A middle ear infection (otitis media) is an infection behind the eardrum. It is very common in young children, often after a cold. It causes ear pain and fever and usually gets better within 3 days, often without antibiotics. Repeated or untreated infections can lead to a discharging ear, hearing loss and, rarely, a serious infection spreading to the bone behind the ear.
Symptoms
Ear pain — young children may pull or rub the ear
Fever
Crying, irritability and poor sleep
Not feeding well
Difficulty hearing
Fluid or pus coming out of the ear (if the eardrum bursts — the pain often eases after this)
Causes
Germs from a cold or throat infection travel up the tube between the throat and the ear
Young children have shorter, flatter ear tubes, so infections are more common
Smoke in the home (cigarettes, wood or other cooking fires)
Bottle-feeding while the baby lies flat
Enlarged adenoids
Prevention
Breastfeed for at least the first 6 months
Keep the child away from cigarette smoke and indoor smoke
Do not bottle-feed a baby who is lying flat
Talk to a doctor
Get advice by video, voice or chat without leaving home.
Vaccinate on time, including the pneumococcal (PCV) vaccine
Wash hands to reduce colds
Treatment
Paracetamol or ibuprofen in the right dose for age and weight, for pain and fever
Many infections get better within 2 to 3 days without antibiotics
Antibiotics (often amoxicillin) if the child is under 2 with both ears infected, has pus from the ear, or is not improving — prescribed by a doctor
For a discharging ear: gently dry the ear with clean cotton wicks; do not put oil, herbs or anything else in the ear
A hearing check if infections keep coming back
Do not give antibiotics without a doctor
Common questions
Does my child always need antibiotics for an ear infection?
No. Many ear infections are caused by viruses or clear up on their own in 2 to 3 days. Pain relief is the main treatment; a doctor will decide if antibiotics are needed.
Can I put oil or drops in the ear?
Do not put oil, garlic, herbs or any drops in the ear unless a doctor prescribes them. If the eardrum is torn, these can cause more infection and damage hearing.
