What is an ear infection?

An ear infection means that the middle ear is infected. The middle ear is the eardrum and the small space behind the eardrum. An ear infection is sometimes called 'acute otitis media'.

How does an ear infection occur?

The small space behind the eardrum in the middle ear is normally filled with air. It is connected to the back of the throat by a tiny channel called the Eustachian tube. The middle ear space sometimes becomes filled with mucus (fluid), often during a 'cold'. The mucus may then become infected by bacteria or viruses. Children with glue ear who have mucus behind their eardrum are more prone to ear infections.

What are the symptoms of an ear infection?

• Earache is common, but does not always occur.
• Dulled hearing may develop for a few days.
• Fever (high temperature) is common.
• Children may feel sick or vomit, and can be generally unwell.
• Young babies cannot point to their pain. One of the causes of a hot, irritable, crying baby is an ear infection.
• Sometimes the eardrum perforates (bursts). This lets out infected mucus and the ear becomes runny for a few days. As the pain of earache is due to a tense eardrum, a burst eardrum often relieves the pain. A perforated eardrum usually heals quickly after the infection clears.

What is the treatment for an ear infection?

Most bouts of ear infection will clear without treatment within 2-3 days. The immune system can usually clear bacteria or viruses that cause ear infections. However, treatments that may be advised include the following.

Painkillers

If the ear infection is causing pain then give painkillers to children regularly until the pain eases. For example, paracetamol or ibuprofen. These drugs will also lower a raised temperature which can make a child feel better. If antibiotics are prescribed (see below), you should still give the painkiller as well until the pain eases.

Antibiotics - are prescribed in some cases only

Antibiotics are not advised in most cases. This is because in most cases the infection clears within 2-3 days on it's own. Also, it is best not to take antibiotics unless needed as side-effects such as diarrhoea can sometimes be a problem. Antibiotics are more likely to be prescribed if:

• The child is under two years old
• The infection is severe, or not settling within 2-3 days.
• Complications develop.

When an ear infection first develops it is common for a doctor to advise a 'wait and see' approach for 2-3 days. This means just using painkillers to ease the pain, and to see if the infection clears. In most cases, the infection clears. However, if it does not then antibiotics may then be used.

Will it happen again, and can it be prevented?

It is quite common for children to have two or more bouts of ear infection throughout childhood. In most cases, there is nothing you can do to prevent the infection form occurring. However, there is some evidence to suggest that an ear infection is less likely to develop:

• In breastfed children.
• In babies who do not use dummies. If you do give your child a dummy, it is best to limit the use. For example, just use a dummy to help a baby get to sleep, but not at other times.
• In children who live in a smoke free home. Passive smoking of babies and children can increase the risk of developing ear infections, chest infections, and other chest problems.

Occasionally, some children have recurring bouts of ear infections close together. If this occurs, a specialist may advise a long course of antibiotics to prevent further bouts occurring.