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Ear infections are a common health concern for children. Most children have had an ear infection by 3 years of age. There are three types of ear infections:
- inner ear infection, or labyrinthitis
- middle ear infection, or otitis media
- outer ear infection, also called swimmer's ear or otitis externa
Inner ear infections
If your child has vertigo, such as a whirling or spinning feeling, he or she may have an inner ear infection. To learn more about inner ear infections, see the Labyrinthitis topic.
Middle ear infections
Middle ear infections are the most common type of ear infection in children. They occur when germs get trapped in the middle ear inside the eardrum, often after a cold. For more information, see Ear Infections and a picture of the middle ear.
Children are more prone to middle ear infections because the tubes that normally drain fluid from the middle ear are smaller and more likely to become blocked, trapping fluid and germs in the middle ear.
How do you know if your child has a middle ear infection? Symptoms can include:
- earache (your child may tug or pull at the ears)
- fluid draining from the ears or loss of balance (less common)
- trouble hearing quiet sounds
- fussiness
- difficulty sleeping
Depending on your child's age and the amount of discomfort your child feels, your doctor may also recommend treating the infection with antibiotics right away or waiting for a few days before prescribing antibiotics. If your child needs antibiotics, it is very important to follow the doctor's instructions exactly. To learn more about antibiotic treatment, see Antibiotics for Middle Ear Infection. Your doctor may also recommend medications to help relieve the ear pain, such as acetaminophen or ibuprofen.
If your child has frequent ear infections or still has fluid stuck in the ear months after the infection, causing hearing loss and speech and language delay, your child may need to have ear tubes inserted to drain the fluid. Find more information on this in Tubes for Ear Infections.
The following precautions will help reduce the risk of middle ear infections:
- Protect your child from second-hand smoke.
- Do not let your child go to sleep sucking on a bottle.
- Do not use a pacifier (soother) very frequently.
- Consider having your child vaccinated against pneumococcus, a bacteria that often causes ear infections.
- Encourage your child to wash his or her hands frequently to avoid infections such as colds, as middle ear infections often develop after a cold.
Outer ear infections (swimmer's ear)
Outer ear infection or swimmer's ear, also called otitis externa, occurs when the ear canal becomes infected by bacteria, fungus, or yeast. This type of infection occurs if the ear canal gets irritated by water, sand, or rough ear cleaning. For more information, see Swimmer's Ear and a picture of the ear canal.
How can you tell if your child has swimmer's ear? Symptoms can include:
- ear pain that gets worse when the child chews or touches her earlobe
- itching or fullness in the ear
- yellowish or brownish discharge
- red or swollen outer ear, especially if the infection is severe
Swimmer's ear is usually treated by giving medicated ear drops and keeping water out of the ears until the infection gets better. Your doctor may also recommend medications for the pain, such as acetaminophen or ibuprofen.
The following precautions will help protect your child from swimmer's ear:
- Do not let your child swim in dirty or polluted water.
- Do not use fingers, sharp objects, or cotton swabs to clean your child's ears.
- Avoid getting soap, shampoo, or other bath products into your child's ears.
- Keep your child's ears dry. Ask your child to shake his or her head gently after showering or swimming, and use a hair dryer on a low setting held several inches away to dry the ears.
How to help your child
Ear infections can be an unpleasant experience for your child. Here are a few tips to help your child cope and feel better:
- Make sure your child gets plenty of rest.
- Help keep things quiet for your child - avoid noisy play activities.
- Use a warm face cloth or heating pad to gently apply heat to the ear - but only for older children, and do not apply overnight.
- Use medications, such as medicated ear drops or antibiotics taken by mouth, exactly as recommended by your child's doctor.
- If your child is in pain, you may offer a pain reliever such as acetaminophen or ibuprofen (do not use ASA, also called Aspirin or acetylsalicylic acid). This is especially useful before they go to bed. Be sure not to exceed the recommended children's dose on the package.
- If your child gets ear infections often and you plan to travel by plane, consult with your doctor on managing symptoms. Children prone to ear infections may have symptoms exacerbated by air travel due to changes in air pressure.
When should I call the doctor?
Call your doctor if your child is taking antibiotics for an ear infection and:
- has an earache after 2 to 3 days of treatment,
- has an armpit temperature over 39°C (102°F) or a fever lasting more than 3 days,
- is very sleepy,
- is fussy or cranky,
- has trouble breathing or breathing quickly, and
- is not hearing well.
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