Symptoms and Prevention of an Ear Infection

Learn how to prevent a child’s everyday cold from turning into a more serious illness, and how to recognize symptoms of an ear infection.

If you’re a parent, prepare your stockpile of tissues, decongestants, and non-aspirin pain relievers. Your child will probably get a cold this year. Scratch that. Your child will probably catch several colds. Kids under age 6 get up to eight of these respiratory infections a year. Most colds are harmless, but in about one out of every five kids they develop into an ear infection, which is a bigger worry.

When viruses populate the nose and mouth during a cold, they can sometimes attract bacteria to the area. Once bacteria start multiplying, they can spread into the middle ear, causing mucus and other fluid to build up behind the eardrum, leading to an ear infection. A single ear infection caused by a cold or other upper respiratory infection is called “acute otitis media.”

Kids are more vulnerable to ear infections than adults because their eustachian tube, which drains fluid out of the ears, is shorter. Some kids develop one ear infection after another, or “chronic otitis media.”

Symptoms of ear infection

Symptoms of an ear infection may look like other health problems; your child's doctor can tell very quickly if her cold has turned into an ear infection and provide the proper treatment.

While symptoms can be different in any child, they generally include:

• Ear pain
• The child tugging or pulling at the ear
• Fussiness, irritability, crankiness
• Difficulty sleeping
• Fever
• Fluid draining from the child's ear
• Difficulty hearing

The problem with ear infections

Ear infections not only cause discomfort and keep kids out of school. They also contribute to the growing issue of antibiotic resistance. The number one reason pediatricians prescribe antibiotics is for ear infections. When these drugs are overused or not taken appropriately, they can spur the development of drug-resistant “superbugs” that are almost impossible to treat.

Repeated ear infections also lead to more serious complications. They can damage children’s hearing, sometimes permanently, and cause speech or developmental delays. Rarely, an ear infection will spread to nearby tissues, or even to the brain.

Preventing ear infections

“Because we now know that the common cold is the precursor to an ear infection, it is important for parents to make extra efforts to prevent their children from catching colds,” said Tasnee Chonmaitree, MD, a pediatric infectious disease specialist at the University of Texas Medical Branch at Galveston.

Easier said than done in kids, whose questionable cleanliness habits and multiple social interactions make them highly efficient germ spreaders. Chonmaitree recommends keeping kids away from anyone who is sick, and avoiding day care. Kids in day care do tend to get more colds — and therefore more ear infections — than children cared for at home, simply because they’re exposed to more germs. However, once they reach elementary school they catch fewer colds than their peers, possibly because that earlier exposure helps them build an immune defense against the virus. It’s not realistic for every parent to avoid putting their child in day care, but Chonmaitree recommends choosing a smaller facility where the germ population is more limited.

Another effective way to avoid colds is to wash your child’s hands with warm water and soap or use an alcohol-based sanitizer throughout the day to clean off any germs that do collect. Using antibacterial soap is essentially useless. And, make sure your child is up-to-date on any recommended vaccinations. Immunizations can prevent illnesses like the flu, which also cause ear infections.

Finally, never smoke around your children. In addition to increasing your child’s risk for asthma, bronchitis, and pneumonia, secondhand smoke can contribute to ear infections.

For children who do develop an ear infection, guidelines from the American Academy of Pediatrics recommend greater discretion in antibiotic prescribing. Many kids who don’t have a fever or severe symptoms may be able to hold off on antibiotics, and instead have their doctor monitor them to make sure the infection is improving.