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What Causes Ear Infections In Toddlers

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What causes ear infections in children?

If your toddlers ear infection hasnt improved several days after he or she first began experiencing symptoms, its time to seek medical attention. The pressure from gradual fluid buildup can eventually rupture the eardrum, leading to yet another medical problem requiring prompt attention.

You should call 911 or visit the emergency room if your child is running a high fever or experiencing severe symptoms, but DispatchHealth can help with mild to moderate cases. We bring the full experience of the doctors visit to your home and can send a detailed report to your childs pediatrician after were done. We can also call in any necessary prescriptions. Schedule an appointment today by calling us or visiting our website.

How Does A Doctor Diagnose A Middle Ear Infection

The first thing a doctor will do is ask you about your childs health. Has your child had a head cold or sore throat recently? Is he having trouble sleeping? Is she pulling at her ears? If an ear infection seems likely, the simplest way for a doctor to tell is to use a lighted instrument, called an otoscope, to look at the eardrum. A red, bulging eardrum indicates an infection.

A doctor also may use a pneumatic otoscope, which blows a puff of air into the ear canal, to check for fluid behind the eardrum. A normal eardrum will move back and forth more easily than an eardrum with fluid behind it.

Tympanometry, which uses sound tones and air pressure, is a diagnostic test a doctor might use if the diagnosis still isnt clear. A tympanometer is a small, soft plug that contains a tiny microphone and speaker as well as a device that varies air pressure in the ear. It measures how flexible the eardrum is at different pressures.

Can Ear Infections Affect Hearing

Fluid buildup in the middle ear also blocks sound, which can lead to temporary hearing problems. Kids having a problem might:

  • not respond to soft sounds
  • need to turn up the TV or radio
  • talk louder
  • seem inattentive at school

In kids who have otitis media with effusion, the fluid behind the eardrum can block sound, so mild temporary hearing loss can happen, but might not be obvious.

A child whose eardrum has ruptured might have ringing or buzzing in the ear and not hear as well as usual.

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When Should I Take My Baby To The Doctor For An Ear Infection

  • Fever. While some pediatricians have different standards for what constitutes a fever, if you suspect an ear infection and your child is running any kind of fever, dont worry about bothering your pediatrician with a call to the office. Definitely call the doctor immediately if your infant is under 3 months old and has a temperature of 100.4 degrees Fahrenheit or higher or if your child is between 3 months and 3 years old and the fever reaches 101.5 degrees F or higher .
  • A discharge of blood, fluid or pus from the ear . This could mean that the pressure from the buildup of fluid in the ear has caused your childs eardrum to rupture which is not as scary as you might think. The release of pressure usually relieves some pain, and the eardrum usually heals itself within a few weeks. Still, youll want to see the pediatrician within a day or so since your child may need antibiotics to kill any bacteria that may have caused the ear infection.
  • No improvement in your childs symptoms. Call if symptoms haven’t diminished after three days with or without antibiotics. Or get in touch if the infection seems to get better and then returns, which could mean that your child has a chronic ear infection.

Where Can I Find Additional Information About Ear Infections

Childhood Diseases  On a Mission to Educate: Ear Infections  Steemit

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language.

Use the following keywords to help you search for organizations that can answer questions and provide printed or electronic information on ear infections:

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Signs Of An Ear Infection

Ear infections are common in babies, and it is helpful to know the classic signs to watch out for:

  • Crying and irritability: Your babys ear is most likely painful, so expect crying and irritability. You may notice more crying when your baby lies down. This is because the ear pressure increases with lying down, leading to an increase in pain and discomfort during an ear infection.
  • Tugging at the ear: Because your baby is too young to tell you that their ear hurts, look for signs such as tugging on the affected ear.
  • Difficulty feeding: The act of sucking and swallowing causes changes in ear pressure and is usually uncomfortable during an ear infection. You may notice that your baby is hungry and seems eager to eat, but stops right away.
  • Trouble sleeping: Expect a restless night or two when your baby has an ear infection. Because lying down is painful, your little one will probably wake throughout the night.
  • Ear drainage: Its possible for your baby to develop ear drainage with an ear infection. The drainage will appear different than normal ear wax, which is orange-yellow or reddish-brown. Infected drainage may appear white, green, yellow, or blood-tinged and have a foul odor.
  • Fever: Its estimated that about 50% of babies and children will develop a fever with an ear infection.

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How Is An Ear Infection Diagnosed

Ear exam

Your healthcare provider will look at your or your childs ear using an instrument called an otoscope. A healthy eardrum will be pinkish gray in color and translucent . If infection is present, the eardrum may be inflamed, swollen or red.

Your healthcare provider may also check the fluid in the middle ear using a pneumatic otoscope, which blows a small amount of air at the eardrum. This should cause the eardrum to move back and forth. The eardrum will not move as easily if there is fluid inside the ear.

Another test, tympanometry, uses air pressure to check for fluid in the middle ear. This test doesnt test hearing. If needed, your healthcare provider will order a hearing test, performed by an audiologist, to determine possible hearing loss if you or your child has had long lasting or frequent ear infections or fluid in the middle ears that is not draining.

Other checks

Your healthcare provider will also check your throat and nasal passage and listen to your breathing with a stethoscope for signs of upper respiratory infections.

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How To Treat Ear Infection In Toddlers

The following treatment procedures could be used to treat an ear infection in toddlers :

  • Antibiotics: A course of antibiotics are prescribed along with eardrops to alleviate pain and inflammation. The duration of the antibiotic course and the type of antibiotics depend on the severity of ear infection and toddlers age. Common antibiotics prescribed for ear infections are cefprozil and amoxicillin. If the toddler has a fever, then he would be prescribed fever alleviating medicines such as acetaminophen and ibuprofen.
  • Tympanostomy tubes: If a toddler suffers from repeated ear infections, then the doctor may recommend insertion of a tympanostomy tube in the ear. This is done rarely in repeated infections. These tubes are about 1 to 1.5mm in length and made from plastic. It is surgically inserted into the eardrum to provide a passage for the fluids from the middle ear. Since the fluids drain into the ear canal, the middle ear becomes less prone to ear infections. The tympanostomy tube can be designed to stay for as little as six months to three years before they fall off on their own. If the toddler still has no improvement, then a new tube is inserted again. This treatment is a long-term procedure and is only done for toddlers with severe chronic otitis media that repeatedly happens for three consecutive months .

What Are The Symptoms Of An Ear Infection

Middle Ear Infections in Children | Merck Manual Consumer Version Quick Facts

There are three main types of ear infections. Each has a different combination of symptoms.

  • Acute otitis media is the most common ear infection. Parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum. This causes pain in the earcommonly called an earache. Your child might also have a fever.
  • Otitis media with effusion sometimes happens after an ear infection has run its course and fluid stays trapped behind the eardrum. A child with OME may have no symptoms, but a doctor will be able to see the fluid behind the eardrum with a special instrument.
  • Chronic otitis media with effusion happens when fluid remains in the middle ear for a long time or returns over and over again, even though there is no infection. COME makes it harder for children to fight new infections and also can affect their hearing.

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When Should I Call The Doctor About An Ear Infection

  • You or your child develops a stiff neck.
  • Your child acts sluggish, looks or acts very sick, or does not stop crying despite all efforts.
  • Your childs walk is not steady he or she is physically very weak.
  • You or your childs ear pain is severe.
  • You or your child has a fever over 104° F .
  • Your child is showing signs of weakness in their face .
  • You see bloody or pus-filled fluid draining from the ear.
  • The fever remains or comes back more than 48 hours after starting an antibiotic.
  • Ear pain is not better after three days of taking an antibiotic.
  • Ear pain is severe.
  • You have any questions or concerns.

What Is An Ear Infection

An ear infection is an inflammation of the middle ear, usually caused by bacteria, that occurs when fluid builds up behind the eardrum. Anyone can get an ear infection, but children get them more often than adults. Five out of six children will have at least one ear infection by their third birthday. In fact, ear infections are the most common reason parents bring their child to a doctor. The scientific name for an ear infection is otitis media .

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How Is An Ear Infection Treated

Treatment of ear infections depends on age, severity of the infection, the nature of the infection and if fluid remains in the middle ear for a long period of time.

Your healthcare provider will recommend medications to relieve you or your childs pain and fever. If the ear infection is mild, depending on the age of the child, your healthcare provider may choose to wait a few days to see if the infection goes away on its own before prescribing an antibiotic.


Antibiotics may be prescribed if bacteria are thought to be the cause of the ear infection. Your healthcare provider may want to wait up to three days before prescribing antibiotics to see if a mild infection clears up on its own when the child is older. If your or your childs ear infection is severe, antibiotics might be started right away.

The American Academy of Pediatrics has recommended when to prescribe antibiotics and when to consider waiting before prescribing based on your childs age, severity of their infection, and your childs temperature. Their recommendations are shown in the table below.

American Academy of Pediatrics Treatment Guide for Acute Otitis Media

Childs Age
in one or both ears Mild for < 48 hours and temp < 102.2° F Treat with antibiotic OR observe. If observe, start antibiotics if child worsens or doesnt improve within 48 to 72 hours of start of symptoms

Pain-relieving medications

Ear tubes

When Else Are Antibiotics Needed

Ear Infection

Antibiotics can be the right treatment for kids who get a lot of ear infections. Their doctors might prescribe daily antibiotics to help prevent future infections. And younger children or those with more severe illness may need antibiotics right from the start.

The “wait-and-see” approach also might not apply to children with other concerns, such as cleft palate, genetic conditions such as Down syndrome, or other illnesses such as immune system disorders.

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How To Treat Ear Infections In My Toddler

When your child has developed an ear infection, there are some things you can do to ease their pain, though ultimately they will need medical treatment to rid their body of the infection.

1. Home Remedies



Cold medication will not help manage an ear infection, but acetaminophen or ibuprofen can help to ease discomfort. Do not provide your child with aspirin for pain.

Be held upright

Children over 2 can sleep with a pillow and younger children can be held or kept upright in their car seat as this will make it easier for the ear to drain. Once they relax, allow them to sleep in their crib.

Take a dropper or tuck a cotton ball

If your child does not have discharge coming from their ear, take a dropper and place 2-3 drops of olive or sesame oil at room temperature into the ear to help release fluid. If your child has pus coming from their ear, tuck a cotton ball into the external ear to absorb it.


Swallowing can release pressure on the inner ear by encouraging drainage. Give your child plenty of fluids or give older children a piece of sugarless gum that will help to naturally promote swallowing.

2. Treatments of a Doctor

  • Antibiotics
  • Insert tympanostomy tubes


What Should I Expect If I Or My Child Has An Ear Infection

Ear infections are common in children. Adults can get them too. Most ear infections are not serious. Your healthcare provider will recommend over-the-counter medications to relieve pain and fever. Pain relief may begin as soon as a few hours after taking the drug.

Your healthcare provider may wait a few days before prescribing an antibiotic. Many infections go away on their own without the need for antibiotics. If you or your child receives an antibiotic, you should start to see improvement within two to three days.

If you or your child has ongoing or frequent infections, or if fluid remains in the middle ear and puts hearing at risk, ear tubes may be surgically implanted in the eardrum to keep fluid draining from the eustachian tube as it normally should.

Never hesitate to contact your healthcare provider if you have any concerns or questions.

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How Do Ear Infections Happen

A middle ear infection usually happens because of swelling in one or both of the eustachian tubes . The tubes let mucus drain from the middle ear into the throat.

A cold, throat infection, acid reflux, or allergies can make the eustachian tubes swell. This blocks the mucus from draining. Then, or grow in the mucus and make pus, which builds up in the middle ear.

When doctors refer to an ear infection, they usually mean otitis media rather than swimmer’s ear . Otitis media with effusion is when noninfected fluid builds up in the ear. It might not cause symptoms, but in some kids, the fluid creates a sensation of ear fullness or “popping.”

Causes And Symptoms Of Ear Infections

Why Does My Child Get Recurring Ear Infections?

Ear infections are the most common ailment among babies and young children. Seventy-five percent of children will have at least one ear infection before their third birthday.

There are two common types of middle ear infections:

  • Acute otitis media is an infection caused by bacteria that travel from fluid trapped in the eustachian tube to the middle ear. The resulting inflammation causes the throat to swell and pressure to build behind the eardrum. Symptoms include fever, pain, nasal congestion, and cough. If the infection is severe, it can cause the eardrum to rupture and fluid to leak from the ear canal.
  • Otitis media with effusion does not present obvious signs of infection but refers to fluid that accumulates in the middle ear. Some children may experience feeling their ears are plugged up but dont notice other symptoms.
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    Tests For Middle Ear Infection

    The GP will look carefully at the inside of your childs ear using an instrument called an otoscope.

    The GP might also do a tympanometry. This test measures how much your childs eardrum can move, and it can help the GP work out whether the ear is normal. Its usually a painless test that takes just a couple of minutes.

    If your child has had several ear infections, or if your doctor thinks there might be a chronic infection or glue ear, the doctor might organise a hearing test. Your child can have a formal hearing test at any age.

    What Causes Ear Infections In Babies

    Ear infections, medically known as acute otitis media, are infections of the middle part of the ear. They are caused by either a viral infection or a bacterial infection. These infections cause fluid to build up in the middle ear, as well as inflammation. In some cases, the eustachian tubes show signs of infection as well.

    Adults can get ear infections, too, but babies and young children are most prone to them, especially children under the age of three. Five out of six children will have had an ear infection by the time they turn three,and 25% of children will experience repeat ear infections.

    The reason babies and young children are more prone to ear infections include:

    • Babies ear passages are different than adults: they are shorter, narrower, and more horizontal in orientation
    • Babies are more likely to get colds and other viruses, which make them more prone to ear infections
    • Babies immune systems are less developed than adults, so their reactions to virus are usually more intenseleading to complications such as ear infections

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