Ear infection in children is a very common illness. As infection of middle ear is the most common, the medical terminology used is otitis media. Likewise, infection of outer ear is called otitis externa. Ear infections are most common in children under 10 years of age.

Otitis media is usually the build-up of fluid in the middle ear. Normally, the space is occupied by air. When suffering from flu, air maybe replaced by mucus or fluid. If this fluid gets infected, it will lead to an ear infection.

Otitis media can then be differentiated into acute (short-term) and chronic (long-term). Chronic otitis media will keep coming back, and these children will suffer from long term ear discharge and pain. The infection is less severe than acute otitis media, which is a short-lasting infection that resolves quickly.


Major signs and symptoms of otitis media include:

severe earache

high fever

flu-like symptoms

decreased hearing capacity of affected ear

associated sore throat

Babies may show signs of ear-pulling, irritability, restlessness, coughing, runny nose and decreased food intake. In unwell babies, ears should always be checked for a possible source of infection.


Common cold is the biggest culprit in causing otitis media. Infection spreads easily from the throat or nose the the ear, which are all connected through the Eustachian tube.

Enlarged tonsils or adenoids may also block the Eustacian tube.

Weak immune system may also lead to recurrent infections of the middle ear.

An uncommon cause of middle ear infection is cholesteatoma. It is a tissue growth inside the ear drum after perforation, which may cause recurrent ear infections, along with hearing loss.


There is no role of antibiotics in treating majority of ear infections, unless they are known to have been caused by bacterial organisms. Use of antibiotics where they are not indicated has led to widespread resistance developing in bacteria, which means that bacteria do not respond to antibiotic treatment in a large number of cases, due to improper prescriptions.

Over the counter painkillers should be used to control fever and pain. Ibuprofen and paracetamol are excellent drugs for symptoms control.

Nasal sprays can be used to relieve  symptoms of underlying flu and congestion.

For patients with recurrent, severe infections, small tubes maybe inserted into the ears to drain the excess fluid, hence preventing infection. This procedure is called tympanostomy.

Alternatively, a small hole maybe made in the ear drum to allow excess fluid to drain out itself. This process is called myringotomy.


Dr. Annie

Physician, mom and wife

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