infections Common in Children

The ear is divided into three parts: outer, middle, and inner. When  bacteria  infect the outer ear, it is called swimmer’s ear.  The middle ear is a small pocket of air behind the eardrum. There will be a middle ear infection when bacteria get into this region, and it fills up with fluid containing germ-fighting cells (pus). When the pus builds up, the ear feels that it is like a balloon about to burst, resulting in pain.

Swimmer’s ear is an infection of the outer ear canal caused by bacteria floating in water reaching the ear passage during swimming and growing there.  Some suggestions to avoid such infections are:  (a) use swimmer’s ear drops to kill bacteria in your ear canal; (b) wear ear plugs to keep water with bacteria out of the ear, especially when diving, (c) dry the ear canal with a hair dryer set on low heat directed at your ear canal after each swim, and  (d) don’t swim in stagnant lakes or pools.

Middle ear infections occur most frequently in children. The inflammation often starts with infections that cause sore throats, colds or other respiratory problems, which then spreads to the middle ear. These can be caused by viruses or bacteria, and can be acute or chronic. High levels of smog or air pollution and smoke from cigarettes can also increase risk of infection.   The condition is chronic when the inflammation persists for a minimum of a month. This differs from an acute ear condition that usually lasts only several weeks, and which accompanies upper respiratory track infection.

How does the bacteria from the throat  or nose  reach the ear?  A passage called the eustachian tube connects the middle ear to the throat. The eustachian tubes keep pressure from building up by letting air move in and out of the middle ear. In children, the eustachian tubes are very small and less able to keep bacteria out. If the child has allergies or catches a cold, the eustachian tubes get blocked up and let bacteria get in the middle ear. Then the number of bacteria can grow inside the middle ear, thus causing an infection. Symptoms of middle ear infections are pain deep in the ear and, sometimes, there is fluid coming out of the ear.

A diagnosis for middle ear infection usually involves looking into the ear with a special flashlight called an otoscope. With the otoscope, the doctor can see the eardrum, the thin membrane between the outer and middle ear.  The doctor may use the otoscope to blow a little puff of air in the ear.  This is to  determine  if the air causes the eardrum to move the way a healthy eardrum does. An infected eardrum won’t move as it should because the pus presses against it and may make it bulge. An infection also can make the eardrum red.  Other tests may include an audiogram which tests the patient’s hearing, and a tympanogram, a machine that checks whether the eardrum moves normally.

Treatment generally involves an individualized, two-pronged approach to minimize pain, address the infection, and reduce the possibility of complications, such as hearing loss. A  doctor may recommend:

(a) antibiotics for ear infections caused by bacteria. Antibiotics may be given as oral pills or in ear-drop form. As antibiotics are ineffective against viruses, they are  not prescribed for middle ear infections caused by a virus.

(b) corticosteroids to reduce ear inflammation and pain.

(c) surgery to insert tubes in the ears to drain excess ear fluid, remove infected tissue, or repair a damaged eardrum.


It is not always easy to know if your child has an ear infection. Your child may contract an ear infection before he or she has learned how to talk. Therefore, you have to observe carefully.

Here are a few signs your child might show you if he or she has an ear infection.

* Does he/she tug or pull at the ears?

* Does he/she cry more than usual?

* Do you see fluid draining out of his/her ears?

* Does he/she have trouble sleeping?

* Can he/she keep her balance?

* Does he/she have trouble hearing?

* Does he/she seem not to respond to quiet sounds?

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